Medical Reform

I am sure that many people have many different opinions of the current state of our healthcare system. Most individuals probably base their opinions on how to fix or not fix our healthcare system based on what part of the system they have most often experienced. If you are a medicare patient and frustrated with the lack of doctors who will see medicare patients and the long delays to get an appointment you probably are frustrated with the inconvenience of trying to get an appointment with a doctor that will take medicare. If you are an HMO patient you are probably frustrated with all the rules and regulations that they are forced to follow and the lack of care they are allowed given all the HMO policies. I think you get the point.

Most people would agree that there needs to be some things addressed within our current healthcare system. I will briefly discuss 1 point today (there are many more); Malpractice.

Many people think that malpractice is a cost of healthcare but really only effects the doctors as they pay their higher insurance premiums and that very little costs trickle down to the patients or the system as a whole. However malpractice is probably the single largest cost and waste of money on the entire healthcare system. Doctors are going to get sued. We now have classes in medical school about how to cope with your first lawsuit. It is not an issue of if but more and issue of how often. So every doctor out there is trained early and often on how to practice "CYA" medicine (cover your ass). For example; if a child comes in who has a hit their head and it is a mild bump at best. The doctor knows the child does not really need an expensive CT scan but the doctor also knows that it is not worth a lawsuit to not scan the kids head and so the kid gets $1000.00+ of tests that the doctor would most likely not do on his own child in the same situation but because he knows of a case where 1 doctor got sued for blah, blah, blah... the tests are performed. This type of medicine is being practiced all day long in every hospital, clinic and surgery center throughout the USA. As you can imagine the CYA medicine singlehandedly cost the healthcare system billions of dollars in unnecessary tests and procedures.

I once spoke with an "ambulance chaser" type attorney and he told me that in order for him to make his $1,000,000.00 salary he needs to file 10 lawsuits against doctors and or hospitals / month. He explained that whether or not the case had any merit at all did not matter. He just knew he needed to convince 10 people to sue / month. He said it was easy to convince the people to sue because they had nothing to lose. The patient does not have to pay anything unless the case gets settled and if it did get settles the attorney took is 30 - 50% and the patient got their money. The attorney said the patients had noting to lose. "Why not sue" he said. So you go in for a procedure and are completely happy with your care and satisfied with the outcome, this attorney will take you case and find some area or way that he can create a complaint and then sue the doctor at no cost to you and then one day you get a call and he says guess what your case for the procedure you were happy with settled and you get a check for $50,000.00. I asked the attorney what would happen if they put payout caps on the malpractice lawsuits and he responded that instead of 10 lawsuits / month he would have to raise it to 30 lawsuits / month to keep his $1,000,000.00 salary and in the cases that really deserved a larger payout would no longer be eligible for a needed larger payout

This attorney actually said to me "you would be stupid not to sue, even if you are happy with the care because you may get a payout." This is why doctors have to practice "CYA" medicine. This kind of medicine is expensive! A CFO at a hospital I was rotating at explained to me that he estimates that they do $50 - $100 million in unnecessary tests and procedures / month in the name of CYA medicine. This is just 1 hospital is 1 community that has 7 other hospitals in the same community.

Ironically there is no mention of malpractice reform in any of the new healthcare reform policies. Many politicians, including our president are attorneys so it makes sense that this huge elephant in the room would be ignored in any new policies. There is big money in malpractice for the attorneys but if it were addressed properly it could literally reduce the need for most if not all of the other cost cutting solutions that have been proposed. Some of the other issues of course should and could be addressed but certainly the malpractice issue is being ignored completely.

What is the solution? I do not claim to have all the answers or maybe even any of the answers. I have an idea but you will have to wait until my next post to read about it. Rest assured though this malpractice and CYA medicine is most likely much bigger and more expensive than any other cost in our healthcare system and is not being addressed and may never be addressed, at least in the foreseeable future.