Category Archives: National

Fear of lawsuits, little time with patients lead to more aggressive care

Nearly half of primary care physicians say patients receive too much medical care. In a study of 627 such physicians, 42% said patients in their practice get too much treatment, and 6% said patients receive too little care. Fifty-two percent of doctors said the amount of care was just right, according to the study published Sept. 26 in Archives of Internal Medicine. Three in four doctors listed medical liability concerns as the primary reason they practice more aggressive medicine. Forty-percent said inadequate time with patients is a factor in practicing more aggressively. About one in four physicians practices medicine more aggressively by ordering more tests and making more referrals than they would like to do. The results are not surprising, said internist Calvin Chou, MD, a professor in the Dept. of Medicine at the University of California, San Francisco, Veterans Affairs Medical Center. He wrote an editorial that accompanied the study. “I run into problems myself when a patient is very demanding of a particular test that I don’t think is particularly warranted,” Dr. Chou said. “I think I’m pretty good at discussing it with them, but I know that I’m not perfect. There are times when it’s easier to…

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Lobby Battle Over Loans for Lawsuits

WASHINGTON — Companies that advance money to plaintiffs involved in personal injury lawsuits are campaigning in state capitals for legislation making clear that their growing industry is not subject to usury limits on interest rates or other state laws that protect borrowers. Instead, the lawsuit lending companies want to adopt a separate and less rigorous set of protections. Since February, they have persuaded legislators in at least five states, including New York, to introduce bills based on the industry’s own proposals. The campaign is drawing strong opposition from chambers of commerce, insurance companies and others who worry that lawsuit loans encourage litigation by emboldening plaintiffs. These critics also argue that the bills would strip protections from borrowers. “They are coming in under the guise of accepting regulation when in fact what they are trying to do is to legalize lawsuit lending and to explicitly exempt themselves for consumer lending requirements,” said Lisa A. Rickard, president of the Institute for Legal Reform, an arm of the United States Chamber of Commerce. These clashes reflect both the uncertain legal status of lawsuit lending and the growing debate over its social value: Should third-party investment in lawsuits be encouraged, tightly restricted or banned…

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Obama, GOP should avoid a standoff on malpractice reform

PRESIDENT OBAMA announced in his State of the Union speech that he would deal with Republicans on one of their pet issues, reform of medical malpractice. But nothing is likely to get done because congressional Democrats oppose the GOP’s trademark solution to high liability costs — a federal law capping damages that malpractice victims can receive. They are right that a cap is too arbitrary, limiting awards even for the most egregious mistakes. But the debate shouldn’t end there. Both parties should find common ground on innovative approaches that not only reduce jury awards but also help doctors and hospitals correct underlying problems. Those approaches — now being tested in more than 20 locations — start with the recognition that the current system has several flaws. The most obvious is that the threat of frivolous lawsuits drives up doctors’ insurance costs, which get passed on to patients. Fear of suits also causes doctors to practice “defensive medicine,’’ ordering unnecessary tests just to prove that they covered all the bases. Meanwhile, the current system fails to provide any relief to many patients who suffer from medical mistakes but are never informed of them or cannot find lawyers to represent them. Finally,…

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Study: Doctors order tests out of fear of lawsuits

SAN DIEGO (AP) — CT scans, MRIs and other pricey imaging tests are often more for the doctor’s benefit than the patient’s, new research confirms. Roughly one-fifth of tests that bone and joint specialists order are because a doctor fears being sued, not because the patient needs them, a first-of-its-kind study in Pennsylvania suggests. The study comes a day after President Barack Obama began a push to overhaul state medical malpractice laws as a way to reduce unnecessary tests that drive up health care costs. “This study is a glimpse behind the curtain of what’s happening in a doctor’s mind,” said its leader, Dr. John Flynn of Children’s Hospital of Philadelphia. If doctors sense you might second-guess them or cause trouble, “you could potentially be risking more tests being done.” Results were reported Wednesday at an American Academy of Orthopedic Surgeons conference in California. Patients expect the highest level of care and think this means the most advanced technology, Flynn said. Many patients feel better when a doctor orders lots of tests — until they get the bill. Besides hurting your wallet and adding to health care costs, unnecessary tests can expose people to radiation that accumulates over a lifetime…

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Medical liability: Lawsuit chances take a toll

Our actions are influenced even when the odds are in our favor. So we save receipts (tax audit risk, 1 in 100), change the smoke detector battery (fire-related fatality odds, 1 in 1,235), and think twice about standing in the rain (chance of being struck by lightning, 1 in 6,250). When it comes to the chances physicians face in terms of being sued, a new AMA report shows they can expect a lawsuit not as matter of possibility, but of probability. More than half — almost 61% — of physicians older than 55 report having been sued. The behaviors that result from those odds should come as no surprise — such as defensive medicine and practice decisions to shield the doctor from risk. And those actions can significantly affect the cost of care and patient access. The AMA found that overall, 42.2% of the 5,825 surveyed physicians had been sued, with nearly a quarter of them hit with lawsuits twice or more. Obstetrician-gynecologists were among the most likely to be sued, and the measures they have taken as a result are predictable. In a 2009 survey, nearly a third of ob-gyns reported cutting back on high-risk obstetric patients, one of…

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Litigation Fears Impact Physician Work Hours

A new study published in the Journal of Law and Economics (2009;54:635-663) has revealed that physicians work fewer hours when their risk of litigation increases. Researchers Eric Helland, of Claremont McKenna College in Claremont, Calif., and Mark H. Showalter, of Brigham Young University in Provo, Utah, found that physicians work an average of 1.7 hours less per week when their expected medical liability risk rises by just 10%. The researchers calculated that a reduction of 1.7 hours per week is the same as “one in 35 physicians leaving a workforce entirely, or about 21,000 physicians.” The study was conducted using data about medical liability risk in each state gathered from insurers. Data was broken down by specialty, and physicians were surveyed about workload and income. The study also found that older physicians (aged 55 years and older), and those with their own practice were more likely to be affected by increased liability risk. Just as the increase in medical liability risk resulted in decreased physician hours, the opposite was true as well. Results indicated that when liability risk decreased, for example when tort reforms such as caps on damages were enacted, physicians saw more patients per week.

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