Practice Beat

March 22, 2002

Malpractice, Our Web Poll, Patient Safety, Managed Care

 

Practice Beat

Jump to:Choose article section...Malpractice: The terrorist attacks had an impact on trials, too Our Web Poll Patient Safety: A doctor wins millions when blame is the name of the game Managed Care: Do doctor financial incentives encourage more care—or less?

Joan R. Rose

Malpractice: The terrorist attacks had an impact on trials, too

The top 10 jury verdicts totaled $5.7 billion last year, but could have been significantly higher if not for the events of Sept. 11, according to Lawyers Weekly USA's annual roundup of the top jury verdicts in cases brought by individuals. The newspaper found that just one of the top 10 was handed down after the terrorist attacks. "In a typical year, the last four months yield three or four of the largest awards," notes attorney Paul J. Martinek, Lawyers Weekly USA editor-in-chief. "The fact that there was only one top 10 award in that time period suggests that a number of big-money trials were delayed."

Three of the highest awards went to plaintiffs in medical malpractice suits: wrongful death of a nursing home patient ($312.8 million, Texas), hospital care of a pregnant woman ($114.9 million, New York), and delivery of a brain-damaged infant ($107.8 million, New York).

Our Web Poll

Was psychiatrist Robert Weitzel, subject of the article "Mercy—or murder?" (Jan. 11, 2002) guilty of killing five patients by ordering morphine for them? Seventy-one percent of the doctors responding said No.

NO71%

YES

Patient Safety: A doctor wins millions when blame is the name of the game

A jury has awarded $4.2 million to an oncologist who claimed she was "scapegoated" by Dana-Farber Cancer Institute in Boston after a Boston Globe health columnist died there eight years ago. (See "Who caused this tragic medication mistake?" Oct. 8, 2001.) The 1994 overdose received widespread publicity and is considered a watershed in the field of patient safety.

The jury found that the hospital and its former chief of staff injured Lois Ayash's reputation and violated her privacy during its probe of the fatal overdose, and awarded Ayash $2.1 million. The newspaper and a former reporter had already been found liable by a judge in 2001 because they refused to reveal confidential sources despite the judge's order; the jury ordered the newspaper to pay the physician another $2.1 million.

Managed Care: Do doctor financial incentives encourage more care—or less?

While some HMOs' and medical groups' financial incentives create a conflict of interest between a doctor's personal financial gain and patients' best interests, they're more likely to be aimed at improving patient care. The Center for Studying Health System Change (HSC), a nonpartisan policy research organization funded by The Robert Wood Johnson Foundation, recently analyzed productivity (a standard measure) and three performance-based measures that are used to adjust base compensation and/or bonuses.

Researchers found that physicians are more likely to be subject to incentives that may encourage use of services (patient satisfaction, productivity, and quality) than to financial incentives that may limit care (profiling).

Overall, doctors are far less likely to face performance-based incentives (32 percent) than the productivity incentives (72 percent) that traditionally have been used to determine compensation.

% of physicians whose practices were affected by financial incentives in 1999

Type of practicePerformance-basedProductivity
ProfilingSatisfaction/quality
Small group (2-9 doctors)10%16%72%
Medium group (10-29 doctors)101870
Large group (30+ doctors)143281
Staff/group-model HMO337065
Other*163772
The author is a Contributing Writer.

 

Joan Rose. Practice Beat. Medical Economics 2002;6:18.