It is hard to comprehend how much health care money is wasted each year due to the legal industry.
From malpractice insurance payments and defensive medicine to the huge volume of medical records now generated simply to cover all
possible angles of a potential lawsuit. Recently a patient of mine was in France and had the onset of a cardiac condition. She
was treated for five days in a French hospital and discharged back to me. I received a full copy of the medical records by mail.
The records were medically complete and detailed. Interestingly, there were less pages from her five day stay in the hospital
than in one of our routine emergency visit charts. They seem more centered around medical information rather than around legal
protection.
Malpractice decisions have in some cases increased the chance of a bad outcome.
When the “clot busting drugs” first became available for use in stroke patients we had some leeway on a time frame in which to
use them. There is a risk anytime these drugs are used though the balance is that often this is the only chance one has to avoid
certain paralysis. The current "legal" time window is three hours. At this point in time, if a stroke workup is completed
at 3 hours and 15 minutes, the option to use this treatment will not be extended. We know if there is a bad outcome we will
be sued due to being 15 minutes past the accepted time window. If we explain this to the stoke patient and if they would
rather risk death than to be severely disabled, we could still be sued by the patient or the surviving family simply because they
were under duress at the time of the stroke and therefore could not really give informed consent. In other words, we have very
little option to treat this patient as they might want.
In the same pattern, I saw a patient
in an outlying Emergency Room when I was a resident who had suffered a bee sting respiratory failure and was brought in by ambulance.
He was a lung cancer survivor by almost ten years, but still had a “Do Not Resuscitate” order on his medical record. He
was unconscious and no family was available. I elected to put him on the ventilator anyway and within two hours he recovered
enough to breath on his own. He was thankful. Never-the-less, for a solid year I worried about the possibility of
a lawsuit for violating his written request. If he had died in the process or with in a year of the event, a gold-digging next
of kin and a clever lawyer could have made a case against me.
What is needed are standing 3 member arbitration
panels that render binding judgments in the face of a bad outcome. Reasonable monetary damages could be awarded for ongoing
care, treatments and support and would be based on similar judgments from across the entire medical system. Any practitioner
mistakes could be tracked specifically and in aggregate to allow re-education or disciplinary action for the practitioner as needed
and the data could be reviewed for system wide problems that also need correcting. This would eliminate the legal industry mantra
that some lives are worth more than others simply because they earn more money. The latter is the reason we have life insurance.
In medical circles, the life of a janitor is just as important as the life of a corporate executive.
The malpractice/legal
industry has no place in medical care!