Evidence-Based vs. Standard-of-Care in Malpractice suits
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http://www.nytimes.com/2010/10/21/opinion/21orszag.html?_r=2&src=me&ref=general
Malpractice lawsuits are one of the reasons that healthcare costs are so damn astronomical, but little has been done to solve this problem. The approach suggested by the Republicans is to set caps on liability, but honestly this does nothing to solve the problem, and can be harmful. What if the suit is warranted, and the damages are greater than the cap? It's unfair to the victim in this case. Caps also do nothing to protect doctors who are unfairly charged with malpractice--they just limit the amount that they can be sued for.
What is a better solution? Change it so that doctors who follow evidence-based medicine--meaning, following current research and guidelines--are protected. Most of the current malpractice laws focus on "standard-of-care" practices. This means that if most of the doctors in your area do a certain test/treatment for a disease, if your doctor does not do it (even if the decision is based on current research and guidelines, and in accordance to your personal needs), you can sue your doctor. This leads to unnecessary testing and/or treatment, because then doctors will be forced to follow the standard-of-care rather than what is truly best for you.
As the article states, this sort of tort-reform would actually promote the adoption of best practices.
Malpractice lawsuits are one of the reasons that healthcare costs are so damn astronomical, but little has been done to solve this problem. The approach suggested by the Republicans is to set caps on liability, but honestly this does nothing to solve the problem, and can be harmful. What if the suit is warranted, and the damages are greater than the cap? It's unfair to the victim in this case. Caps also do nothing to protect doctors who are unfairly charged with malpractice--they just limit the amount that they can be sued for.
What is a better solution? Change it so that doctors who follow evidence-based medicine--meaning, following current research and guidelines--are protected. Most of the current malpractice laws focus on "standard-of-care" practices. This means that if most of the doctors in your area do a certain test/treatment for a disease, if your doctor does not do it (even if the decision is based on current research and guidelines, and in accordance to your personal needs), you can sue your doctor. This leads to unnecessary testing and/or treatment, because then doctors will be forced to follow the standard-of-care rather than what is truly best for you.
As the article states, this sort of tort-reform would actually promote the adoption of best practices.
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animefreak_usa
Child of Samael
Should have a peer review board before they can sue... maybe a pre hearing before someone could sue.
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If I had to choose between the two, I would support evidence based malpractice. If you have signs of lupus then the doctor shouldn't do tests for hepatitis just because that is what everybody else is doing (yes, I realize that the two have next to nothing in common and logically a doctor would never test for such but, it's a hypothetical goddamn it).
An alternative is the "sorry works" system which is when a doctor reports medical errors to the administrators who then begin the process of negotiations. This system is already in place in the University of Michigan health system and has already reduced lawsuits, cut litigation costs and sped the resolution of cases.
Another alternative is the "health courts" which is the system the Scandinavian countries and New Zealand have in place. Basically, it's a no-fault system much like workers compensation.
Here is a link to a article written by Barack Obama and Hilary Clinton (in 2006) discussing malpractice reform.
Link
An alternative is the "sorry works" system which is when a doctor reports medical errors to the administrators who then begin the process of negotiations. This system is already in place in the University of Michigan health system and has already reduced lawsuits, cut litigation costs and sped the resolution of cases.
Another alternative is the "health courts" which is the system the Scandinavian countries and New Zealand have in place. Basically, it's a no-fault system much like workers compensation.
Here is a link to a article written by Barack Obama and Hilary Clinton (in 2006) discussing malpractice reform.
Link
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The article Penguin linked makes a great point: a big factor in what makes patients decide to sue is the lack of communication between the patient and doctor. However, the current practices WRT malpractice torts actually make the communication worse, as doctors are afraid to discuss controversial procedures or errors for fear of being sued.
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This is a very interesting topic, I should have posted on this sooner as a medical student.
The hard part from being a doctor is to ensure the patient that what happened to them is not malpractice. For example, in my country there's once a case where an under-aged mother (let's say 18), with little educational background, having two babies inside her womb, and must be labored through Cesarean section, but one of the baby is already dead. The doctor have two choices, to labor both of the babies but risking the mother's life because of massive blood loss or leaving the dead baby inside and labor it per vaginam (normal, through vagina) after one or two weeks after the section but also risking the mother's life indirectly by the risk of poisoning her with the dead baby. In case such as these, where communication is limited because it's an emergency case and the educational background of the mother are little to none, the doctor must choose the safest way by leaving the baby inside. But after the dead baby is born, the mother sued the doctor because of malpractice, and until now the outcome is still hasn't clear.
Both of evidence-based and standard of care dictates that both of the options are harmful for the mother, so the doctor must choose the smallest risk.
The hard part from being a doctor is to ensure the patient that what happened to them is not malpractice. For example, in my country there's once a case where an under-aged mother (let's say 18), with little educational background, having two babies inside her womb, and must be labored through Cesarean section, but one of the baby is already dead. The doctor have two choices, to labor both of the babies but risking the mother's life because of massive blood loss or leaving the dead baby inside and labor it per vaginam (normal, through vagina) after one or two weeks after the section but also risking the mother's life indirectly by the risk of poisoning her with the dead baby. In case such as these, where communication is limited because it's an emergency case and the educational background of the mother are little to none, the doctor must choose the safest way by leaving the baby inside. But after the dead baby is born, the mother sued the doctor because of malpractice, and until now the outcome is still hasn't clear.
Both of evidence-based and standard of care dictates that both of the options are harmful for the mother, so the doctor must choose the smallest risk.
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In situations like that it's really difficult, but I believe evidence-based suits would be better, since you can show that either way, there is significant risk to the mother, so no matter what you did, something was gonna get screwed up.
And I guess this is something that patients have to learn as well--going to the doctor doesn't mean you will be cured. The human body is way more complicated than cars or computers, and more shit can go wrong, even when doctors are doing everything right.
And I guess this is something that patients have to learn as well--going to the doctor doesn't mean you will be cured. The human body is way more complicated than cars or computers, and more shit can go wrong, even when doctors are doing everything right.
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Nekohime wrote...
And I guess this is something that patients have to learn as well--going to the doctor doesn't mean you will be cured. The human body is way more complicated than cars or computers, and more shit can go wrong, even when doctors are doing everything right.
That's right. Because we are trying to understand the mystery created by (I'm Catholic) our God, so the medicine knowledge is also termed ' the nearest knowledge with God', and what doctors can do can't fight the will of God.