Tuesday, March 12, 2013

Sue Everyone: It Pays

      If you haven't heard enough from me about why doctors might not want to practice medicine, here's another one for the stack.
     The specter of malpractice risk has grown to mammoth proportions..
     Remember when 45 people were killed a few months ago by tainted steroid shots?  The New England compounding pharmacy responsible for that meningitis outbreak has filed for bankruptcy because it can't settle the more than 700 claims against it.
     There isn't enough money in the insurance carrier's coffers.  
     So, who are the plaintiff's lawyers suing next?   The doctors who ordered and administered the shots.  
     "Patients have sued doctors successfully in the past after being injured by medical products under claims such as failure to warn, medical negligence ad product liability," says a report in American Medical News.  "The suits can mean faster and larger payouts for plaintiffs than those against drug or device makers."
     In other words, doctors are easier targets than pharmaceutical companies.  They're unlikely to go to trial, and they carry malpractice insurance and have personal assets that can be targeted for payouts.
     How can doctors be expected to "warn" patients about the thousands of "potential" hazards inherent in any treatment--especially the risks of prescription medications and injectable drugs?   The package inserts for these products list hundreds of possible side effects and hazards, including death.  Is a note in the chart likely to protect a patient against a lawsuit if the patient says, "The doctor didn't tell me this could happen"?
     "In July 2012, a San Diego court granted a $7.5 million award to a patient against her doctor and a manufacturer after she allegedly acquired frostbite from using a cold-therapy medical device," the same article reports.
     "In 2011 physicians with the Rehabilitation Institute of Chicago, without admitting wrongdoing, agreed to pay a $3.7 million settlement to the family of a patient who allegedly died after being administered a fentanyl patch.  The woman's husband sued the institute and its doctors for negligence for prescribing the patch."  (If the doctor hadn't prescribed pain medicine, the doctor could have been sued for not treating the patient's pain.)
     The claim made by attorneys is that the doctor "knew or should have known" about the potential risks for patients, and should have informed them, and documented what was said.
     No doctor wants to be sued.  But if doctors informed patients of all the potential risks of treatments, and put it all in writing, there wouldn't be time for a the doctor-patient relationship.
     So doctors choose to spend time with patients, rather than exercising self-protection.  They push the feeling of being "at risk" below consciousness, where also reside anxiety about healthcare reform, anger over the dictatorship of insurance companies, and the strangeness of having to work within a system that is at cross-purposes when it comes to patient care.  
     Do we take good care of patients, and put ourselves at risk?  Do we forgo treatment options because they might be harmful, or ignore remote dangers in order to help people feel better? 

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