Category Archives: News

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decisions and reputations — leaving less time for patients — only for the lawsuits to be dropped, dismissed or withdrawn for lack of merit.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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Iowa Senate Advances Bill To Discourage Med Mal Suits

The Iowa Senate on Monday approved a tort reform bill that would cap noneconomic damages in medical malpractice cases at $250,000 and require injured patients to obtain a “certificate of merit” from a medical expert before filing suit. S.F. 465 passed the Iowa Legislature’s upper house in a 28-21 vote that was split along party lines, with 28 Republicans voting to approve the proposed legislation and 20 Democrats and one independent senator voting no. If approved, the bill would impose a $250,000 cap on noneconomic damages such as pain and suffering, similar to a federal bill recently floated by Republicans in Congress. In addition, the bill would require medical malpractice plaintiffs to file a certificate of merit — essentially an expert opinion vouching for the validity of the claims — which is designed to weed out and discourage frivolous lawsuits. The bill would also make certain statements made by doctors to patients regarding adverse medical incidents inadmissible in court, and would tighten the requirements as to who can qualify as an expert medical witness. During floor debate on Monday, a Republican proponent of the bill, state Sen. Charles Schneider of West Des Moines, said that the proposed legislation would help…

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Bill to change medical professional liabilities law passes state Senate

A bill that would change current state medical professional liabilities law has passed the state Senate. Senate Bill 338 would requires lawsuits against long-term care providers to be brought in the county in which the facility is located. Senate Judiciary Chairman Charles Trump, R-Morgan, is the sponsor of the bill. It has been sent to the House of Delegates Judiciary Committee. “Currently, most of the cases are brought in Kanawha County because corporate headquarters are in Charleston or because a company has a facility in Kanawha County,” said Patrick Kelly, CEO of the West Virginia Health Care Association. “If the bill passes, the people who know the facility best, local citizens, will hear the cases. “What’s happening now is that some of the facilities have a corporate office in Charleston, so if you have a case in the Northern or Eastern Panhandle, those folks have to leave their facility to come to Kanawha County. You can’t take an administrator or nurses out of the building for a long period of time.” The bill also would define occurrence as “any and all injuries to a patient arising from health care rendered by a healthcare facility or a healthcare provider and includes…

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Lawmakers seek to cap damages in medical malpractice cases

Doctors who worry about medical malpractice lawsuits would get major relief under legislation that was approved by a House committee Tuesday and that would make it harder for patients to come after their money. The legislation, approved by the House Judiciary Committee in an 18-17 vote, would cap damages that can be paid by doctors, hospitals, and nursing homes. (Many states already limit awards paid by individual providers.) It would cover individuals who are insured under Medicare, Medicaid, veterans or military health plans, and the Affordable Care Act, and could also impact people covered under COBRA or health savings plans. In introducing the measure, Iowa Republican Representative Steve King referred to airlines, which, he said, “throw blame out the window” after an accident, and instead focus on how to prevent it from happening again. His comment enraged several Democrats, who accused King of favoring the economic interests of health care providers over malpractice victims — and of showing a lack of basic knowledge about law. “We cast blame,” said Florida Democratic Representative Ted Deutch. “That’s how the justice system works.” Lobbyists for medical professionals were delighted with the legislation. “Instead of being able to focus on their patients, more and more doctors…

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GOP Again Proposes Malpractice Tort Reform, With a Twist

Over the past 20 years, House Republicans repeatedly have passed malpractice tort reform that caps non-economic damages at $250,000, only to be stymied by Senate Democrats who view such measures as an intrusion on a plaintiff’s right to his or her day in court. Today, the Republican-controlled House Judiciary Committee narrowly approved another such medical liability bill, but one with a twist. The reforms would apply to malpractice suits in which the plaintiff received healthcare covered through a federal program, subsidy, or tax benefit. In other words, healthcare provided under Medicare, Medicaid, or private health plans subsidized by the Affordable Care Act. For that matter, the bill also would govern litigation involving services paid for by employer-sponsored health plans, because premiums enjoy federal tax exemption. Bill supporters contend that if the federal government is shelling out billions of dollars for healthcare, Congress should ensure that it’s getting the most bang for the taxpayer buck. The cap on non-economic, or pain and suffering, damages as well as other reforms in the bill, the argument goes, will deter frivolous malpractice suits, relieve physicians of the pressure to practice defensive medicine, lower malpractice insurance premiums, and increase access to healthcare. Bill supporters point…

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Scope of practice should set limits on medical liability testimony

Which medical professionals are qualified to provide medical causation testimony before a court? In Frausto v. Yakima HMA, the Supreme Court of Washington will determine whether an advanced registered nurse practitioner (ARNP) is qualified to testify as to the causation of a patient’s medical condition. Rudy Frausto, a quadriplegic, presented to Yakima Regional Medical Center with symptoms of general body weakness, influenza and pneumonia. He was treated for 10 days and, during that time, developed decubitus ulcers. Frausto sued the hospital for medical malpractice. To support his claim, Frausto offered an affidavit from Karen Wilkinson, an ARNP. Wilkinson’s affidavit stated that the hospital had failed to provide Frausto with proper bedding, skin assessments and other care and had thus caused the bed sores. A trial court noted that Wilkinson had practiced as a licensed nurse for more than 26 years, had taught other nurses and had extensive experience as a staff nurse. The court held that she was qualified to testify as to the standard of care. But the court also held that Wilkinson, as a nurse, was unqualified to testify about medical causation. Frausto appealed to the Supreme Court of Washington. “The ability to testify accurately regarding causation is…

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Tort Reform Introduced in Iowa Legislature

On Monday, both the House and Senate Judiciary Committees introduced bills on tort reform HSB 105  and SSB 1087  This IMS-crafted tort reform package represents the most comprehensive reforms to Iowa’s medical liability system in more than a generation and marks the culmination of years of work by numerous physician leaders throughout our state. Watch for updates in the IMS Advocate. The bill would enact the following: $250,000 Cap on Noneconomic Damages Strengthened Expert Witness Standards Certificate of Merit in All Suits Affirmative Defense for Evidence-Based Medicine Limiting Contingency Fee Arrangements Expanding Candor A Brief History of Tort Reform in Iowa In 2004, IMS championed the passage of a $250,000 cap on non-economic damages, which was ultimately vetoed by then-Governor Vilsack. In the wake of this setback, IMS redoubled its efforts, devoting significant time and resources into developing additional reform proposals to help improve our liability climate. In 2011, IMS-crafted Certificate of Merit legislation passed the Iowa House but failed to pass the Democratically-controlled Iowa Senate. 2013 also saw significant House action on an IMS-crafted tort reform package that included a $250,000 cap on noneconomic damages and a Certificate of Merit requirement. After the legislature again failed to enact meaningful reforms that…

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Judd Gregg: Five easy pieces

Big agendas and bigger issues are being talked about by the new president and the Republican Congress. This is a good thing. This new government should aim to act boldly and quickly. For conservatives, there are also smaller but significant issues — points of unfinished business, some dating back as far as President Reagan — that should be completed. Here are five, all of which are doable. First, repeal Davis-Bacon. This law, which was enacted in 1931 and purports to ensure that workers on public projects are paid the prevailing local wage, was in fact a pay-off to Big Labor for its support of the Democratic Party. It costs taxpayers dearly. By inflating labor costs, Davis-Bacon inflates overall construction costs for the federal government. If the Trump administration and Congress are going to do an infrastructure bill to push the economy forward, repealing Davis-Bacon would increase its impact. Repeal would also make the point that taxpayers should not be footing the bill to pay off special interests such as trade unions. Repeal of Davis-Bacon could be included in a reconciliation bill. Second, pass medical malpractice tort reform. Just as President Trump and Congress look to replace ObamaCare by delivering better care at…

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