Bouncer Dies, and Family Blames City's Smoking Ban

[CyberGnu]

Spencer:

The reason physicians leave their field of medicine (its not like they stop being physicians) is not because they cant afford malpractice insurance it's because paying the premiums cuts into their high salaries. So its not like these Albert Sweitzers are being forced to give up their lifes work and live in the streets.

Well, it's called capitalism, isn't it? If the current system causes a severe shortage of obstreicians, shouldn't we change the system?

Maybe it is a question of perspective: It's not really the doctors we worry about, it is the people who, as Ming said, have to drive 6 hours for delivering a baby.

Everyone wants to blame the lawyers but lets not forget that a jury of peers decides these cases and sets the awards. You want someone to blame for the rising costs of malpractice insurance that cuts into physicians profits? Blame the juries who give the awards. Blame yourself.

Eh, how about the lawyers who donate substantial amounts of money to politicians just to make sure tort reform is not voted through? Can we blame them? After all, the jury of peers can only rule on cases withing the realms of the law...

[Sikander]

Originally posted by SpencerH

Except that the group who opposes these types of suggestions is the AMA. They want to keep their star-chamber powers, and it's abundantly clear that the boys-club members stick together. They don’t accept that anyone else (beside a judge) should be able to regulate the activities of their members. Why is it that I can go onto ebay and see how many complaints have been filed against someone who is going to sell me a cpu but I cant find out how many operations a surgeon has bungled who will do eye surgery on me?

I agree to some extent about being able to look at a physicians record. The only objection I would have to this is if this record is based on only complaints and / or suits that were lost in jury trials or to out of court settlements. There may well be an honest difference of opinion about whether a certain action or lack thereof falls short of a particular standard. The AMA's record on this issue is as you say deplorable, so much so that both my mother and step father resigned from that organization. But a degree of expert opinion in these cases is crucial IMO. We don't try military men in civilian courts for offenses committed which are connected to their service, as we rightly feel that this is such a specialized endeavor that those best situated to judge them are those who have lived in that same environment. The same could be said for medicine.

This sort of thing exists, but the degree which it actually functions varies quite a bit from place to place, and especially from era to era. My mother was one of the people who was chosen to sit on these review panels, and let me tell you she was a real hard as$. But the secrecy of these panels makes them invisible. They do overall have some good effect, but they instill no confidence in the public because they are invisible.

Originally posted by SpencerH
Sikander:

Lots of businesses have lots of high costs associated with them. Whether a physician spends 25% or 75% of their gross income on malprctice costs is irrelevant. Show me a starving physician on food stamps and we'll talk. I have no sympathy for these guys whining about malpractice costs while driving the latest mercedes.

I know a lot of upper middle class physicians. My friend Bart makes about $80,000 a year. He has three kids and works a lot of odd hours. Compare that to my girlfirend who is a pharmacist and makes $100,000 a year working nights. Bart drives a Bonneville, and my girlfriend drives a Saturn. I know probably 100 physicians, and only about 10 do I consider wealthy. The few truly wealthy physicians I know are usually business moguls, for instance starting labs or larger group practices. They are physicians, but most of their money comes from business deals rather than from salaries. One of the better fields for this is Radiology, where a wealthy or politically connected Radiologist can become very wealthy indeed.

I disagree that complaining about the costs of malpracrice insurance is whining about nothing. The bottom line is that we the consumer pay for this, either directly or by not being able to afford care that we need.

Originally posted by SpencerH
I have no sympathy for the Insurance companies.

Everyone wants to blame the lawyers but lets not forget that a jury of peers decides these cases and sets the awards. You want someone to blame for the rising costs of malpractice insurance that cuts into physicians profits? Blame the juries who give the awards. Blame yourself.

I'd be willing to blame myself, but I know damn well that any ambulance chaser in his right mind will never allow me to be seated on a jury. And for good reason.

Just because a majority decides something is right doesn't make it so, a principal vindicated with regularity in our tort system. The victims here are everyone who needs healthcare and hasn't been awarded a huge award, contingency fee or insurance sales bonus, that is to say the vast majority. While we need some way to protect the public from malpractice and malfeasance, I don't think the current system meets those goals with anything like the sort of efficiency that we demand from our other institutions. As medicine the last time I looked eats up about 12+% of our resources even a small increase in efficiency is going to pay large dividends.

[SpencerH]

Originally posted by CyberGnu
Spencer:

Well, it's called capitalism, isn't it? If the current system causes a severe shortage of obstreicians, shouldn't we change the system?

Maybe it is a question of perspective: It's not really the doctors we worry about, it is the people who, as Ming said, have to drive 6 hours for delivering a baby.

Exactly, medicine is a business, you dont have to spend a great deal of time in a major hospital (as I do) to know that. I'm all in favor of changing the tort system but I'm adamantly opposed to change if we continue to strengthen the monopoly stranglehold that the AMA has over virtually every aspect of medicine. The obstetricians dont think its worth their while to deliver babies, fine! We cut their stranglehold on the system and allow midwives to do deliveries without the OK from the hospital physicians (just as is available in every european country). Since the midwives dont have the power of the AMA to make demands we can start afresh with tort reform with respect to that aspect of medicine.

Eh, how about the lawyers who donate substantial amounts of money to politicians just to make sure tort reform is not voted through? Can we blame them? After all, the jury of peers can only rule on cases withing the realms of the law...

Whether laywers oppose tort reform while physicians support it doesnt change the absolute fact that juries set the amounts of damages. That aspect of a civil trial is not set by law (yet).

[SpencerH]

Originally posted by Sikander

I agree to some extent about being able to look at a physicians record. The only objection I would have to this is if this record is based on only complaints and / or suits that were lost in jury trials or to out of court settlements. There may well be an honest difference of opinion about whether a certain action or lack thereof falls short of a particular standard.

Thats's one of the AMA's arguments, that good physicians who are sued will have a bad record therefore the public should not have access to that info. I say that if we can see their records we will be able to tell the good from the bad. If you buy from ebay you can tell the good sellers who have a few bad comments from those who are genuinely bad.

I agree that there can be a genuine difference of opinion about whether an action or lack thereof falls short of a particular standard and can therefore be considered negligence. The other aspect of this though is simply allowing us to judge the skill of the physician. Wouldnt you like to know the real risk of laser eye surgery including the experience and skill of the surgeon? Of course you would.

The AMA's record on this issue is as you say deplorable, so much so that both my mother and step father resigned from that organization. But a degree of expert opinion in these cases is crucial IMO. We don't try military men in civilian courts for offenses committed which are connected to their service, as we rightly feel that this is such a specialized endeavor that those best situated to judge them are those who have lived in that same environment. The same could be said for medicine.

This sort of thing exists, but the degree which it actually functions varies quite a bit from place to place, and especially from era to era. My mother was one of the people who was chosen to sit on these review panels, and let me tell you she was a real hard as$. But the secrecy of these panels makes them invisible. They do overall have some good effect, but they instill no confidence in the public because they are invisible.

The AMA would have us believe that it's unfair to the physician to allow non-physicians to be involved in judging their work. What about their hippocritic oath to do no harm? Isnt keeping silent about sub-par physicians in order to possibly protect other physicians in conflict with that? I say its unfair to the public to not allow their (ie non-physicians) involvement in this matter. A jury of your peers can judge guilt or innocence in a murder trial but cant judge whether a surgeon has not been negligent outside of a civil court

I know a lot of upper middle class physicians. My friend Bart makes about $80,000 a year. He has three kids and works a lot of odd hours. Compare that to my girlfirend who is a pharmacist and makes $100,000 a year working nights. Bart drives a Bonneville, and my girlfriend drives a Saturn. I know probably 100 physicians, and only about 10 do I consider wealthy. The few truly wealthy physicians I know are usually business moguls, for instance starting labs or larger group practices. They are physicians, but most of their money comes from business deals rather than from salaries. One of the better fields for this is Radiology, where a wealthy or politically connected Radiologist can become very wealthy indeed.

The only physicians that I know that only make 80K are residents. Of course none of these are country GP's.

I disagree that complaining about the costs of malpracrice insurance is whining about nothing. The bottom line is that we the consumer pay for this, either directly or by not being able to afford care that we need.

I didnt say it was whining about nothing. Its whining about money, and sure the consumer pays for it. Lets reform the system but not until the physicians show public accountability.

..... While we need some way to protect the public from malpractice and malfeasance, I don't think the current system meets those goals with anything like the sort of efficiency that we demand from our other institutions. As medicine the last time I looked eats up about 12+% of our resources even a small increase in efficiency is going to pay large dividends.

Exactly, medicine is big business. Why do we continue to pretend that all physicians are altruists? If we dont allow microsoft and other monopolies to do as they wish why to we allow the physicians to do so?