Articles Posted in Conflicts of Interest

We already live in an unfortunate situation in America where when we are sick or injured, we expect the medical bill to be shockingly high. Every test, treatment, and drug that the doctor or nurse administers drives the price higher and higher and higher. And those tests can seem arbitrary. The costs of medical treatment can sky rocket when one suffers an injury caused by the negligence of another. Sadly, this is more true than anywhere else in the medical field when it comes to diagnostic tests.

Patients can Face Different Charges When it Comes to Scans

The New York Times recently reported on the problem of patients faces repeat and often times nonsensical charges for medical tests and scans. It told the story of a retired math professor who went through two separate outpatient echo-cardiograms in a three year period. One of the tests took a mere thirty minutes. The other took an hour and a half and involved a cardiologist. The longer test was done at a high end medical facility while the shorter test was done at just a regular local hospital. Yet, when the retiree received the bills for both tests, the shorter test cost $5,500 while the longer test only cost $1,400. This really bothered him.
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Improved Efficiency. Streamlining. Outsourcing. These and similar business buzzwords have been used to promote various industry changes for decades. However, less frequently have they been used in discussions about healthcare and medical treatment. But that is changing. The medical care of today may look very different from that received in future decades.

For example, consider the idea of “remote medicine.” Demographic trends make clear that more and more individuals will need face-to-face time with doctors to discuss their ailments and receive treatment information. To help accommodate that demand, some believe that “remote” interaction between doctors and patients is the answer. This telemedicine extends to conversations between doctors and patients and well as between medical professionals (doctors, nurses, and other specialists).

Those most familiar with the situation suggest that remote medical support may become the primary form of care in the future. They assert that many patients are already being monitored remotely by doctors after they are discharged, particularly those with diabetes, heart disease and lung disease. And others are even having surgery performed remotely by doctors using high-tech robots.

Recently, the Aon/ASHRM Hospital and Physician Professional Liability Benchmark report was released for 2013. According to an article on the release from Claims Journal, this marked the fourteenth year that the study has been conducted. Considering that the project has been underway for nearly a decade and a half, it offers a helpful example of trends in the area of professional liability. Of course, it must be kept in mind that the report is crafted from the insurance perspective, but it is still useful to examine the results to get a feel for one analysis of current malpractice claim and insurance trends.

The Results

Perhaps the most headline-grabbing takeaway from the report is that the rate of medical malpractice growth is at the lowest in the entire history of the report itself. This reflects the same results we have seen time and again in similar reports–medical malpractice payouts are lower than ever. This basic fact is contrary to the claims of so many who continue to push for various tort “reform” efforts to take away even more rights from injured patients.

How do you prove your doctor committed medical malpractice? What specific evidence may be used in the case to convince a jury of what happened?

Every case is different, but in general, all of this information is collected by a plaintiff’s attorney via the “discovery” process. As the name implies, discovery is the part of the civil lawsuit process where both sides interview relevant parties (depositions), request access to documents that each side possess, and otherwise gather evidence to be used in a potential trial. It is hard to overestimate the importance of the discovery process. It is often the crux of any medical malpractice lawsuit–where the truth about what happens truly rises to the surface.

Unfortunately, for the same reason that this process is so critical uncovering misconduct, those who are often held responsible for misconduct–large corporations–are working to limit the discovery process.

Discussions about medical malpractice, tort reform, and healthcare costs are frequently framed in terms of “Doctors vs. Lawyers.” This is unfortunate, because it distracts from very real problems: the need to limit medical errors and reign in health care costs. Doctors are obviously focused on helping sick and injured patients with their medical needs. Lawyers are focused on helping sick and injured patients protect their legal rights. There is no inherent reason why those goals are at odds. A more holistic approach is needed to change focus on discuss the real underlying issues.

From that perspective, a new article written this month by a doctor Board Certified in Internal Medicine offers a helpful way forward.

The Reality of Med Mal Costs

Last week we touched on the fact that arbitration agreements were making their way into many more settings than in the past. That includes different health care agreements between patients and providers. The trend is alarming, and it is important for Illinois community members to be on the look out for arbitration agreements. More residents need to understand the ramifications of being forced into arbitration when they are harmed by caregiving errors.

So what is so bad about arbitration? In short, the entire process is slanted to give big-defendants (like hospitals and medical clinics) advantages that they would not have in the traditional civil justice system. A few of the most important include;


Last week, Medscape shared a five-part story that analyzed doctor perceptions about apologizing to patients following a medical error. Does apologizing to a patient lead to less conflict and better outcomes than staying silent?

The main tension is between potential legal liability and a desire to be honest with patients. On one hand, doctors may be tempted to act on their natural human instinct and say “I’m sorry” when a mistake was made. However, there is concern that the apology itself may be used as evidence that malpractice was committed in a legal action that may stem from the incident.

To combat the fear, a majority of states, including Illinois, have passed “apology laws” which generally do not allow doctor apologies to be admitted as evidence in a future malpractice case. One of the leaders of the movement to pass such laws run a company called “Sorry Works! LLC.” The man lost his own brother from malpractice and his family filed suit. He noted that his motivation in bringing the lawsuit was not money–they wanted accountability and acknowledgment.

This week Reuters shared the news that a large pharmaceutical company, PharMerica, was hit by a lawsuit filed by the U.S. government. The suit claims that the company engaged in a series of illegal activities. The allegations suggest that patients lives were put in danger by PharMerica’s actions and significant funds were funneled fraudulently from Medicare as a result.

Whistleblower Comes Forward

The U.S. government lawsuit against PharMerica comes two years after the same allegations were made in a whistleblower lawsuit filed by a former employee of the company. The whistleblower, who worked as a pharmacy operations manager at one company facility, explained how the pharmacy dispensed medication without first getting valid prescriptions from doctors.

In an ideal world, medical professionals would do everything in their power to eliminate every manner of preventable error, because they would have to pay for the consequences of mistakes. Medical malpractice lawsuits are supposed to work somewhat in that manner–requiring hospitals to pay for the consequences of their inadequate care, spurring them to make changes that eliminate harmful care.

Yet, a troubling new Yahoo Health article is a reminder that in a perverse way, many hospitals actually profit from making medical mistakes. That is because the mistakes cause patients more harm, requiring even more care—and hospitals get paid for that extra care. This cycle of more and more treatment is obviously bad for the patient, bad for insurance companies, and bad for taxpayers footing the bill on much medical care. Hospitals are the only ones to benefit. All of this is one key reason why more are looking at alternative ways to make medical payments–like “managed care” systems.

Profitable Medical Errors

Few policy issues are fraught with more confusion, complexity, and disagreement that health care costs. Many argue that ballooning state and federal budgets are driven by the rise in healthcare costs being borne by governments. This is mirrored in rising healthcare insurance premiums being paid by individual community members.

There is little disagreement regarding the fact that costs are rising, but there is considerable misunderstanding about why they are rising and what should be done to turn things around.

Some ideas have been shown to be red herrings, like enacting tort reform laws to limit the rights of medical malpractice victims. Beyond having serious consequences on patient safety efforts, these legal changes do nothing to impact costs.

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