That makes me chuckle. I’ve heard this line before. Only the “bad docs” are sued, and if we rid ourself of them, malpractice will go away. My experience and the experience of my colleagues is the opposite. Anyone on the chart, no matter how peripherally involved will dragged through the mud.

You can’t. That’s the problem. Look at the failure to warn cases like Levine. Finding the warning, which said be careful, not good enough is hideously irrationality. People fight hard to get into drug trials where the data is insufficient for any warning labels.

So the hospitals that you are afillitated with are no longer allowing doctors to deliver babies because of “economics, not based on any claims etc.”? This sounds like an insurance remimursement issue, not a caps issue. Or am I still missing something?

As for your second point, re: rural vs. metro doctors. What is funny is that my sister practices in a rural area. As of the 2000 census, says Wikipedia, the city population was a little over 13,000.

I have never heard of a neurosurgeon practicing in a small market. I would imagine that rural hospitals do not have the facilities, demand, or money to entice a neuro. to set up shop.

I have never sued a GP or internist. In fact, the only non-surgeon that I have ever sued has been a chiropractor, and I do not lump chiros. and doctors in the same category. Don’t even get me started on chiros.

There is a common thread between most (if not ) all of the surgeons that I have sued: a terrible, foreign medical school; a terrible residency; locums stints all over the county; never staying in one place for any significant amount of time; and, prior privileging issues (usually resulting in a suspension).

The political climate is too much to take a case where Mr.-otherwise-good-doctor made a split-second error. I sue doctors that are ill equipped and should not be doing complicated surgery in the first place. I do not sue good doctors, nor will I ever sue a good doctor who simply made a wrong call. Mistakes happen.

Regarding your point that you would be “crazy to want to expand or even continue coverage,” I represent several physician practice groups (they all know and are totally fine with me suing other docs; they get updates on my cases) and a lot of good docs. are self-insuring with other good practice groups. They peer review each other cases, etc.., and they are saving lots of money.

B.rad, what do you think would be a fair amount to cap for pain and suffering?

It was a decision based on economics, not based on any claims etc. The community loses out.

It’s nice that your sister makes near 7 figures and 50K is sure a small chunk of that but the majority of docs make no where near that, especially ones who work in small rural towns, and especially ones who are GPs, internists. Their coverage cost is a MUCH greater proportion than your sister. And rural areas are where there is the greatest need for medical care. There is already a shortage of specialists like neurosurgeons who cover small hospitals and ERs, but but with the overturning of this law, you would have to be crazy to want to expand or even continue coverage. This is not good news if you or your loved one is in urgent need of one of these specialists. Paul, this is not a “scare tactic”, this is going to be the reality of the situation.

Regarding your second post, I am sorry that your premiums are rising. My sister — a surgeon — also complains that her premiums are rising, too. She complains that she paid $50,000 in premiums last year. But for someone that took home very close to seven figures last year, I do not feel too sorry for her.

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“Jay Markowitz” apparently believes that an injured person is entitled to pain and suffering damages only if she can use that money for something like a car or “vacation.” Wow!

Jay also writes that so “long as my future is secure and there is money to provide for that, what good would a ridiculously large sum of money be to me?” I have never seen a doctor carry more than a million in insurance and some carry none. One of my clients now has over 1.5 million in past medical bills (with most all subsequent providers) asserting liens, and over three million in future medical bills. So, no, one millions dollars does not take care of everything for my client.

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Bob Lipton’s post is bizarre. Regarding Bob’s second point (“I’d rather give all the money to you than have a lawyer grab 30% of it.”), I have rarely seen a malpractice carrier offer anything until we get a trial date, and that only happens after a few years.

We had one case where the negligence was so clear that the defendant doctor could not find an expert to support his theory. And having dealt with that doctor’s carrier and attorneys on prior cases, I know that they can find experts. The doctor also admitted to falsifying his op. notes. Yet, after three years consisting of two (unsuccessful) dispositive motions filed by them, depositions, discovery, an unsuccessful Daubert challenge to our experts, they did not offer one dime. They ended up paying what we demanded in the beginning. And I was later told by a former associate attorney for the defendant what they billed to defend that case — it was about 35% more than our fee.

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William Nuesslein: what if I could show that “a doctor acted deliberately” or was so grossly negligent that he knew we was putting a patient at risk? Would that satisfy you that the damages should not be capped?

Your example illustrates the unintended consequences of removing caps. Cases with negligence but with less of an emotional component (perhaps involving an elderly person with little or nothing to contribute to society) will be glossed over in favor of these highly emotional cases with the potential of a massive payout. Wheel out the patient at trial, especially a child, get a sympathetic jury and it’s all over for the defendant doctor. It’s a dog and pony show to extract as much money as possible.

Also, look at my example in the 1st comment. There really is not one positive outcome for hospitals and docs in Illinois as a result of the court ruling. Our group’s insurance rates were rising prior to the law capping pain and suffering a few years ago, then actually leveled off and decreased since the law was enacted. If I were a young OB doc who was just out of training, why would I choose to practice in Illinois? If people don’t think physicians make practice decisions for these reasons, they are mistaken. At a time when the health care system might be overhauled in an effort to get more people greater access to services, this certainly is not a step in the right direction.

For the benefit of a tiny few at the expense of the masses.

Mal-practice theory does not distinguish between adverse outcome and slip-shod doctoring because it is ex post facto. If a clever lawyer comes up with some tie in to something, no matter how ridiculous, money can flow. Juries tend to be oblivious to the fact that all decisions have some Type 1 and Type 2 errors. It is part of life. Medical care has some hazard to it no matter the quality of the doctor. Mayor Koch almost died from hearth problems, and now looks like a million bucks. His operations could very well have been catastrophic, but he had able surgeons and terrific luck.

I would ask Paul to think about appendicitis before the twentieth century being a death sentence. Childhood diceses are now rare and Polio has been eliminated from most of the world. The scurge of smallpox from the whole world.

When I imagine the scenario of being in a vegetative state, I would like to be relieved of life, and not that concerned with leaving money for a shirt-tail relative and a lawyer.

let us, for the moment, ignore the issue of what malpractice is outside of the legal issues. Let us consider this question:

How much would you charge me to come by your house every day and kick the s**t out of you so that you you are confined to your bed for the rest of your life. You breathe via a breathing tube; your adult children sleep at your bedside to turn you over so as to prevent bed sores; your adult kids bathe you and change your diaper; you communicate by blinking your eyes. But you are totally aware of all of this, and are expected to live for another thirty years without any material change in your situation. In other words, you are confined to your bed til you die.

How much would you charge me for this? Because that is what malpractice awards are. And I’d rather give all the money to you than have a lawyer grab 30% of it.

As for me, I hope that my family would shoot me and then basically destroy the doctor.

Bob

As long as my future is secure and there is money to provide for that, what good would a ridiculously large P&S award be to me?