Archives: August 2019

August 2019 Newsletter

Liability reforms must be more than skin deep An analysis by University of Virginia (UVA) researchers on the prevalence of unnecessary medical tests highlighted the effect on health care costs and patient anxiety, leading a retired neurologist to reflect on how reforms must go beyond the superficial. The initiative followed a report by UVA researchers Andrew Parsons, a hospitalist and an assistant professor of medicine, and Joe Wiencek, a pathologist and an assistant professor of pathology, which found that diagnostic care that offered little value to patients is estimated to cost our health care system $800 billion annually. By offering technical solutions, such as a screen alert when a doctor orders a certain test and a weekly email that analyzes the amount of tests a doctor orders as compared with their peers, they seek to drive down unnecessary costs. Retired Virginia neurologist Dr. Justiniano F. Campa urged policymakers and patients to consider the root cause – a physician’s fear of being faced with a lawsuit. “I have to point out that the main reason for those tests lies in doctors’ fear of being sued, an event that can stop and destroy a hard-earned reputation and career,” Campa writes. While he…

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Opinion/Letter: Unnecessary tests need deep reform

SOURCE: The Daily Progress The July 28 issue of The Daily Progress relates the initiative from two young members of the University of Virginia faculty, Dr. Joseph Wiencek and Dr. Andrew Parsons, about reducing unnecessary medical tests. As a retired neurologist from 40 years of clinical practice, I have to point out that the main reason for those tests lies in doctors’ fear of being sued, an event that can stop and destroy a hard-earned reputation and career. One of my UVa mentors told us, “If you practice long enough, you will be sued.” This fear might lead doctors to: 1) order more tests, 2) refer patients to more expensive tertiary care hospitals and 3) contribute to the current flight to become hospital employees, where ordering more tests is easy and expected, instead of remaining in independent practice. Add these three contingencies, and guess what is the additional cost to our health care? A figure for this cost is not readily available and seldom mentioned, truly a political taboo. Yet I and my contemporary colleagues estimate it at 20% to 25%. When one compares this malpractice cost in the U.S. to the likely 3% in the European countries, it is…

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Woman Who Never Saw Doctor Claims Mistreatment; More

SOURCE: Medspace In a decision that critics charge could lead to an uptick in certain types of medical malpractice lawsuits, the Connecticut Supreme Court ruled last month that doctors owe a duty of care to some third-party non-patients, according to a July 12 report in the Hartford Courant.[1] The decision turns on a case that pitted an anonymous woman against a Norwalk internist. In 2013, the woman and her boyfriend, whose name was also withheld in the suit, began a relationship. Before they became physically intimate, however, both agreed to be tested for sexually transmitted diseases. The woman turned out to be disease free. But the man, tested under the internist’s supervision, was found to be infected with the herpes simplex virus. Soon afterward, an employee of the medical practice, tasked by the doctor to communicate this result, mistakenly reported a negative rather than a positive outcome. After the couple’s relationship became sexual, the woman, in time, experienced herpes outbreaks. This led her partner to follow up with the internist, who apologized after learning of his employee’s error. The woman then sued the internist. At trial, the defense moved to have her negligence suit dismissed, arguing that it was actually…

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Utah Supreme Court strikes down law requiring agency pre-approval of medical malpractice claims

SOURCE: The Jurist Utah’s Supreme Court has unanimously struck down a state law requiring medical malpractice plaintiffs to obtain a “certificate of compliance” from a state agency. The court ruled that the law, known as the Malpractice Act, was unconstitutional as it violates the separation of powers doctrine by limiting the role of the judiciary. In Utah, a certificate of compliance is issued once Utah’s Division of Occupational and Professional Licensing (DOPL) reviews a malpractice claim and determines it has merit. If the claim is rejected by the DOPL, plaintiffs can still receive the certificate upon attestation of their claims by an expert. In the case, a patient’s widow, Yolanda Vega, accused health care providers of causing the death of her husband, who died a week after surgery. Vega sought a certificate of compliance from the DOPL but was denied and filed suit. The trial court dismissed the case for failing to comply with the Malpractice Act, and Vega subsequently appealed. The Utah Supreme Court reversed and remanded the case, agreeing with Vega that the Malpractice Act was facially unconstitutional. Specifically, the court cited to the separation of powers doctrine, where the roles of executive branch (the DOPL) must not…

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UVa researchers lead effort to reduce unnecessary medical tests

SOURCE: The Daily Progress Unnecessary medical tests can add to a patient’s costs, discomfort and anxiety as more and more tests cascade in an effort to chase the cause of a symptom. A doctor may order those tests out of a worthy desire to take care of a patient, according to University of Virginia researchers, but when the tests are not needed, they don’t add much value. Instead, according to Dr. Andrew Parsons, a hospitalist and an assistant professor of medicine, and Joe Wiencek, a pathologist and an assistant professor of pathology, hospitals and medical schools can do a better job educating doctors and patients about what tests are supposed to do and when they’re effective — and when to avoid them. The two have teamed up as part of a UVa effort to examine levels of testing and try out various methods to ensure that only useful tests are ordered. “Even in the beginning of medical school, they instill a culture that you should be quite thorough,” Parsons said. “And that makes sense, but we’re trying to switch that culture from thoroughness to appropriateness.” In a June report for the journal Clinical Lab Manager, the two researchers wrote that…

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