I saw a news report last night stating that Dr. Red Duke is leading a group seeking legislative reform. The group is seeking 3 changes: 1) More money for trauma centers. 2) A cap on medical malpractice damages to help curb insurance rates. 3) Regulation to ensure that your insurance company pays the doctors accurately and promptly. This is bound to get my conservative bretheren up in arms. A year ago I would have been too. But ever since becoming the son in law of a physician, I have really looked at how this system works (or fails to work). I don't know much about point 1, but points 2 and 3 are a MUST. Doctors are experiencing financial difficulty at an alarming rate. Those who have an option are simply getting out. That's sad because we have lost many talented doctors. This situation has been outlined on an ABC news report a few months ago. Insurance companies (Aetna being among the worst) are taking an extraordinarily long time to pay doctors if they ever pay at all. When they do pay, the amount they are paying doctors for their services is steadily DECREASING. The result is that doctors must see more patients in order to recoup their costs and (gasp) take home a salary. When a doctor sees more patients they spend less time with each and the more likely it is that a mistake will be made. When a doctor makes a mistake it is called malpractice. Juries are giving out larger and larger judgments for acts of malpractice. The judgment amounts (even here in Texas) have become ludicrous. Many other damages are capped in Texas, why not med mal? Add to all of this that medical malpractice insurance rates DOUBLED last year in Texas (300% increase for hospitals). Did the amount of judgments double last year? I doubt it. So why the sharp increase? I have no idea. It does not make sense. This adds to the doctor's fixed costs and then they must see MORE PATIENTS in order to recoup. The problem becomes compounded. I think that the insurance companies should be forced to pay in a timely manner in accordance with the policy terms whenever a valid claim is made. This is NOT the norm today. The doctors have no right to sue the insurance companies in these instances. Their only recourse is against the patient (who likely cannot pay if a judgment is rendered). But the professional we entrust our lives to should not have to spend as much time with their lawyer as they do with their patients just to merely be paid for services rendered. This has become a very real problem and must be dealt with before (not if but before) it becomes a crisis.
Damn, we agree! The reason they want more trauma centers is because there are more than 40 million people in America with no health insurance. The only way for them to get their children or their family adequate healthcare is to go to a trauma center or emergency room. As it stands, most of the public hospitals have been eliminated putting a severe strain on other ER's. As a result, those who need trauma care can't get it and those without health insurance struggle to get any care at all for themselves and their families. Go Red.
So true, so true. After seeing the woes of the medical profession the past couple of years, I decided the best field for me was in business. I can easily say I was born to be a doctor, but the fiscal situation is not the most pleasant right now. After seeing an uncle almost paying $70,000 in malpractice insurance the field seemed riduculous to me. While most doctors pay near to 75% of that amount it is still absurd. This is the only profession held up to standards such as this. The problem is not the standards, but the awards the jury hands out, and the over zealous lawyers who bring these cases to court. Often times I have seen, the lawyer get more than half of what the award given. In my family the past 3 generation have been mainly filled in this medical profession. Initially I wanted to be a doctor when I was young, but after reviewing the actual realities and fiscal situation of medicine with my father and uncle, I could easily make the decision that there is no financial reward left in this field. Every doctor you talk to today, tells you to stay away from medicine. BTW I'm set to graduate from Business School next year, and already have signed a tentative contract with a firm in Chicago.
It was bound to happen at some point. But while trauma centers are important, without the other reforms there will be no decent doctors to staff them. At a recent meeting of a medical society in Texas, it was announced by the President of the Association that this year practitioners would see no profits. No profits!!!! Imagine if your professional association told you that you would essentially make no money. Add to the equation a few grand a month in student loan payments. The result is not pretty...bankruptcy. Doctor remuneration is a system into which they have precious little input and no rights to fight for their wages. These are men and women who have given so much of their lives honing this craft and making sacrifices (not to mention their families sacrificing). When you have Dr. Duke complaining about it, you know it has gotten way out of control. They should have a right to be paid for their services like anybody else. That is simply not accurate. There are 3 things to note here: 1) A lawyer typically has no idea what the standard of care is in a particular case. That is something doctors know. All the lawyer sees is a set of facts which on their face look egregious. No lawyer wants to get tagged with sanctions for a frivolous case. 2) ALL med mal suits plaintiffs must submit a cirriculum vitae of a medical expert (doctor) and a letter from said doctor stating that the case has merit. 3) Half? Are you sure? I have never seen a contingency fee larger than 40%. Anything higher could be challenged as unconscionable. When it is 40%, often the attorney pays the costs up front. In a med mal case these costs can be enormous (expert testimony, videos, etc.). We can debate lawyer fees all night long, but I don't think that most are unreasonable given the difficulty of prosecuting one of these cases successfully and the outlays made by the attorney along the way. Bottom line, while it is easy to just blame lawyers for the problems faced by doctors, it is way too simplistic an answer. More accurate is that insurance companies have caused this mess with high premiums for med mal coverage and slow to no payment on the patient side. Personally, I think the premuims have risen so fast is to cover their bad stock and real estate investments, not any wrongdoing by the doctors. Ridiculous.
I just read an article from US News and World Report from July 1, 2002. It basically says that healthcare is in a state of crisis in 12 states and teetering on crisis in 30 states. this is because doctors cannot forge a living and are shutting their doors. For instance a hospital that serves 1 million people in California currently has only one orthopedist. The other specialties in danger are cardiologists, OB-GYNs, and neurologists. These are not the folks you want driven out of business. In 1993, the average med mal judgment was $1.95M. In 1999, the average judgment was $3.5M. That is one hell of an increase folks. Why? Who knows. I hate to say it, but it looks like the plaintiff's bar may be out of control here.
Lack of timely payment from the insurance companies is a HUGE problem for doctors in Texas. Perry may be handed his a$$ this fall in the election because he vetoed a bill passed by the Legislature, supported by the profession, and promised passage by Perry. Perry was bought, plain and simple, and I hope it comes back to bite him. The doctors are furious.
Don't I know it. My father in law in a staunch conservative and refuses to vote for Perry. As much as I don't like Tony Sanchez I cannot in good conscience support Perry either.
Now that Dr. Duke has undertaken this cause, I wonder if there is anything that we can do in order to bring more pressure to bear. Perhaps we could start an online petition. Any thoughts...anybody?
I am for the reforms... I also think we could use some reform of the jury system. The fact that 12 people who are not bright enough to get out of jury duty can decide a case and award, in some cases, billions of dollars is preposterous. That may sound unamerican, but so is allowing businesses - even an entire profession - to be utterly destroyed by 12 idiots who have collectively have no earthly idea what the hell they are doing.
While I like the jury system, I can't help but see your point. The concept of the "standard of care in the medical profession" is difficult for most people to understand. People see a horribly damaged human being and decide that somebody must be held accountable -- even if nobody was really at fault. Med mal cases always have a very sympathetic plaintiff (either dead or severely impaired). Many times the doctor did the best they could with a person who was already damaged when they got to them. Medicine is a noble profession, but one where the practitioner should be allowed to see the fruits of their many years of labor and sacrifice. Save the huge judgments for the few doctors that deserve it (taking out the wrong lung, etc).
I don't know what I'm gonna do yet. I cannot vote for a guy who had the power to sign legislation to ensure that doctors can earn a living, and that we can all get care in the years to come. Not to mention the fact that he TOLD the doctors that he would sign the legislation...and then when he gets the chance it is vetoed. I agree with the conservative side of things. But I am sick and freaking tired of Republicans being in the pocket of insurance companies. It's too damned distasteful. Maybe I'll write in a vote for MadMax!!!!
