A noteworthy podcast: I join Dr. Saurabh Jha [@RogueRad on Twitter] for an lengthy discussion of how American tort and medical malpractice law has changed over the past century, similarities and differences with Britain, how ethics in the legal field stacks up against ethical trends in medicine and the pharmaceutical business, contingency fees, the successes and shortcomings of legislated tort reform, trends in the courts, incentives for medical testing, and much more. It’s all part of Dr. Jha’s podcast series, associated with the Journal of the American College of Radiology. You can listen here.
- Wrong on many other issues, the American Medical Association is right to resist an artificial 3-day limit on opiate prescriptions [Jeffrey Singer, Cato; Jacob Sullum]
- “Does Ride-Sharing Substitute for Ambulances?” [Leon S. Moskatel and David J. G. Slusky, Cato Research Briefs in Economic Policy No. 114]
- Fourth Circuit tosses Maryland law banning “price gouging” of “essential” generic drugs, finding that state violates Dormant Commerce Clause by presuming to control transactions entirely outside its boundaries [Zack Buck, Bill of Health; Stephen McConnell, Drug and Device Law]
- President Trump signs “right to try” legislation expanding right of terminally ill patients to enter unapproved therapies; squaring this with existing FDA regulation may present knotty problems [Michael Cannon, Cato; Michael Maharrey (“In fact, victories in 40 state legislatures preceded Trump’s signing ceremony”); earlier here, here, and at Cato Unbound last year] More cautions from Jim Beck on liability angle [Drug and Device Law]
- Florida, departing from other states’ practice, caps its outside lawyers’ recovery at $50 million: “Latest Wave Of State Opioid Lawsuits Shows Diverging Strategies And Lawyer Pay Scales” [Daniel Fisher, Forbes]
- In medical innovation, “equality is a mediocre goal. Aim for progress.” [Tyler Cowen]
- Outcry among British doctors after trainee pediatrician convicted of negligent homicide in death of patient following systemic errors at understaffed hospital [Telegraph, Saurabh Jha, Medscape, General Medical Council]
- “There’s no particular reason to think that smokers will be happier with denatured tobacco than drinkers have been with weak beer.” [J.D. Tuccille on FDA plans to reduce nicotine level in cigarettes]
- “Why Doesn’t the Surgeon General Seek FDA Reclassification of Naloxone to OTC?” [Jeffrey Singer, Cato]
- “1 in 3 physicians has been sued; by age 55, 1 in 2 hit with suit” [Kevin B. O’Reilly, AMA Wire] “Best and worst states for doctors” [John S Kiernan, WalletHub]
- “Soon came a ‘routine’ urine drug test, ostensibly to ensure she didn’t abuse the powerful drug. A year later, she got the bill for that test. It was $17,850.” [Beth Mole, ArsTechnica]
- Milkshakes could be next as sugar-tax Tories in Britain pursue the logic of joylessness [Andrew Stuttaford, National Review]
Should gatekeepers to the medical profession test prospective doctors on their adherence to tenets of social justice? [Devorah Goldman, Weekly Standard]
New York Times deep dive into the ethical morass of pelvic-mesh-suit recruitment, in which lawsuit shops recruit women into often unnecessary and sometimes dangerous surgery to remove implanted material, a step needed for claims to be lucrative. [Matthew Goldstein and Jessica Silver-Greenberg, New York Times] Opening paragraphs:
Jerri Plummer was at home in Arkansas, watching television with her three children, when a stranger called to warn that her life was in danger.
The caller identified herself only as Yolanda. She told Ms. Plummer that the vaginal mesh implant supporting her bladder was defective and needed to be removed. If Ms. Plummer didn’t act quickly, the caller urged, she might die.
And how, in the age of HIPAA, did the recruiter on the phone come to know so very much about the medical history of the woman being pitched? What follows is a story of conduct that is shocking, appalling, unethical — but neither surprising nor unusual to those of us who have been writing about the abuses of the litigation business for many years. Plaintiffs suing over back pain after accidents, for example, are regularly steered into unnecessary back surgery, and plaintiffs in the breast-implant litigation were steered into removal surgeries for which the only indications were legal, not medical. These alas are the incentives of injury litigation: run up the medicals (the higher the bill for testing and therapy, the higher the claim value) and if you’re suing over a drug or therapy itself, maybe disengage from it to show your fears are genuine.
All that said, congratulations to the Times and reporters Goldstein and Silver-Greenberg for an investigation that shines a bright light on the need for reform. More: Beck.
- “The dominant narrative about pain treatment being a major pathway to addiction is wrong, [and] an agenda heavily weighted toward pill control is not enough.” [Sally Satel on origins of opioid crisis]
- The press gets it wrong: “A Young Mother Died Because Her Flu Meds Were Too Expensive – Or Did She?” [Josh Bloom, ACSH]
- New research brief: tort reform could have effects in both directions on innovation [Alberto Galasso and Hong Luo, Cato]
- Appalling: editor of The Lancet extols Marx as a guide to understanding medical science [Theodore Dalrymple, Law and Liberty]
- “We harbor a suspicion that half the drug/device tort cases we encounter are really medical malpractice cases in search of a deeper pocket” [Stephen McConnell, Drug & Device Law Blog]
- Should the Food and Drug Administration concern itself with the effect of its decisions on drug prices? [David Hyman and William Kovacic, Regulation mag]
Today, organizations of all kinds are ruled by the belief that the path to success is quantifying human performance, publicizing the results, and dividing up the rewards based on the numbers. But in our zeal to instill the evaluation process with scientific rigor, we’ve gone from measuring performance to fixating on measuring itself. The result is a tyranny of metrics that threatens the quality of our lives and most important institutions. In this timely and powerful book, Jerry Muller uncovers the damage our obsession with metrics is causing–and shows how we can begin to fix the problem.
Filled with examples from education, medicine, business and finance, government, the police and military, and philanthropy and foreign aid, this brief and accessible book explains why the seemingly irresistible pressure to quantify performance distorts and distracts, whether by encouraging “gaming the stats” or “teaching to the test.” That’s because what can and does get measured is not always worth measuring, may not be what we really want to know, and may draw effort away from the things we care about. Along the way, we learn why paying for measured performance doesn’t work, why surgical scorecards may increase deaths, and much more. But metrics can be good when used as a complement to—rather than a replacement for—judgment based on personal experience, and Muller also gives examples of when metrics have been beneficial.
Also with an epigraph from Aaron Haspel: “Those who believe that what you cannot quantify does not exist also believe that what you can quantify, does.”
- “Oral Contraceptives Should be Free (From the Third-Party Trap)” [Jeffrey Singer, Cato]
- Arbitrator awards $17.5 million after hospital fires neurosurgeon: in retaliation, or because he didn’t disclose problems with the law unrelated to practice? [Mike Baker, Seattle Times]
- Idea of empowering government to rewrite recipes for packaged food has gotten more traction in British public health sector than here [Sean Poulter, Daily Mail]
- Encyclopedia time: you can look up a variety of health topics in the now-online Encyclopedia of Libertarianism including Michael Cannon on health care generally, Gene Healy and Bruce Benson on illegal drugs, Jeffrey Schaler on psychiatry. And the Routledge Encyclopedia of Libertarianism includes Jessica Flanigan on libertarianism and medicine;
- If treatment deviating from the standard of care is the standard for malpractice, then some patients in pursuit of unconventional therapy choose it, and the law of waivers and of assumption of risk should respect their autonomy [Nadia Sawicki via TortsProf]
- About the Washington Post’s big opioid-legislation exposé, a few questions [Robert VerBruggen]
- Whether or not California’s 1975 MICRA law limiting medical liability serves as a model for anything national, its results merit study by other states [H. Thomas Watson, Robert H. Wright, and S. Thomas Todd, WLF]
- No, Kaiser Health News and Scientific American, a 1-in-3 rate of post-marketing drug safety alerts does not prove FDA too lax [“Scott Alexander,” Slate Star Codex]
- Jim Hood Watch: “Mississippi AG, with the help of outside attorneys, sues pharma companies over allegedly unapproved drugs” [Jessica Karmasek, Legal Newsline]
- When deconstruction met evidence-based medicine and denunciations of “microfascism” ensued [Dave Holmes et al., International Journal of Evidence-Based Healthcare, 2006 via Nicholas Christakis]
- Sen. Joe Manchin’s “approve one opioid, yank another from market” bill to tie FDA hands is a bad idea [Jeffrey Singer, Huffington Post]
- Death by a thousand clicks: what Boston doctors can’t stand about electronic medical records [John Levinson, Bruce Price and Vikas Saini, WBUR]