Injuryboard Commentary - Malpractice

Are Malpractice Claims Running Doctors Out of Business?

Mike Ferrara — Tue, 08 Dec 2009 21:06:14 GMT

In an effort to cap or otherwise limit malpractice claims across the country, tort reformers tell us again and again how the high cost of malpractice insurance is running doctors out of business. They’re scarcely scraping by, we hear, and tort reform is the only answer.

There are a number of reasons why this is bogus (check out our Cherry Hill blog for more info), but here is the latest from Forbes Magazine’s Top 25 Paying Jobs in the US. The salaries speak for themselves.

No. 1 Surgeons

Average Annual Pay: $206,770

One-Year Change: +8.0%

Employees in Field: 47,070

Best-Paying State: Wisconsin

The Job: Treat diseases, injuries and deformities by invasive methods, such as manual manipulation or by using instruments and appliances

No. 2 Anesthesiologists

Average Annual Pay: $197,570

One-Year Change: +2.5%

Employees in Field: 34,230

Best-Paying State: Kentucky

The Job: Administer anesthetics during surgery or other medical procedures.

No. 3 Orthodontists

Average Annual Pay: $194,930

One-Year Change: +5.2%

Employees in Field: 5,500

Best-Paying State: New Hampshire

The Job: Examine, diagnose and treat dental malocclusions and oral cavity anomalies. Design and fabricate appliances to realign teeth and jaws.

No. 4 Obstetrician and Gynecologists

Average Annual Pay: $192,780

One-Year Change: +5.0%

Employees in Field: 19,750

Best-Paying State: Wisconsin

The Job: Diagnose, treat and help prevent diseases of women, especially those affecting the reproductive system and the process of childbirth.

No. 5 Oral and Maxillofacial Surgeons

Average Annual Pay: $190,420

One-Year Change: +6.7%

Employees in Field: 4,760

Best-Paying State: Michigan

The Job: Perform surgery on mouths and jaws.

No. 6 Internists, General

Average Annual Pay: $176,740

One-Year Change: +5.7%

Employees in Field: 46,980

Best-Paying State: Wisconsin

The Job: Diagnose and provide nonsurgical treatment of diseases and injuries of in

No. 7 Prosthodontists

Average Annual Pay: $169,810

One-Year Change: +0.3

Employees in Field: 370

Best-Paying State: New Jersey

The Job: Construct oral prostheses to replace missing teeth and other oral structures.

No. 8 Physicians and Surgeons, All Other

Average Annual Pay: $165,000

One-Year Change: +6.3%

Employees in Field: 26,850

Best-Paying State: Minnesota

The Job: All physicians and surgeons outside of the main specialties.

No. 9 Family and General Practitioners

Average Annual Pay: $161,490

One-Year Change: +5.1%

Employees in Field: 106,210

Best-Paying State: Wisconsin

The Job: Diagnose, treat and help prevent diseases and injuries that commonly occur in the general population.

No. 10 Chief Executives

Average Annual Pay: $160,440

One-Year Change: +6.0%

Employees in Field: 301,930

Best-Paying State: New Jersey

The Job: Determine and formulate policies and provide the overall direction of companies or private- and public-sector organizations within the guidelines set up by a board of directors.

No. 11 Dentists, General

Average Annual Pay: $154,270

One-Year Change: +4.9%

Employees in Field: 85,910

Best-Paying State: Alaska

The Job: Diagnose and treat diseases, injuries and malformations of teeth and gums and related oral structures.

No. 12 Psychiatrists

Average Annual Pay: $154,050

One-Year Change: +4.4%

Employees in Field: 22,140

Best-Paying State: Nevada

The Job: Diagnose, treat and help prevent disorders of the mind.

No. 13 Pediatricians, General

Average Annual Pay: $153,370

One-Year Change: +5.6%

Employees in Field: 29,170

Best-Paying State: Kentucky

The Job: Diagnose, treat and help prevent children's diseases and injuries.

No. 14 Dentists, All Other Specialists

Average Annual Pay: $142,070

One-Year Change: +18.0%

Employees in Field: 4,770

Best-Paying State: Oregon

The Job: Specialist dentists excluding oral and maxillofacial surgeons, orthodontists and prosthodontists.

No. 15 Podiatrists

Average Annual Pay: $125,760

One-Year Change: +5.0%

Employees in Field: 9,670

Best-Paying State: Idaho

The Job: Diagnose and treat diseases and deformities of the human foot.

Originally posted at InjuryBoard by Mike Ferrara

Consequences of Dental Negligence

Jim Lewis — Mon, 07 Dec 2009 19:32:54 GMT

Dental care and treatment mostly consist of non-invasive procedures and for the most part your visit to the dentist is usually routine and injury free. However, a small percentage of dental visits aren’t so kind. In fact, there can be certain complications that could arise as a result of simple procedures gone horribly wrong and that could bring life-altering changes in one’s oral health.

Examples of dental malpractice cases of which a patient can claim for compensation are:

-Nerve injuries affecting a patient’s ability to taste
- Nerve injuries causing paresthesia or permanent numbness in the tongue
- Complications arising from improperly completed crowns and bridges
- Dentists’ failures to take a patient’s relevant medical history into account before acting
- Certain complications from anaesthesia, even when releases are signed
- Unnecessary extraction of multiple teeth
- Extraction of wrong teeth

The examples listed above can be accountable as negligence on the part of the dentist. A dentist can also be sued for failure to do something which they could have done, such as failing to diagnose oral cancer and other serious oral problems. This is an act of omission by a dentist which could result in substantial harm to the patient. If you have been a victim of a dental negligence and malpractice, you should seek a competent personal injury lawyer who can help you in this matter.

About the Editors: Shapiro, Cooper, Lewis & Appleton personal injury law firm (VA-NC law offices ) edits the injury law blogs Virginia Beach Injuryboard, Norfolk Injuryboard, and Northeast North Carolina Injuryboard as a pro bono service to consumers.

Originally posted at InjuryBoard by Jim Lewis

Straight Talk on Tort Reform from Texas

Bret Hanna — Mon, 23 Nov 2009 23:20:37 GMT

Texas passed sweeping tort reform legislation in 2003 that, to a great extent, eliminated medical malpractice cases in the Lone Star State. Jennifer Bard is the Alvin R. Allison Professor of Law and director of the Health Law Program at Texas Tech University School of Law and an adjunct associate professor in the Department of Psychiatry, Texas Tech University School of Medicine, and she incorporates the Texas experience with tort reform into her analysis which concludes that such measures do not reduce health care costs. Here is her piece which appeared Saturday in the Houston Chronicle:

It's not as rare as you think for President Barack Obama and Gov. Sarah Palin to be in complete agreement on an issue of national importance.

In August, she wrote on her Facebook page that “we cannot have health care reform without litigation reform.” Speaking to the American Association of family physicians a few weeks later, President Obama said, “I have talked to enough doctors to know that defensive medicine may be contributing to unnecessary costs. ... So I am proposing that we move forward on a range of ideas about how to put patient safety first and let doctors focus on practicing medicine.” Both of them are wrong. There is no evidence to suggest that limiting the rights of individuals to bring lawsuits will either lower the cost of health care or increase its quality. In fact, were this true, Texas would have the cheapest and best health care in the nation. The provisions of the tort reform legislation passed in 2003 have essentially eliminated medical malpractice suits. Indeed, things are so bad the lawyers for the insurance companies are complaining about the loss of business.

The only evidence we have that defensive medicine, defined as doing extra tests or surgery based on fear of litigation, drives up costs is from the least reliable source possible — the doctors themselves. Doctors' objections to law suits aren't financial — they are philosophical. Doctors are on the whole good people who devote their lives to helping others. Yet somewhere in their training they acquire the idea that this puts them beyond the constraints and hassles faced by every other professional. Lawsuits are time-consuming and embarrassing. They require explaining one's actions to a group of nondoctors, something doctors feel inappropriate. What doctors want isn't reform, it is an exemption. And that's just not how we do things in the United States.

As in all other cases involving a professional, every medical malpractice case depends on another physician's testimony that the offending doctor caused the patient's harm by acting below the standard of a reasonable physician in similar circumstances. To say that a jury isn't qualified to choose the testimony of one expert witness over another in a medical malpractice case is to say they shouldn't be allowed to do so in cases involving exploding tires because they are not automobile engineers. Unless Obama and Palin are interested in trading in our legal system for one with less citizen input — say one more like China's — then not only isn't litigation reform a necessary part of health care reform, it is no part of health care reform.

But don't throw out the baby with the bath water. Perhaps doctors are practicing defensive medicine, but that doesn't mean litigation reform will change their habits. First, it is hard to attribute overtesting to fear of litigation when the current payment system financially rewards doctors and hospitals for the number of tests they order and procedures they run, rather than on the time they spend talking to the patient to find out what's wrong. Second, it is entirely possible that those interested in selling them malpractice insurance have greatly inflated the risk. After all, given the relative rareness with which medical malpractice suits are brought, fear of litigation should no more be motivating a doctor's decisions than fear of alien abduction.

No one has ever suggested that civil litigation can directly reduce medical error. Reducing infection rates by adopting uniform protocols for hand-washing and instrument sterilization is not the same as pressuring a company to withdraw a defective product from the market. But our system of civil justice, as outlined in the United States Constitution, is not to blame for health costs or medical malpractice. Health reform can take place without litigation reform — both systems may be broken but they are not dependent on each other.

So perhaps if Obama and Palin really want to lower the cost of health care and improve its quality, they should be listening to economists and safety experts rather than either doctors or lawyers.

This analysis is spot on and from someone who does not appear to have "skin the game." Yes she is a lawyer, but not one that makes her living representing those injured by medical malpractice or working for the insurance companies that hire lawyers to defend doctors when claims are pursued against them for malpractice. We should consider her analysis in the objective light in which it is presented.

Originally posted at InjuryBoard by Bret Hanna

Health Care By The Numbers

Mike Bryant — Sat, 21 Nov 2009 12:58:00 GMT

The Congressional Budget Office released a report this past month that found: wait for it, that if we had tort reform money will be saved. Shocking, if you stop making the negligent and the grossly negligent pay for the damage they do, they get to keep their money. Those reports don't surprise me , nor do they scare me as a trial lawyer. Because, the question keeps going back to: saves money for whom?

The only way you get savings from the system is at best indirect. That the Medical Malpractice Insurance companies will do something that they have in the past been reluctant to do, which is lower premiums, and as a result, those savings will be passed on to the health Insurance companies, who will then pass those savings onto the consumers. The other potential savings will be that all of these doctors who are prescribing unnecessary and fraudulent tests will stop doing this and there will be savings there. This is a lot of very questionable gate keepers who we are expecting to do the right thing for others and not just for themselves.

But let's look at the CBO's numbers. Surprise, they are exactly what trial lawyers have been saying; one half of one percent of the whole system. Yes, this is the shocking number that some Republicans are claiming can be used to fix the whole medical reform mess. Now, I'll admit that 11 billion dollars is a lot of money, but what does it compare to?

There is the report from Washington University, which found that in 2007 there was $2.7 trillion (yes that's a trillion) spent on health care overall. So to start with, we are really talking about numbers that need to be compared, and not just blow horned by town meeting paid infiltrators.

The same report found that there is also $68 billion that is lost in fraud. That number works out to the fraud being 80% by the medical providers ( the ones that we want to give the savings back), 10% by consumers, and balance by others such as the insurance companies themselves.

Let's look at the Insurance numbers as the American Association for Justice did recently,they found:

Today, while premiums and health care costs skyrocket, malpractice insurers have average profits higher than 99 percent of Fortune 500 companies.

The key findings of the report, which analyzes the annual financial statements of the 10 largest U.S. medical malpractice insurers, include:

The average profit of these insurance companies is higher than 99 percent of all Fortune 500 companies and 35 times higher than the Fortune 500 average for the same time period.

Malpractice insurers have seen their profit margins range from 5.9 percent to 74.8 percent, with an average of 31.2 percent.

Medical malpractice insurers have underestimated profits and overestimated losses, creating overblown insurance “crises” to garner support for limiting patients’ legal rights. Then years later after the “crises” abated, revised filings show the companies were never in the financial peril they claimed.

After overestimating losses, insurers have since reported that losses over the last five years have been approximately 13.5 percent lower than initially reported.

By overestimating losses, companies have underestimated profits. Insurers averaged about 5.1 percent higher profits last year and 12.4 percent higher profits two years ago; these levels of profits will likely rise as upward revisions are made.

Medical negligence laws were passed under false pretenses. Overblown reported losses were used by the insurance industry to justify new measures restricting the rights of those injured by medical negligence.

Yep, there is gobs of money being made, and I would bet they are funneling right into those U S Chamber ads that are calling for tort reform and fighting against a system they just love to gouge.

There are far better ways to fix this system and to pay for it without changes that deny people their constitutional protections.

Originally posted at InjuryBoard by Mike Bryant

The Attacks On The Health Care Plan: Looks Like They Were Planned Out

Mike Bryant — Sat, 21 Nov 2009 09:48:58 GMT

Are you torn with all of the health care debates? What is being talked about and what isn't? Who is behind what and what do the leaders of our country really want to do? Who has bought off who and why is anyone saying that they would rather keep things the way they are?

I've talked to enough people about this issue to know that many people are confused about why this is such a battle. Why the plan isn't just to sit down and to work something out and get a plan put together. It's been interesting to discuss with people the role that trial lawyers are playing in the issue and also the roles of the insurance companies. I, like many of the people here at the Injuryboard, have been out front talking about the issues every chance we get.

What was illuminating was to run across the game plan of the opposition to any change. Rolling Stone recently uncovered this interesting memo:

The 10 Rules For The Stopping Of The "WASHINGTON TAKEOVER” Of Health care

(1) Humanize your approach. Abandon and exile ALL references to the “health care system.” From now on, health care is about people. Before you speak, think of the three components of tone that matter most: Individualize. Personalize. Humanize.

(2) Acknowledge the “crisis” or suffer the consequences. If you say there is no health care crisis, you give your listener permission to ignore everything else you say. It is a credibility killer for most Americans. A better approach is to define the crisis in your terms. “If you’re one of the millions who can’t afford health care, it is a crisis.” Better yet, “If some bureaucrat puts himself between you and your doctor, denying you exactly what you need, that’s a crisis.” And the best: “If you have to wait weeks for tests and months for treatment, that’s a health care crisis.”

(3) “Time” is the government health care killer. As Mick Jagger once sang, “Time is on Your Side.” Nothing else turns people against the government takeover of health care than the realistic expectation that it will result in delayed and potentially even denied treatment, procedures and/or medications. “Waiting to buy a car or even a house won’t kill you. But waiting for the health care you need – could. Delayed care is denied care.”

(4) The arguments against the Democrats’ health care plan must center around “politicians,” “bureaucrats,” and “Washington” … not the free market, tax incentives, or competition. Stop talking economic theory and start personalizing the impact of a government takeover of health care. They don’t want to hear that you’re opposed to government health care because it’s too expensive (any help from the government to lower costs will be embraced) or because it’s anti-competitive (they don’t know about or care about current limits to competition). But they are deathly afraid that a government takeover will lower their quality of care – so they are extremely receptive to the anti-Washington approach. It’s not an economic issue. It’s a bureaucratic issue.

(5) The health care denial horror stories from Canada & Co. do resonate, but you have to humanize them. You’ll notice we recommend the phrase “government takeover” rather than “government run” or “government controlled” It’s because too many politician say “we don’t want a government run health care system like Canada or Great Britain” without explaining those consequences. There is a better approach. “In countries with government run health care, politicians make YOUR health care decisions.THEY decide if you’ll get the procedure you need, or if you are disqualified because the treatment is too expensive or because you are too old. We can’t have that in America.”

(6) Health care quality = “getting the treatment you need, when you need it.” That is how Americans define quality, and so should you. Once again, focus on the importance of timeliness, but then add to it the specter of “denial.” Nothing will anger Americans more than the chance that they will be denied the health care they need for whatever reason. This is also important because it is an attribute of a government health care system that the Democrats CANNOT offer. So say it. “The plan put forward by the Democrats will deny people treatments they need and make them wait to get the treatments they are allowed to receive.”

(7) “One-size-does-NOT-fit-all.” The idea that a “committee of Washington bureaucrats” will establish the standard of care for all Americans and decide who gets what treatment based on how much it costs is anathema to Americans. Your approach? Call for the “protection of the personalized doctor-patient relationship.” It allows you to fight to protect and improve something good rather than only fighting to prevent something bad.

(8) WASTE, FRAUD, and ABUSE are your best targets for how to bring down costs. Make no mistake: the high cost of health care is still public enemy number one on this issue – and why so many Americans (including Republicans and conservatives) think the Democrats can handle health care better than the GOP. You can’t blame it on the lack of a private market; in case you missed it, capitalism isn’t exactly in vogue these days. But you can and should blame it on the waste, fraud, and abuse that is rampant in anything and everything the government controls.

(9) Americans will expect the government to look out for those who truly can’t afford health care. Here is the perfect sentence for addressing cost and the limited role for government that wins you allies rather than enemies: “A balanced, common sense approach that provides assistance to those who truly need it and keeps health care patient-centered rather than government-centered for everyone.”

(10) It’s not enough to just say what you’re against. You have to tell them what you’re for. It’s okay (and even necessary) for your campaign to center around why this health care plan is bad for America. But if you offer no vision for what’s better for America, you’ll be relegated to insignificance at best and labeled obstructionist at worst. What Americans are looking for in health care that your “solution” will provide is, in a word, more: “more access to more treatments and more doctors…with less interference from insurance companies and Washington politicians and special interests.”

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Reading this list, it seems clear that there are a group of people who don't want to get anything done. The people who ran the country for eight years and put profits in front of people and drove many parts of the economy into the dirt. It is made up of people who scream capitalism all the way to the bailout window. People who need to either come to the table and talk sense or get out of the way and let those who care about the consumer put together something that will truly make a difference.

Originally posted at InjuryBoard by Mike Bryant

Health care Reform Must Put Patients First Because Medical Errors Happen All Too Often

Christopher Nace — Mon, 16 Nov 2009 10:00:52 GMT

There has been a lot of emphasis during the health care reform debate on medical malpractice reform. But this report by CNN's Heidi Collins demonstrates just how frequently egregious medical errors occur.

There are also other stories about the effects of medical errors at www.98000reasons.org. Take for instance the story of Blake Fought:

The 98000 Reasons website has six other stories of families harmed by medical errors. The fact is that medical errors happen. And people are injured and have their lives turned upside down by these errors. Limiting the rights of these victims to be compensated for the errors of others would serve to only put the cost of these mistakes on the shoulders of those who are injured through no fault of there own.

In short, it would be a travesty of justice to limit patient rights to protect the profits of insurance companies. Health care reform must put patients first, not insurance companies. Please visit 98000 Reasons, listen to the stories, and contact your Senators and ask them to vote against any limitations on patient rights.

Originally posted at InjuryBoard by Christopher Nace

New York State Bar Takes Stand Against Tort Reform

Bret Hanna — Sun, 15 Nov 2009 14:33:10 GMT

The New York State Bar Association took a strong stand against tort reform last Friday. President Michael Getnick issued a statement calling on the U.S. Senate to reject calls for caps on pain and suffering damages in medical malpractice cases as part of health care reform. Here is the press release:

ALBANY, NY (11/13/2009)(readMedia)-- New York State Bar Association President Michael E. Getnick (Getnick Livingston Atkinson & Priore, LLP and of counsel to Getnick & Getnick of New York City), in a letter today, called on the U.S. Senate to reject any proposals that would discriminate against medical malpractice victims while also jeopardizing public safety by capping the amount of compensation that victims could receive for pain and suffering. Such proposals have been raised in the debate over national health care reform legislation.

In his letter to U.S. Senators Charles Schumer and Kristin Gillibrand, President Getnick restated the State Bar's long-held position that the authority to change medical liability laws should rest with the states and not the federal government.

"As Senate activity on this topic continues, I want to reiterate our long standing objections to those tort and medical malpractice reform proposals that have resurfaced as part of the current debate," wrote Getnick. "We object to legislation to cap pain and suffering compensation for victims of medical malpractice. Such caps would unjustly discriminate against classes of accident victims who suffer devastating physical and psychological losses.

"For over 200 years the authority to promulgate medical liability laws has rested with the states, which are the repository of experience and expertise in these matters," Getnick noted in the letter. "I am pleased that the House, in passing Bill 3962, The Affordable Health Care for America Act, refrained from including provisions advocated by some members that would have resulted in federal tort laws encroaching upon the authority of the states."

Getnick noted that legislation recently passed by the House of Representatives would provide for incentive payments to states that adopt alternative medical liability laws without imposing caps on damages and other unacceptable measures. According to Getnick, providing such incentive payments to states is an appropriate alternative to proposals that would impair the ability of victims to seek remedy in the justice system.

"In assessing the current tort system, it is at least as important to consider the victims of malpractice in comparison to those who cause them personal injury," he said. "We have seen in the past that the attack of tort reformers is a movement that favors cost savings over quality and that emphasizes the corporate bottom line over safety of the public.

"As the health care debate progresses with you and your colleagues in the Senate we strongly urge Congress to focus on health care problems and to ensure that the individual victims of medical malpractice are not placed in a secondary position as compared to those who have created the very victims from which they seek protection in the name of tort reform," Getnick concluded.

A copy of the letter can be found here. This very public support for the civil justice system and the rights of those injured by medical malpractice should be applauded and endorsed by Bar Associations across the country. In addition, all citizens interested in preserving their rights should contact their senators and convey the same message.

Originally posted at InjuryBoard by Bret Hanna

Protect Yourself From Bad Doctors

Ed Normand — Sat, 14 Nov 2009 17:03:00 GMT

Did you know...

While the new health care bill is being debated in Washington, there is something individuals can do right now to ensure that they are receiving the best possible care. Most of the doctor malpractice in the country is committed repeatedly by just a small percentage of physicians. The Florida Department of Health publishes public profiles for every licensed medical doctor, osteopathic doctor, chiropractor, podiatrist, and advanced registered nurse practitioner practicing in the state. Each profile contains self-reported information about the medical practitioner that may help in selecting a doctor, or finding out more about the health professional that is currently treating you. The website also lists whether the practitioner carries medical malpractice insurance, and whether they have been involved in any medical malpractice litigation. For the website, go to: Medical Malpractice .

Originally posted at InjuryBoard by Ed Normand

Woman's Experience at Hospital Exemplifies Problems with Mistaken Identity and Wrong-Site Surgeries

David Mittleman — Fri, 13 Nov 2009 10:12:47 GMT

When Kerry Higuera started bleeding three months into her pregnancy, she instantly rushed to the hospital. Fearful that she was miscarrying, she knew that seeing her doctor would most likely give her the best chance to save her pregnancy. Unfortunately, that decision ultimately changed her life for the worse.

Upon arriving at Banner Thunderbird Medical Center in Glendale, Arizona in February 2008, a nurse lead Higuera to a room and was instructed to wait for a doctor. However, just a few minutes later, another nurse poked her head into the room and told Kerry that the doctor wanted her to undergo a CT scan of her abdomen. Kerry questioned the nurse, but followed along anyway, confident that her doctor knew the correct procedures to perform.

After the CT scan, the nurse led Kerry back into a waiting room. Soon, the emergency room physician, two radiologists, and a representative from the hospital’s human resources came to speak with her. With such large crowd, Kerry was positive that it was bad news that she had miscarried. In fact, it was much worse news. According to the group of doctors, there were two Kerrys in the hospital that night: Higuera and another, younger woman named Kerry who needed the CT scan. Immediately, the hospital staffers offered to purchase Kerry Higuera flowers and also offered her coupons for free meals in the hospital cafeteria.

No large studies have been done on the effects of CT scans on fetuses. However, experts say that a fetus exposed to radiation can, in some cases, develop physical and mental growth problems. Kerry is being represented by legal counsel in the matter and appears to be moving toward litigation against the hospital, according to a CNN report. Her child, Nathan, is now 15 months old and shows signs of delayed growth. Kerry feels guilty for going to the emergency room that night in February 2008. However, her story is not unfamiliar: patients trust doctors and other hospital staff to be informed and aware.

Indeed, the five wrong-site surgeries at Rhode Island Hospital exemplify the fact that it isn’t uncommon for a hospital patient to fall victim to hospital errors. However, according to Jim Conway, the senior vice president of the Institute for Healthcare Improvement, there are some steps you can follow to avoid falling victim to wrong-site surgery or mistaken identity blunders. For example:

1. Say: "My name is Mary Smith, my date of birth is October 21, 1965, and I'm here for an appendectomy."

You might feel like an idiot, but say this to every doctor, nurse, and technician who takes care of you.

2. Say: "Please check my ID bracelet."

Hospital staff is supposed to confirm your identity in at least two ways, according to Nancy Foster, vice president for quality and patient safety policy at the American Hospital Association. One of those ways is to check your ID, or scan it if it has a bar code. Another way is to ask you for your name and date of birth.

Of course, you should check your bracelet to make sure the information on it is correct.

3. Say: "Please look in my chart and tell me what procedure I'm having."

If a nurse states that you're having an appendectomy and she's right, that's not enough, because that nurse won't necessarily be there with you in the operating room.

"Make sure the nurse is looking at your chart when she tells you what procedure or test you're having," says Ilene Corina, president of PULSE, New York, a grass-roots patient safety organization.

4. Say: "I want to mark up my surgical site with the surgeon present."

Hospitals these days often hand patients a pen and ask them to mark where they're going to have surgery. Corina says you should do it in front of the surgeon who will be with you in the operating room, and not just in front of the person who hands you the pen.

"If you mark it and the surgeon doesn't know about the marking, what's the point of marking it?" Corina asks.

5. Be impolite.

Foster, the executive at the hospital association, gives this example.

"If the nurse comes in and says, 'Are you Mary Jones?' and you're really Miriam Jones, you might just nod your head and say yes because you're too polite to correct her," Foster says. "Don't be polite."

Higuera now wishes she'd been impolite and followed her instincts.

Originally posted at InjuryBoard by David Mittleman

Tort Reform Myth Debunked - Damages Caps do not Lower Malpractice Insurance Premiums

Bret Hanna — Thu, 12 Nov 2009 16:49:08 GMT

We've all heard the claims. Jackpot payouts in medical malpractice cases have caused malpractice insurance premiums to go so high that doctors are leaving certain specialties or leaving the profession altogether. To combat this, tort-reformers everywhere call for caps on non-economic damages as a magic bullet for fixing this "problem." Utah is no different.

The Utah Medical Insurance Association, or UMIA, bills itself as the "premier non-profit professional liability insurance in the Intermountain West." The UMIA website offers the following description of the company:

UMIA is a physician owned and directed medical liability insurance company. Practicing physicians are its foundation and strength. As UMIA enters its 28th year of service of the physicians of the Intermountain area, the vision of the future includes a dedication to:

Maximizing the value of the insured’s premium dollar

Reducing patient injury by improving patient care

Providing innovative leadership in fair patient compensation for culpable liability claims

Developing effective practice and risk management programs

The Utah Medical Association started UMIA in response to a loss of affordable and available medical liability insurance because the commercial multi-line insurers providing coverage at that time withdrew from the market or raised rates astronomically. UMIA is a reciprocal inter-insurance exchange providing liability insurance in Idaho, Montana, Utah, and Wyoming.

UMIA is financially strong with assets at 185.9 million and 43.1 million in surplus. The Company is rated (A-) Excellent by the AM Best Company and has held this rating for many years. A major strength is the leadership provided by the Board of Directors and Board of Governors, both comprised of practicing physicians who understand the needs, trends, concerns, and pressures of current medical practice. Competent and responsive service to policyholders had been and remains the essential element of the Association’s mission and success. Risk management and loss prevention activities remain a high priority.

The bulk of UMIA policies are written in Utah which has been "tort-reformed." Here is a list of "reforms" that have passed in Utah:

Shortened Statute of Limitations §78B-3-404

Statute of Repose (claims expire even if patient unaware of injury such as undiagnosed cancer) §78B-3-404

Abrogation of Collateral Source Rule (negligent care provider gets the benefit of insurance that the patient paid for or that taxpayers provide) §78B-3-405

Cap on Noneconomic Damages §78B-3-410

Periodic Payment of Future Damages Delaying by Years or Decades the Patient’s Receipt of an Award §78B-3-414

Arbitration Agreements §78B-3-421

Restriction on Informed Consent Claims §78B-3-406

Restriction on Warranty, Guaranty and Contract Claims §78B-3-408

Limits on Use of Admissions of Fault §78B-3-422

Governmental Immunity Act Time Limits for Claims against the University, residents and other trainees

Governmental Immunity Act total damages limits in certain circumstances §63G-7-604

Immunity for Emergency Medical Assistance (including paid services) provided by governmental employees §63G-7-302(5)(s)

Increased Burden of Proof for Emergency Room Care §58-13-2.5 et seq.

Notice of Intent Required Before Lawsuit §78B-3-412

Prelitigation Screening Mandatory Before Lawsuit §78B-3-416

Federal Tort Claims Act limits on Claims Against the VA Hospital

Absolute Immunity for 911 Calls §69-2-6

Prohibition on Access to and Use of Peer Review, Incident and Credentialing Materials §26-25-1

Limit on Attorney Fees §78B-3-411

Limitation on Therapist’s Duty to Warn §78B-3-604

Limitation on Damages for Loss of Consortium §30-2-11(7)

Good Samaritan Act §78-4-501

Extension of Good Samaritan Act and Health Care Providers Immunity from Liability Act to nurse practitioners §58-31b-701

Immunity for care provider who renders care at scene of emergency without duty to respond §58-13-2

Immunity (except for gross negligence or willful misconduct) for uncompensated care §58-13-3

Immunity for certain care providers during emergency declarations §26-49-501

Retired health care provider volunteers are immune from suit if care is uncompensated §58-81-104(5)

Separate prior trial on any statute of limitations issue §78B-2-114

Most of these "reforms" have been in place for years, if not decades, so there can be no argument that not enough time has passed to evaluate their effectiveness. This is particularly true when looking at the effectiveness of the caps on non-economic damages which injured patients have suffered with for a long, long time. Given that, let's look at 5 years worth of historical data taken from UMIA's 2008 Annual Statement:

In 2008, gross premiums written were $70,607,300, up $16 million from 2004.
In 2008, the total assets of UMIA were $230,718,580, up $64 million from 2004.
In 2008, the total losses paid were $26,601,949, up $13 million from 2004, but only $2.5 million from 2006.

These numbers demonstrate that UMIA took in almost 3 times more just in premiums in 2008 than they paid out in claims and a similar ratio applies for each year. Moreover, these numbers underscore that damages caps do not lower premiums. Just because tort reformers repeatedly claim a connection between damages caps and lower premiums does not make it so.

Originally posted at InjuryBoard by Bret Hanna