“there is a right way and a wrong way to reduce the costs of defensive medicine.”

Just one of each? How . . . symmetrical.

But the article then proceeds to describe what seem to me two wrong ways; wrong because they each involve a significant amount of arbitrary straitjacketing

1. Cap on malpractice awards
2. Safe harbor for physicians who meticulously follow and do not depart from “standards”.

#1 straitjackets the patient. Even Emanuel et al. don’t like that.

#2 straitjackets physicians. It sounds like cookbook medicine to me. That is apparently not what Emanuel et. al. intend, but there can be no assurance that cookbook medicine wouldn’t rapidly emerge once such a safe harbor were enacted into law. Even I don’t like that.

But the article also says that the guidelines must: “Consider . . . patient preferences as appropriate.” Doesn’t that allay my worry? No, it doesn’t. It doesn’t tell me who will consider my preferences; or who will actually decide what is “appropriate” – my physician? The committee that wrote the standards? The government bureaucrats who wrote the regulations implementing the legislation? A judge?

No, I don’t like this because I still expect my physician to treat me as a unique human patient, not as some sort of average mammal with a heart beat. Averages mislead; on average, Americans have one ovary and one testicle. Is it not still true that that averages have no clinical meaning?