New York’s medical malpractice system needs comprehensive reforms. The writers note that many states allow patients to file suit based on when they discover that there was a medical error, but, unlike New York, most of those states also have caps on damages and other laws that balance the effects of wider discovery rules. Pegging New York’s statute of limitations to a patient’s subjective knowledge will potentially lead to far more claims and greater financial exposure for the state’s doctors and hospitals.
Despite scoring high on various quality indicators, New York’s hospitals and doctors have among the highest medical malpractice costs in the United States. Many doctors logically conclude that the state is simply too hostile an environment to practice medicine.
Finally, the same study that the writers cite to blame hospitals and doctors (“To Err Is Human”) emphasizes that improving patient safety requires a shift away from a culture of blame. Other studies have concluded that the drivers of malpractice liability are varied and not necessarily related to the quality of care.
Medical malpractice is a complex issue that deserves thoughtful discourse. Only through comprehensive reform — not narrow, piecemeal legislation — can we achieve appropriate balance and minimize inequities.
KENNETH E. RASKE
JOSEPH R. MALDONADO Jr.
New York
The writers are presidents of the Greater New York Hospital Association and Medical Society of the State of New York, respectively.
To the Editor:
“Legislative Malpractice” leaves the impression that there are few medical malpractice lawsuits and that those few are meritorious and result in awards that “are generally modest.” My experience as a lawyer defending doctors for over 30 years is quite the opposite.
The potential amounts that a jury can award are often way above the $1.3 million in insurance coverage that most doctors carry. Thus the doctor who is a defendant in such a lawsuit is confronted with the decision of whether to go to trial and defend what may be quite good medicine and thus risk his own personal assets, or decide to settle.
Doctors study medicine for years. Now comes a lawsuit and a jury of lay people often without college or postcollege degrees (and almost certainly no medical school) tasked to determine what the proper treatment should have been. But the jury is not allowed to do any research. Medical articles are not allowed into evidence. I have had jurors tell me after their verdicts that the medical issues were just too complex for them.
It is this jury that must decide whether the doctor rendered proper medical treatment even though the patient died, was rendered paralyzed or suffered a permanent brain injury at birth. You don’t need a college degree to see who has the sympathy factor on their side.
In such circumstances virtually all doctors decide to settle. That is the system of medical malpractice in New York State.
BARRY M. VIUKER
New York
To the Editor:
While Thomas Moore and Steve Cohen are correct to point out that only 1 percent of patients who are harmed in the course of medical care file a malpractice suit, they fail to point out that more than 60 percent of the suits that are filed are ultimately abandoned, and that 75 percent of cases that go to trial result in judgments for the doctor or hospital.
These facts demonstrate that our current malpractice system is highly inefficient, neither protecting patients from bad doctors nor protecting doctors from specious lawsuits, the defenses of which cost our health care system hundreds of millions of dollars each year.
The main beneficiaries of the current system are the attorneys for both sides who collect all those fees. Given that reality, it is unlikely we will see meaningful reform to our medical malpractice system any time soon.
RON L. ALTERMAN
Boston