Letter: Readers comment on Medical Economics stories

Sea change in medicine

I want to thank Elizabeth A. Pector, MD, for such an insightful article regarding the bureaucratization of medicine ("Sea change in medicine: Will we sink or swim?" [From the Board], February 10 issue). I have felt the same frustrations but do not express myself as well as Dr. Pector.

Keep up the good work!

A jury of peers not easy to find

I read with great interest the article "The case for medical courts" (by Christopher W. Roberts, MD, JD, FACP, FACEP, February 10 issue) and the opinion by the trial lawyers that a specialized court would not be reflective of the public view or the common good that juries should provide. The current system is reflective of the public's misconception that doctors make a lot of money, live in luxurious homes, drive luxury vehicles, and, as such, can easily afford to give up some of this wealth.

I seem to recall the phrase "entitled to a trial by a jury of one's peers." Yet how many people on a jury are a physician's peers, in the educational sense? If my spouse, a social worker with a master's degree, were selected for a malpractice trial, she would be disqualified because she could not be expected to render an impartial verdict.

Yet if you were to poll jurors regarding physicians' income, lifestyle, etc., do you believe that they would say the above misconceptions are not true? Of course not! This makes them prejudiced against the defendant; however, these questions are never asked in jury selection. How can you expect a jury of laypeople-many with educations far below that of the defendant-to learn all the science, art, and nuance of the practice of medicine during a 2-week trial and then render an opinion against a defendant who has trained and practiced for years? I would accept a malpractice law judge as my educational and socioeconomic peer.

The only people who would be shortchanged in a specialized court system would be the lawyers, whose fee schedules would be curtailed-similar to an HMO for the legal system. Any attempt to institute a "loser pays" system would be shut down by the American Civil Liberties Union and the trial lawyers as totally unfair to the poor. But everyone would be guaranteed access to the specialized courts at an affordable cost with competent representation and fair and swift awards. Refusing to come before the specialty court and demanding a jury trial could bring with it the risk of "loser pays," along with the potential for higher rewards. Trial lawyers and plaintiffs alike would take heed before deciding to proceed to this venue.

The legal system in our country began with noble intent but has been hijacked by the trial lawyers and will continue to serve their needs under guise of "the public good." Only when someone has the resolve to stand up to the trial lawyers and revamp the system will things become fair for all involved. As we move toward a more socialized type of medical system, the impact of the current legal system becomes more apparent, and the need to change it becomes imperative.

PETER J. KUZMICK, DO
Manasquan, New Jersey