Letters to the Editors

February 18, 2005

Join the club; It's a dilemma

Join the club I read with interest, shock, and then a growing sense of irony the October 8 article, "We settled, I lost." ( http://www.memag.com/memag/article/articleDetail.jsp?id=127166) And for the first time in ages, I felt compelled to comment.

My heart goes out to general surgeon Bob J. Herrin, the physician who got duped in the settlement process. But, what really fascinates me is the way the defense attorneys were paid.

As the article states: "Under a controversial but increasingly common arrangement, some malpractice carriers are paying their defense attorneys a flat-rate, per-case fee . . . whether the case goes to trial or not. For those attorneys, that system of payment creates obvious economic pressure to settle." The earlier they settle, the more money they make. As at least one defense lawyer admitted, it creates a potential conflict of interest.

Doctors are also judged on the outcomes-specifically, the health status of their patients. We are unable to scrimp on care, lest we not earn a glowing report card from the HMO, or get any quality-incentive dollars.

I, for one, welcome the attorneys to this crazy system. With our legal brethren in the fray, maybe the time for reform will come at last!

Patricia J. Roy, DO

Muskegon, MI

It's a dilemma To effect any real change in the malpractice insurance picture ["Behind the med-mal crisis," January 7 at http://www.memag.com/memag/article/articleDetail.jsp?id=141338], all sides need to agree on a number of mandatory requirements. Here are the six steps-all of which come with a guarantee of immunity from suit or retaliation-that I would recommend:

1. Reporting of medical errors/near-misses;

2. Physician apologies for adverse outcomes;

3. Disclosure to patients of adverse outcomes and early claim resolution;

4. Risk management training, including verification of implementation;

5. Patient satisfaction tracking, to identify doctor outliers for compulsory patient satisfaction training;

6. Regulation of inadequate insurance rates.

Additional benefits to implementing these steps would be better healthcare and more satisfied doctors and patients.

James H. Cunningham Jr., Pres.

Cunningham Group

Oak Park, IL

In 1972, I became one of the first physicians in the state of Michigan to be refused medical liability insurance. Just before my application for coverage landed at Medical Protective, the insurance company of choice for Michigan physicians, it dropped out of the market.

It took an act of the legislature to create a fund to insure doctors like me; and I had to borrow an additional $1,000 to help capitalize the newly-formed company.

The real tragedy of the med-mal crisis, which doesn't come out in your article, is that it turns young, idealistic physicians into fearful, nervous providers-with one eye always on their own risk, and another on the bottom line (we have to pay those frighteningly high premiums). Leaving not much vision left to actually look at the patient as a human being who is suffering and in need of comfort.

In an effort to be "fairly compensated," patients and lawyers have effectively destroyed the system that would provide them with uninhibited, enthusiastic, self-sacrificing care.