Medical errors are a much worse problem than physicians paying lots of insurance. And there are plenty of physicians available. Everyone wants to be a doctor because it is the highest-paying single profession in the US.[/QB]<hr></blockquote>
Where do you see plenty of physicians avalaible ? : in order to be a senior physician you must have more than 10 years of studies. Even if many people are ready to do the job because it's the highest paying single profession in US (it's not the case in France), you will have to wait more than 10 years to have new physicians. And if everyone is ready to earn like doctors, not everyone are ready to do their jobs and to have followed their studies. I regret to do not be able to play piano, but i do not regret to have spent hours of training in order to play. As you said medical errors have importants consequences, thus MD have importants responsabilities and thus importants fees.
The problem of high cost of medical insurance, is that it's the patient who will suffer finally. Why ?
Because doctors have a new priority, not the best cares for their patients, but to have the less problems possibles. It's call Defensive medecine. For example never cure a big fat diabetics, says it's too dangerous, do not give him a chance to save his leg, in case of complication you will be responsible. Just cure the more simple cases and always choose the therapy which bring the less complications even it the results are worse.
US have one the most highest rate of the Caesarean intervention of the world. Why ? because physicians do not want to take any risk each time it may have a complication they practice the surgery. At a result a lot more women have caesarians than in France (twice the number).
Final point : who paid the insurance : the patient, the more expansive the insurance will become, the more money will be waste in this aera. If things continue, a vast amount of money will be used to feed the judiciary system. The system will finish to collapse. Bush is wize to have made this cap.
And i find strange that Liberals find bad this decision. Afterall the liberals should have made it. Making the health system more expansive is not the good way to cure the maximum number of patients.
not sure where you live....we have a hard time finding doctors, and an even harder time keeping doctors...and try finding pediatricians....they are paid the least, so few want to go into it....most people are going into law or business now....GW and his CEO buddies have shown that it doesn't matter if you do a good job or if the company makes money or if you keep people working, you will make your millions even if the company folds....so it is best to be the top dog....doctors have less and less say, less and less control...and, as a result, fewer and fewer people are going into medicene....g
It's amazing the number of simalaritties between France and US. Pediatricians lack in France too, because it's the worth paid job in the medical aera .
An another amazing thing is that we are two of the oldest member of AI, perhaps it's because is we are youngs in our heads dispite the lenght of our studies.
Putting a cap on jury awards in medical malpractice is intended to limit the cost of insurances. It's seems obvious.
I will add we have the same problem in France with an extraordinary inflation of the cost of medical insurance, why the vast majority of MD in France have theirs fees unchanged since eight years. (in France only a minority of MD in the private aera have the right to make their own fees, for example the removal of the appendix is paid 140 $ for the surgeon).
The physician surplus in the US is well known. Medical schools have been tightening admissions for years for that very reason, so that now it's virtually impossible to get into med school. They accept something like 2% of applicants. If they accepted 1-2% more, we would have way too many doctors. I'm sure there are regions of the US where doctors don't want to go and live, just like with any profession. But overall, there is a surplus right now and into the future.
Obviously if we had a shortage, increasing admissions is not going to turn things around in a single year. But 1) we don't have a shortage, not even close, and 2) this is a long-term issue, not a short-term one.
The reason medical malpractice lawsuits are so frequent is because medicine is not well-regulated enough. This lack of regulation causes the high number of errors. And the reason medicine is not well-regulated enough is because doctors oppose regulation. Doctors' groups want to have total control over the hospitals/practices, and so they won't take regulation from outsiders. This is what leads to things like poor controls over medication (like keeping lethal undiluted drugs around) and hence lawsuits.
Again, the way to stop huge insurance payments is to STOP SCREWING UP. Not simply cap the payments and leave everything else unchanged. The way to stop screwing up is to put regulations in place that are based on examining where errors occur and correcting them.
Do a search on "To Err is Human." It's the Institute of Medicine's analysis of the causes of the absurd number of medical errors in the US. They make pretty specific recommendations for improving the situation.
Powerdoc, there is a discussion here on medical malpractice insurance costs as related to jury awards in such suits. I've already submitted a claim, warrant and backing that capping such awards will not stop rising malpractice rates from continuing to soar. The "obvious" doesn't apply here.
An another amazing thing is that we are two of the oldest member of AI, perhaps it's because is we are youngs in our heads dispite the lenght of our studies. </strong><hr></blockquote>
Please send me a prescription for a ten pack of those PD.
Lawyers will sue for anything... even if they don't have a case... Heck it's just their own time so even if they THINK they might win they go for it...
You see in most cases lawyers get 33% (one third) of a judgement and their reason is 'well we don't win all of the cases we file so we need to extort err charge those fees when we do win'.
As it is today a 'joe lawyer' can sue without fear as many times as he/she likes and while the only cost to him/he is the time and paperwork fees the company/doctor/insurance-company/etc on the other end has to PAY their own inhouse lawyers to defend itself and where 'joe lawyer' might only sure 'company x' once or twice a year (maybe) 'company x' could be seeing HUNDREDS of other 'joe lawyers' from around the country all gunning for cash.
This really isn't fair.
What *I* would love to see is the following:
1 - If you sue you must have a case...
2 - If you sue and win the case the ALL legal fees would be paid by the company/firm that lost the case.
3 - If you sue and lose the legal fees would be paid based on a CASE REVIEW of the suit. If you sue and the case is found to have NO MERIT AT ALL the person who filed the BOGUS case would be forced to pay the legal fees for the people they tired to sue in the first place.
This to me would sure cut down on some of the silly-a$$ lawsuites that I've heard about and just maybe make a 'slock-lawyer' think twice about going into court on a case that has no merit.
a typical quote i see from doctors...malpractice matters some, HMO's and Insurance are much bigger reasons why doctors flee or retire or change profession... [quote] California doctors are heading for small towns in such states as Texas, Alabama and North Carolina where doctors say they have considerably more control over their medical decisions, get paid a fair fee for their services and can afford to live comfortably. Of those doctors not clearing out of the area, a good number are retiring early or changing professions. Of those still practicing here, some are dropping out of the HMO system altogether, and growing numbers are joining the union, something unheard of not so long ago. <hr></blockquote>
malpractice is a small part of the problem, but GW would rather go after lawyers than HMO and insurance companies and trying to tackle the real ways to keep insurance affordable....that doesn't put money in the pocket of his rich friends...g
The reason medical malpractice lawsuits are so frequent is because medicine is not well-regulated enough. This lack of regulation causes the high number of errors. And the reason medicine is not well-regulated enough is because doctors oppose regulation. Doctors' groups want to have total control over the hospitals/practices, and so they won't take regulation from outsiders. This is what leads to things like poor controls over medication (like keeping lethal undiluted drugs around) and hence lawsuits.
Again, the way to stop huge insurance payments is to STOP SCREWING UP. Not simply cap the payments and leave everything else unchanged. The way to stop screwing up is to put regulations in place that are based on examining where errors occur and correcting them.
</strong><hr></blockquote>
The number of screwing up is very low. All error are reported in the media, but who care if there is thousand of good practice performed each days.
Of course some errors can be avoided, via the use of security procedure : for example never made an antiseptia with a non colored substance while practicing a rachi-anesthesia or any others procedures, otherwise be cautious. While removing human tissue, give it immediatly to the analysis, don't put it in the table, soemone should put it accidently in the garbage (sometimes the tissue sample is very little) ...
I think many doctors are aware of this . We really don't like to commit error, believe me.
Now we like to respect intelligent procedures, and not irrealistic ones made by people that have never leave their central agencies. For example desinfection procedure in France, that are not possible to be followed strictly without curing only three patients instead of ten (and if you do cure only three patients, then you should close the hospital immedialty).
When you speak of regulation, you refer to what ? Regulation by the private insurance who are more worried about paying the less possible than any others thing, and they seem to be quite active (see Thegelding's post)
Regulation by outsider who don't know anything about medecine just statistic ? I said NO. How the hell that someone without any medical knowlegde outside some statistics knowledge can regulate my activitie ?
Should i give advice to Tiger woods the next time he play master because i have made some statistic about golf ? In order to understand some problems you have to practice. Can you give advices about the art of violon if you don't practice your self ?
Sorry Brussel, but i don't get at all your point. This regulation thing is crap, only doctors can regulate others doctors. When we have doubts about our practice we ask others advice. Regulation should only be based upon others doctors practice.
There would be always screw up in medecine, if you want to have airplance crash, don't take airplanes, if you don't want car accident dont take cars. The risk is inherent to the job. A 100 % proof medicine is an utopia, medecine is made by human on human and not by gods on others gods. The vast majority of your so called screwing up are complications. Can we sue the patient because he did not reacted in the normal way ? One day i will do a malpractice, because i am human and thus subject by the error. Maybe i have already commited some, but as i was lucky no complications occured. We try to do our job as best as possible, we cure much more patients than one hundred years ago, due to medical progress the life expectancy is way higher, but we haven't got the control of the life or our patients : people are free to smoke, to get drunk, to hurt themselves and break their bones ...to eat shit ...Some are ready to sue their orthopedics because they do not walk so good after their accident, but who will sue them (their insurance for example) because they where drunk when they had their accident ? They are bad doctors for sure, like there is bad politicians, bad judges , bad electricians , bad engineers ...There is no real way to remove bad people completely from any professions without hurting the whole profession. There is no way to reduce the number of morons in the word, that's not a reason to erase the whole humanity.
The main problems is MONEY.
As thegelding reported in one of his link, the number of trials is due to the fact it's more eathier to win a trial for a supposed malpractice than to play to hazards games.
<strong>The number of screwing up is very low. All error are reported in the media, but who care if there is thousand of good practice performed each days.</strong><hr></blockquote>
Unfortunately it is not low. 100,000 people, probably more, die in the US each year from preventable medical mistakes, making it one of the leading causes of death.
Your post confirms my point - that doctors don't want any regulation. Each individual doctor knows best and we should let them simply do their job and everything will be fine. My opinion on that comes from "<a href="http://books.nap.edu/html/to_err_is_human/exec_summ.html#Summary"; target="_blank">To err is human</a>," the Institute of Medicine's report on medical errors and how to improve things. Their point is that individual doctors and institutions have NOT done the right thing and everything is not fine.
Taking an airplane is a good example. It is much safer to take an airplane than to go to a doctor. There have been very few deaths due to errors on airplanes in the US in the past decade, even if you include 9/11 as an error (compare 3,000 on 9/11 to 100,000/year). And they have very strict oversight. Should our airline industry be free from regulation and we should simply trust them to do the right thing because they're such well-educated and smart people?
I'm giving you a hard time PowerDoc, but I do genuinely think it is a serious problem that could be improved. And I think the number and cost of lawsuits is telling us that something is wrong. And reducing the impact of suits will reduce the likelihood that it will improve.
Unfortunately it is not low. 100,000 people, probably more, die in the US each year from preventable medical mistakes, making it one of the leading causes of death.
Your post confirms my point - that doctors don't want any regulation. Each individual doctor knows best and we should let them simply do their job and everything will be fine. My opinion on that comes from "<a href="http://books.nap.edu/html/to_err_is_human/exec_summ.html#Summary"; target="_blank">To err is human</a>," the Institute of Medicine's report on medical errors and how to improve things. Their point is that individual doctors and institutions have NOT done the right thing and everything is not fine.
Taking an airplane is a good example. It is much safer to take an airplane than to go to a doctor. There have been very few deaths due to errors on airplanes in the US in the past decade, even if you include 9/11 as an error (compare 3,000 on 9/11 to 100,000/year). And they have very strict oversight. Should our airline industry be free from regulation and we should simply trust them to do the right thing because they're such well-educated and smart people?
I'm giving you a hard time PowerDoc, but I do genuinely think it is a serious problem that could be improved. And I think the number and cost of lawsuits is telling us that something is wrong. And reducing the impact of suits will reduce the likelihood that it will improve.</strong><hr></blockquote>
This article is a technocratic work. I will speak of what i know : my exercice in my private hospital. There is full of various regulations and procedures :
- procedures dealing with infections : washing hands, materials , rooms, patients, declarations of the nosocomials infections (infection get in the hospital) and prionic procedures. Our specialised nurses are the warrant of the respect of these procedures. There is often discussion of how make the best sterilisation of the operative ground. Things are evolved since i come here. There where change in the last four years. Now we mostly employ only single use material (not the classical surgical tools), for the dressing for example.
we do not practice dirty (infected) surgery in rooms dedicated to clean surgery like orthopedia, ophtalmologia, vasculare surgery ... and even we practice something dirty, there is a special washing procedure of the operative room.
- procedures dealing with the quality of material using at the contact of the patient, norms of construction and report of any incident implying materials.
- respect of a chart of the rights of patients (ten points, from respect of the medical secret, to the right to decide his treatment)
- Europeans norms of treatment (we said consensus) for some pathologia : for example , the way you will cure surgicaly a melanoma is the same for all europe. It's call legal medical reference (reference medicales opposables en Français).
- procedures dealing with the security of the hospital, like any public building but more strictly
- procedures dealing with the financial aspect of medecine.
- respect of a deontologic code in medecine, with various question answered, from the medical secret, to many otherrs things (one hundred articles) you should loose your medical license if you do not respect it.
- self made procedure, build a surgical procedure allowing to do less mistake. This procedure is mostly an individual variation of what we have learned from our medical university. I am sorry but you will not find two surgeons doing exactly the same thing , what works great with one can work less with an another one.
We are not dealing with mechanics, we deal with biological tissues and human psychologia, thus subject to an infinite number of factors, that cannot be resumed completely in a strict organigram. Medecine is an art, it's not pure technology nor pure human relations , it's a mix. On some aera procedures are possible and necessary , but you cannot regulate everything in medecine.
What is bad, is regulation build without the cooperation of the doctors. It leads to stupid reglementation, like for each patient in the hospital the sterilisation room must have ten square feets. As a result our brand new sterilisation is not anymore at the norm, and we will be oblige to build an another one, just two or three years after. Can we explain me, this story of ten square meters per patient ? It's BS.
Some people of our NHS visit our hospital, and some of them said that some norms could not being followed. Why because it have been made by people working in their office, who never worked in the aera they are supposed to regulate. They are more concerned to protect themself with a long list of laws supposed to improve the security rather than ask how it will cost and if it's practically possible to follow them.
I don't know what it's the case of US, but i doubt that it's worse in US than in France. I know US people are serious guys and i doubt there is no real organisation inside your hospitals. I have visited the San Diego hospital eleven years ago and the organisation was at the top.
And the Republicans will present what? A plan that plays on the public's bias against jury awards and one based on "common sense" and the "obvious" rather than something that will actually do what it's intended to do?
<strong>And the Republicans will present what? A plan that plays on the public's bias against jury awards and one based on "common sense" and the "obvious" rather than something that will actually do what it's intended to do?</strong><hr></blockquote>
Oh, it will do what it's intended to do.
Unfortunately it will be intended to make lobbying corporations richer at everyone else's expense, preferably by making their lives worse in some intangible manner. The "common sense, knee-jerk reaction" will simply be camouflage.
I mean when was the last time a problem actually got solved by this process, other than the problem of big business not making enough money.
Comments
Medical errors are a much worse problem than physicians paying lots of insurance. And there are plenty of physicians available. Everyone wants to be a doctor because it is the highest-paying single profession in the US.[/QB]<hr></blockquote>
Where do you see plenty of physicians avalaible ? : in order to be a senior physician you must have more than 10 years of studies. Even if many people are ready to do the job because it's the highest paying single profession in US (it's not the case in France), you will have to wait more than 10 years to have new physicians. And if everyone is ready to earn like doctors, not everyone are ready to do their jobs and to have followed their studies. I regret to do not be able to play piano, but i do not regret to have spent hours of training in order to play. As you said medical errors have importants consequences, thus MD have importants responsabilities and thus importants fees.
The problem of high cost of medical insurance, is that it's the patient who will suffer finally. Why ?
Because doctors have a new priority, not the best cares for their patients, but to have the less problems possibles. It's call Defensive medecine. For example never cure a big fat diabetics, says it's too dangerous, do not give him a chance to save his leg, in case of complication you will be responsible. Just cure the more simple cases and always choose the therapy which bring the less complications even it the results are worse.
US have one the most highest rate of the Caesarean intervention of the world. Why ? because physicians do not want to take any risk each time it may have a complication they practice the surgery. At a result a lot more women have caesarians than in France (twice the number).
Final point : who paid the insurance : the patient, the more expansive the insurance will become, the more money will be waste in this aera. If things continue, a vast amount of money will be used to feed the judiciary system. The system will finish to collapse. Bush is wize to have made this cap.
And i find strange that Liberals find bad this decision. Afterall the liberals should have made it. Making the health system more expansive is not the good way to cure the maximum number of patients.
<strong>
not sure where you live....we have a hard time finding doctors, and an even harder time keeping doctors...and try finding pediatricians....they are paid the least, so few want to go into it....most people are going into law or business now....GW and his CEO buddies have shown that it doesn't matter if you do a good job or if the company makes money or if you keep people working, you will make your millions even if the company folds....so it is best to be the top dog....doctors have less and less say, less and less control...and, as a result, fewer and fewer people are going into medicene....g
[ 01-17-2003: Message edited by: thegelding ]</strong><hr></blockquote>
It's amazing the number of simalaritties between France and US. Pediatricians lack in France too, because it's the worth paid job in the medical aera .
An another amazing thing is that we are two of the oldest member of AI, perhaps it's because is we are youngs in our heads dispite the lenght of our studies.
[ 01-17-2003: Message edited by: Powerdoc ]</p>
I will add we have the same problem in France with an extraordinary inflation of the cost of medical insurance, why the vast majority of MD in France have theirs fees unchanged since eight years. (in France only a minority of MD in the private aera have the right to make their own fees, for example the removal of the appendix is paid 140 $ for the surgeon).
The physician surplus in the US is well known. Medical schools have been tightening admissions for years for that very reason, so that now it's virtually impossible to get into med school. They accept something like 2% of applicants. If they accepted 1-2% more, we would have way too many doctors. I'm sure there are regions of the US where doctors don't want to go and live, just like with any profession. But overall, there is a surplus right now and into the future.
Obviously if we had a shortage, increasing admissions is not going to turn things around in a single year. But 1) we don't have a shortage, not even close, and 2) this is a long-term issue, not a short-term one.
The reason medical malpractice lawsuits are so frequent is because medicine is not well-regulated enough. This lack of regulation causes the high number of errors. And the reason medicine is not well-regulated enough is because doctors oppose regulation. Doctors' groups want to have total control over the hospitals/practices, and so they won't take regulation from outsiders. This is what leads to things like poor controls over medication (like keeping lethal undiluted drugs around) and hence lawsuits.
Again, the way to stop huge insurance payments is to STOP SCREWING UP. Not simply cap the payments and leave everything else unchanged. The way to stop screwing up is to put regulations in place that are based on examining where errors occur and correcting them.
Do a search on "To Err is Human." It's the Institute of Medicine's analysis of the causes of the absurd number of medical errors in the US. They make pretty specific recommendations for improving the situation.
<strong>
An another amazing thing is that we are two of the oldest member of AI, perhaps it's because is we are youngs in our heads dispite the lenght of our studies.
Please send me a prescription for a ten pack of those PD.
Lawyers will sue for anything... even if they don't have a case... Heck it's just their own time so even if they THINK they might win they go for it...
You see in most cases lawyers get 33% (one third) of a judgement and their reason is 'well we don't win all of the cases we file so we need to extort err charge those fees when we do win'.
As it is today a 'joe lawyer' can sue without fear as many times as he/she likes and while the only cost to him/he is the time and paperwork fees the company/doctor/insurance-company/etc on the other end has to PAY their own inhouse lawyers to defend itself and where 'joe lawyer' might only sure 'company x' once or twice a year (maybe) 'company x' could be seeing HUNDREDS of other 'joe lawyers' from around the country all gunning for cash.
This really isn't fair.
What *I* would love to see is the following:
1 - If you sue you must have a case...
2 - If you sue and win the case the ALL legal fees would be paid by the company/firm that lost the case.
3 - If you sue and lose the legal fees would be paid based on a CASE REVIEW of the suit. If you sue and the case is found to have NO MERIT AT ALL the person who filed the BOGUS case would be forced to pay the legal fees for the people they tired to sue in the first place.
This to me would sure cut down on some of the silly-a$$ lawsuites that I've heard about and just maybe make a 'slock-lawyer' think twice about going into court on a case that has no merit.
Dave
<a href="http://www.cbsnews.com/stories/2002/07/10/eveningnews/main514761.shtml"; target="_blank">doctors needed</a>
<a href="http://news.theolympian.com/health/doctorshortage/doctor_drain/41002.shtml"; target="_blank">and more info</a>
a typical quote i see from doctors...malpractice matters some, HMO's and Insurance are much bigger reasons why doctors flee or retire or change profession... [quote] California doctors are heading for small towns in such states as Texas, Alabama and North Carolina where doctors say they have considerably more control over their medical decisions, get paid a fair fee for their services and can afford to live comfortably. Of those doctors not clearing out of the area, a good number are retiring early or changing professions. Of those still practicing here, some are dropping out of the HMO system altogether, and growing numbers are joining the union, something unheard of not so long ago. <hr></blockquote>
<a href="http://www.svcn.com/archives/sunnyvalesun/01.31.01/cover-0105.html"; target="_blank">more</a>
and the problems are worse in Canada and England and Australia....not counting the less developed countries....
put doctor surplus in google and you get one article from 1996...put doctor shortage in google and see what you get....g
nice article <a href="http://www.svcn.com/archives/cupertinocourier/01.24.01/cover-0104.html"; target="_blank">here</a>
malpractice is a small part of the problem, but GW would rather go after lawyers than HMO and insurance companies and trying to tackle the real ways to keep insurance affordable....that doesn't put money in the pocket of his rich friends...g
shall i go <a href="http://www.kfoxtv.com/specialreports/shortage.html"; target="_blank">on??</a>
[ 01-17-2003: Message edited by: thegelding ]</p>
<strong>
Please send me a prescription for a ten pack of those PD.</strong><hr></blockquote>
You don't need those, Anders you will stay young in your head for ever (in the right sense of the word of course !)
<strong>PowerDoc & thegelding:
The reason medical malpractice lawsuits are so frequent is because medicine is not well-regulated enough. This lack of regulation causes the high number of errors. And the reason medicine is not well-regulated enough is because doctors oppose regulation. Doctors' groups want to have total control over the hospitals/practices, and so they won't take regulation from outsiders. This is what leads to things like poor controls over medication (like keeping lethal undiluted drugs around) and hence lawsuits.
Again, the way to stop huge insurance payments is to STOP SCREWING UP. Not simply cap the payments and leave everything else unchanged. The way to stop screwing up is to put regulations in place that are based on examining where errors occur and correcting them.
</strong><hr></blockquote>
The number of screwing up is very low. All error are reported in the media, but who care if there is thousand of good practice performed each days.
Of course some errors can be avoided, via the use of security procedure : for example never made an antiseptia with a non colored substance while practicing a rachi-anesthesia or any others procedures, otherwise be cautious. While removing human tissue, give it immediatly to the analysis, don't put it in the table, soemone should put it accidently in the garbage (sometimes the tissue sample is very little) ...
I think many doctors are aware of this . We really don't like to commit error, believe me.
Now we like to respect intelligent procedures, and not irrealistic ones made by people that have never leave their central agencies. For example desinfection procedure in France, that are not possible to be followed strictly without curing only three patients instead of ten (and if you do cure only three patients, then you should close the hospital immedialty).
When you speak of regulation, you refer to what ? Regulation by the private insurance who are more worried about paying the less possible than any others thing, and they seem to be quite active (see Thegelding's post)
Regulation by outsider who don't know anything about medecine just statistic ? I said NO. How the hell that someone without any medical knowlegde outside some statistics knowledge can regulate my activitie ?
Should i give advice to Tiger woods the next time he play master because i have made some statistic about golf ? In order to understand some problems you have to practice. Can you give advices about the art of violon if you don't practice your self ?
Sorry Brussel, but i don't get at all your point. This regulation thing is crap, only doctors can regulate others doctors. When we have doubts about our practice we ask others advice. Regulation should only be based upon others doctors practice.
There would be always screw up in medecine, if you want to have airplance crash, don't take airplanes, if you don't want car accident dont take cars. The risk is inherent to the job. A 100 % proof medicine is an utopia, medecine is made by human on human and not by gods on others gods. The vast majority of your so called screwing up are complications. Can we sue the patient because he did not reacted in the normal way ? One day i will do a malpractice, because i am human and thus subject by the error. Maybe i have already commited some, but as i was lucky no complications occured. We try to do our job as best as possible, we cure much more patients than one hundred years ago, due to medical progress the life expectancy is way higher, but we haven't got the control of the life or our patients : people are free to smoke, to get drunk, to hurt themselves and break their bones ...to eat shit ...Some are ready to sue their orthopedics because they do not walk so good after their accident, but who will sue them (their insurance for example) because they where drunk when they had their accident ? They are bad doctors for sure, like there is bad politicians, bad judges , bad electricians , bad engineers ...There is no real way to remove bad people completely from any professions without hurting the whole profession. There is no way to reduce the number of morons in the word, that's not a reason to erase the whole humanity.
The main problems is MONEY.
As thegelding reported in one of his link, the number of trials is due to the fact it's more eathier to win a trial for a supposed malpractice than to play to hazards games.
<strong>The number of screwing up is very low. All error are reported in the media, but who care if there is thousand of good practice performed each days.</strong><hr></blockquote>
Unfortunately it is not low. 100,000 people, probably more, die in the US each year from preventable medical mistakes, making it one of the leading causes of death.
Your post confirms my point - that doctors don't want any regulation. Each individual doctor knows best and we should let them simply do their job and everything will be fine. My opinion on that comes from "<a href="http://books.nap.edu/html/to_err_is_human/exec_summ.html#Summary"; target="_blank">To err is human</a>," the Institute of Medicine's report on medical errors and how to improve things. Their point is that individual doctors and institutions have NOT done the right thing and everything is not fine.
Taking an airplane is a good example. It is much safer to take an airplane than to go to a doctor. There have been very few deaths due to errors on airplanes in the US in the past decade, even if you include 9/11 as an error (compare 3,000 on 9/11 to 100,000/year). And they have very strict oversight. Should our airline industry be free from regulation and we should simply trust them to do the right thing because they're such well-educated and smart people?
I'm giving you a hard time PowerDoc, but I do genuinely think it is a serious problem that could be improved. And I think the number and cost of lawsuits is telling us that something is wrong. And reducing the impact of suits will reduce the likelihood that it will improve.
<strong>
Unfortunately it is not low. 100,000 people, probably more, die in the US each year from preventable medical mistakes, making it one of the leading causes of death.
Your post confirms my point - that doctors don't want any regulation. Each individual doctor knows best and we should let them simply do their job and everything will be fine. My opinion on that comes from "<a href="http://books.nap.edu/html/to_err_is_human/exec_summ.html#Summary"; target="_blank">To err is human</a>," the Institute of Medicine's report on medical errors and how to improve things. Their point is that individual doctors and institutions have NOT done the right thing and everything is not fine.
Taking an airplane is a good example. It is much safer to take an airplane than to go to a doctor. There have been very few deaths due to errors on airplanes in the US in the past decade, even if you include 9/11 as an error (compare 3,000 on 9/11 to 100,000/year). And they have very strict oversight. Should our airline industry be free from regulation and we should simply trust them to do the right thing because they're such well-educated and smart people?
I'm giving you a hard time PowerDoc, but I do genuinely think it is a serious problem that could be improved. And I think the number and cost of lawsuits is telling us that something is wrong. And reducing the impact of suits will reduce the likelihood that it will improve.</strong><hr></blockquote>
This article is a technocratic work. I will speak of what i know : my exercice in my private hospital. There is full of various regulations and procedures :
- procedures dealing with infections : washing hands, materials , rooms, patients, declarations of the nosocomials infections (infection get in the hospital) and prionic procedures. Our specialised nurses are the warrant of the respect of these procedures. There is often discussion of how make the best sterilisation of the operative ground. Things are evolved since i come here. There where change in the last four years. Now we mostly employ only single use material (not the classical surgical tools), for the dressing for example.
we do not practice dirty (infected) surgery in rooms dedicated to clean surgery like orthopedia, ophtalmologia, vasculare surgery ... and even we practice something dirty, there is a special washing procedure of the operative room.
- procedures dealing with the quality of material using at the contact of the patient, norms of construction and report of any incident implying materials.
- respect of a chart of the rights of patients (ten points, from respect of the medical secret, to the right to decide his treatment)
- Europeans norms of treatment (we said consensus) for some pathologia : for example , the way you will cure surgicaly a melanoma is the same for all europe. It's call legal medical reference (reference medicales opposables en Français).
- procedures dealing with the security of the hospital, like any public building but more strictly
- procedures dealing with the financial aspect of medecine.
- respect of a deontologic code in medecine, with various question answered, from the medical secret, to many otherrs things (one hundred articles) you should loose your medical license if you do not respect it.
- self made procedure, build a surgical procedure allowing to do less mistake. This procedure is mostly an individual variation of what we have learned from our medical university. I am sorry but you will not find two surgeons doing exactly the same thing , what works great with one can work less with an another one.
We are not dealing with mechanics, we deal with biological tissues and human psychologia, thus subject to an infinite number of factors, that cannot be resumed completely in a strict organigram. Medecine is an art, it's not pure technology nor pure human relations , it's a mix. On some aera procedures are possible and necessary , but you cannot regulate everything in medecine.
What is bad, is regulation build without the cooperation of the doctors. It leads to stupid reglementation, like for each patient in the hospital the sterilisation room must have ten square feets. As a result our brand new sterilisation is not anymore at the norm, and we will be oblige to build an another one, just two or three years after. Can we explain me, this story of ten square meters per patient ? It's BS.
Some people of our NHS visit our hospital, and some of them said that some norms could not being followed. Why because it have been made by people working in their office, who never worked in the aera they are supposed to regulate. They are more concerned to protect themself with a long list of laws supposed to improve the security rather than ask how it will cost and if it's practically possible to follow them.
I don't know what it's the case of US, but i doubt that it's worse in US than in France. I know US people are serious guys and i doubt there is no real organisation inside your hospitals. I have visited the San Diego hospital eleven years ago and the organisation was at the top.
[ 01-18-2003: Message edited by: Powerdoc ]</p>
<strong>And the Republicans will present what? A plan that plays on the public's bias against jury awards and one based on "common sense" and the "obvious" rather than something that will actually do what it's intended to do?</strong><hr></blockquote>
Oh, it will do what it's intended to do.
Unfortunately it will be intended to make lobbying corporations richer at everyone else's expense, preferably by making their lives worse in some intangible manner. The "common sense, knee-jerk reaction" will simply be camouflage.
I mean when was the last time a problem actually got solved by this process, other than the problem of big business not making enough money.
I wish I wasn't forced to be this cynical.