MedSmarts

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Is Malpractice Reform a License to Kill?

Malpractice Reforms
That Enable Malpractice

Friday, October 20, 2017

Criminal Cases Medical Malpractice

Criminal Cases Medical Malpractice (Photo credit: baslow)

It appears that many malpractice-prone doctors flee to nearby states that enact laws that purport to “reform” medical malpractice by capping non-economic damages patients may receive.

That, at least, is the conclusion of a recent malpractice report in the Journal of Law and Economics.

This means doctors guilty of frequent malpractice injury to patients can simply move their dysfunctional shops to states that pass these so-called reforms -where they’re less likely to be sued for their medical incompetence.

And if they live close enough to the border with those states, they can do so without even moving their residences – free to continue harming patients they’re apparently not qualified to treat.

This reminded me of why I wrote Our Healthcare Sucks in the first place. The rampant and repeated failure of government – state governments in this case – and of the profession itself to protect patients from medical harm has left millions of Americans at increased risk of medical injury and treatment-induced death.

The author of this study estimates these purported malpractice reforms result in increased deaths in those states – due to its effect of importing actual malpractice – equal to a doubling of that state’s homicide rate.

You read that right – these ill-conceived and self-serving “malpractice reforms” are effectively licenses to kill. 

Protect Us From the Reformers

So here’s the take-home lesson: if you live in a state that’s passed “malpractice reforms” that cap non-economic damages to patients – and especially if you live near the border with another state – be careful of any doctors who set-up shop in your state after these laws were passed.

Far from serving the public interest, these laws appear instead to be an open invitation to the medically inept in nearby states to bring their ineptitude across state lines.

When special interests – in this case, medical societies – exert pressure on lawmakers, one person’s “malpractice reform” becomes another person’s actual malpractice.

In other words, intentional or not, state medical societies that pressure their weak-kneed, uninformed, and sometimes corrupt legislators to cap malpractice damages are effectively importing actual malpractice. This harms and even kills patients in their states – to the tune of doubling that state’s murder rate!

Now no one’s suggesting these merchants of death are the majority of physicians by any means. But there are far too many of them. And many more are guilty of lesser violations of patient trust and safety that have become the norm in many parts of America.

And further enabling the worst of them – essentially offering them a safe harbor to come practice their brand of incompetent medicine in your state – is enabling malpractice, not preventing it.

Why You Need to Manage Your Own Healthcare

If nothing else, this should inspire you to take charge of your and your family’s healthcare.

And if you’re naively clinging to hopes of Obamacare solving this crisis for you, think again.

I’ve written elsewhere about the glaring failure of Obamacare to address medical malpractice in a more effective manner than current patch-quilt measures (see “Obamacare Omissions May Prove Most Important“).

This latest evidence shows how truly dangerous are state laws that masquerade as malpractice reform but actually cause even more malpractice – and more patient deaths. 

Our Healthcare Sucks gives you a view of the “big picture” in American medicine – the structural flaws like medical malpractice that are already “baked in the cake” and that Obamacare barely touches. These include things like…

  • “Technology transfer” deals between academic medical centers and pharmaceutical and medical device companies;

  • Rampant medical errors that cause treatment-induced disease and premature death;

  • Incoherent medical prescribing practices;

  • Physician bias and impairment: and

  • Doctor-centered patient care practices that deprive patients of the coordinated, home-based support needed for chronic diseases that account for most of our medical spending.

Proactive Patient-ing

These system failures leave us with no real choice but to become more proactive consumers of medical care by applying a more skeptical mindset to our medical decisions.

And the added pressure on physician time with patients that another 20+ million Americans accessing the healthcare system under Obamacare makes our need for greater skepticism even more compelling. 

As medical consumers, we now need more than ever to protect ourselves in our interactions with our doctors – and not just those fleeing nearby states to avoid malpractice liability – by:

  • Asking lots of questions …

  • Ask if it‘s an actual “emergency” or “elective” – If it’s not an emergency, take time to…

  • Learn about your choices (don’t be prodded by fear or ignorance);

  • Confirm answers with third-party sources (internet–based with caution);

  • Learn about alternatives with the best evidence of safety & effectiveness;

  • Assess relative risks – Compare risk-to-reward ratio with alternatives;

  • Focus on STEP DOWN in risk – Medications instead of surgery, diet instead of medications;

  • Get a SECOND OPINION – Ask about “watchful waiting” and aggressive monitoring as an initial approach; and

  • Consider ways to reduce need for – & risks of  – treatments & procedures – Appropriate physical activities, targeted nutritional supplements that enhance or reduce treatments, immune system support, etc.

You’ve Got the Final Say

The key thing to remember is that YOU decide, not your doctor, whether you want the treatment or procedure being recommended. 

Since up to half of treatments and procedures are unnecessary, consumers are well-justified in adopting a more skeptical attitude toward any and all tests, procedures, hospitalizations, or drugs being prescribed for them.

Patients have the final say in what is done to their bodies and shouldn’t be cavalier about highly invasive surgeries – or the general anesthesia often accompanying them – simply because their doctors recommend it. The evidence tells us, after all, that their ordering practices often leave a lot to be desired.

There’s a lot of our money being wasted in the “gray areas” of medicine where solid arguments can be made that doing nothing – and closely monitoring patients’ conditions – is a better choice than whatever medical intervention is being considered.

In short, to survive this era of high-tech medical excess, consumers have to refuse to be “infantilized” by their fear of dying. They instead need to be more assertive in applying low-tech, old-fashioned notions like caution, prudence, and skepticism to their medical decisions. 

Conscious Living

Living longer and healthier – and reducing your family’s future burden – is about conscious living. This means thinking first about what and how much you eat, standing more and sitting less, walking more, climbing stairs, deep breathing, and sleeping better.

It also means learning to say “no” to doctors when their recommendations aren’t supported by the evidence in the medical literature.

The internet makes this feasible by allowing us to access information prior generations never could.

The unbridled greed of a large portion of the current generation of American doctors is evidenced by their rabid overuse of expensive technologies that often add little value and by the financial gains that too often motivate their zeal.

This generation of medical patients needs the internet to help “level the playing field” of knowledge about disease, as well as about medical tests and procedures.

Access to credible and objective evidence available via the internet is one of the few tools to help consumers protect themselves from becoming pawns in their doctors’ business plans. And it’s mostly free or at minimal cost, especially when compared to the costs of continued ignorance.

This kind of objective support and assistance will be essential in what is certain to be a protracted and uphill struggle to protect your family – and your wallet – from the high-tech medical excesses threatening to bankrupt America.

Some caution is also required on the internet, of course, as the “barriers to entry” are low and scammers and spammers are never in short supply.

But following some basic rules to authenticate the reliability of information should prevent you from going too far astray.

Qualified internet resources can help patients become better medical consumers by learning, sharing, and implementing medical and lifestyle “best practices to reduce treatment risks and enhance longevity and quality of life.

The government can’t be trusted to do it for us.

Most doctors won’t do it for us.

We must do it for ourselves – simple as that.

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