Archives: April 2017

April 2017 Newsletter

  Medical liability reform – an issue of Price With Tom Price at the helm of the Department of Health and Human Services, and Congress likely to make systematic health care changes, chances for medical liability reform are stronger than ever.  So say several experts in the field. Writing in the New England Journal of Medicine, noted medical liability system scholars Michelle M. Mello, J.D., Ph.D., Allen Kachalia, M.D., J.D., and David M. Studdert, LL.B., Sc.D convey their opinions on the opportunities that lie ahead for proponents of medical liability reform with Secretary Price as an advocate. Citing medical liability in his confirmation hearings, as “a really difficult challenge,” Secretary Price has long been a champion of reforms that reduce medical lawsuit abuse. Acknowledging that “the liability system has well-documented problems, and its reform was omitted from the Affordable Care Act,” the authors support a way forward in the near term. While the current liability system is no longer at the precipice of crisis, Mello, Kachalia, and Studdert agree that “a period of calm in liability insurance markets is the best time to proceed with sensible reform.” The deck is stacked in support of reasonable limits on non-economic damages, with…

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The Tort Bar’s Senate Undertaker

It’s good to be a Senator, especially if you are a Republican who is the most important opponent of tort reform on Capitol Hill. Witness the largesse that the plaintiffs bar is bestowing on South Carolina’s Lindsey Graham in its moment of maximum political peril. On Thursday Mr. Graham was feted in Houston at a fundraiser hosted by Mark Lanier, who can afford it. The Lanier Law Firm has vacuumed up some $13 billion in tort verdicts over the years from Vioxx to asbestos. The invitation asks Mr. Lanier’s tort comrades to share their wealth to the tune of $500 to $5,400 for “Team Graham.” “Our goal is to show Senator Graham an appreciation from both sides of the bar for what he can help do, especially with tort reform running rampant from the house,” Mr. Lanier added in an email. “It will take Senator Graham to help educate folks and lead the charge from the Republican side.” Mr. Graham has every right to take campaign cash from all comers, and in this case he is a true believer. He’s long fought tort reform, and his legal friends have rewarded him with some $3.7 million over his 24-year Senate career….

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Pushing Back on Medical Liability Misconceptions – NYT Letter to the Editor

To the Editor Re G.O.P. Bill Would Make Medical Malpractice Suits Harder to Win (April 15): In 40 years of practicing medicine, I’ve witnessed a change in physician culture. Physicians no longer rely on clinical judgement based on training, experience and the best available evidence. The fear of lawsuits drives providers to adapt behaviors that lead to increased health-care costs. More than 90% of physicians engage in defensive medicine by practicing assurance behavior; ordering tests, particularly imaging tests, performing diagnostic procedures and referring patients for consultation. These behaviors have become standard of care. Patients also become educated through the internet and media to this new standard and change their expectations of their care perpetuating this expensive cycle. The current” patchwork quilt” medical liability system neither effectively compensates persons injured from medical negligence nor encourages the addressing system errors to improve patient safety. The Protecting Access to Care Act pending in Congress would address these inefficiencies. Most importantly, passing these sensible reforms represents a critical first step in restoring the appropriate practice of medicine where physicians make decisions based only on the patients well being. Stuart L. Weinstein, MD Iowa City, Iowa

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A Doctor’s Place is in the Exam Room

An orthopaedic surgeon and a neurosurgeon walk into a room… Unfortunately, this is not the start of a joke. While we would prefer to be sharing best practices and treating patients in our exam rooms, the fact is we’re spending more time than we’d like in a courtroom. Because our medical liability system is broken, orthopaedic surgeons, neurosurgeons, OB-GYNs and other specialty physicians continue to find themselves on the receiving end of meritless lawsuits. As a pediatric orthopaedic surgeon practicing for more than 40 years in Iowa City, I’ve seen countless colleagues forced to defend their treatment decisions and reputations — leaving less time for patients — only for the lawsuits to be dropped, dismissed or withdrawn for lack of merit. Our medical liability system costs too much, takes too long, undermines the doctor-patient relationship and does not serve the needs of patients or physicians. Too often, the cost of defensive medicine — the tests and procedures above and beyond what is medically necessary to limit exposure to litigation — is tacked on to health care bills, leading to steep increases in costs year after year. When applied to 2015 health care spending, defensive medicine adds anywhere from $160 billion…

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Medical Liability – Prospect for Federal Reform

Medical malpractice reform appears to be back on the federal policy agenda. The appointment of Tom Price, a long-time proponent of tort reform, as secretary of health and human services, in conjunction with Republican control of both houses of Congress, has created fertile conditions for several Republican proposals that have languished for years without the requisite support. Although it has been debated many times, a major federal foray into medical liability, a state-based area of law, would be unprecedented. The prospect raises several questions: Which reforms are on the table? Would they be effective? And is the time right? Although Price has not announced any specific proposals since his nomination, “lawsuit abuse” has long been an important issue to him. During his confirmation hearings, he described medical liability as “a really difficult challenge” and noted that there were “some exciting opportunities out there.” While serving in the House of Representatives, Price (R-GA) sponsored several bills aimed at limiting health care providers’ liability, most recently H.R. 2300 in 2015. Key elements of these bills are represented in H.R. 277, introduced by other House Republicans on January 4, 2017; H.R. 1215, introduced on February 24, 2017, by Representative Steve King (R-IA); and…

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