Sunday, July 27, 2008

More motives for the bad doctors' unethical acts

From the June 3, 2005 Illinois State Bar Association Bar News:

A world-renowned professor was commissioned by the ISBA to perform a scholarly study of the effects of medical liability cases on the medical profession (and in particular, physicians, surgeons and insurance rates).

According to the ISBA-commissioned study, jury awards apparently have not caused the recent spike in doctors' liability insurance premiums, caps won't result in smaller payouts in the vast majority of cases, and doctors are not fleeing Illinois.

The most interesting part of this study is that it was "deep sixed." The common refrain has been that tort reform (including the Illinois General Assembly's medical malpractice reform act which proposes to set caps on non-economic damages and create a currently nonexistent medical disciplinary board) is crucial to ensure patient access to physicians.

What about the concern (as discussed in the Duke/Vidmar study) about the health of the malpractice companies?

1. Is is true that outlays of money from the insurance companies constituted less than 1% of all payouts (settlements, verdicts, etc) from medical malpractice case over numerous years?

2. Is it true that the insurance companies made bad investments and lost lots of money in the stock market just like many people?

3. What about doctors and surgeons who are partial owners of their own health insurance plan to their patients (i.e. Dr. Chris Dangles of Carle Clinic Association and Health Alliance Medical Plans or HAMP)? Were surgeons such as Dr. Dangles motivated by his own personal financial situation to encourage patients with HAMP insurance to undergo unnecessary surgery?

Tough economic times hit even surgeons and maybe that is the motivation to make bad business decisions by practitioners and insurance players.

Professor disputes view that jury awards raise rates

[First, bloggers and blogettes - before you read what the ISBA reports, read what the author says at the actual study:]

A study of medical malpractice in Illinois by a Duke University law professor reveals that the tort system is not the cause of dramatic increases in malpractice insurance premiums for doctors.

Prof. Neil Vidmar was commissioned by the Illinois State Bar Association to analyze all available data to determine whether medical malpractice claims and jury awards had increased in recent years.

Vidmar's study looked especially at cases in Cook, DuPage, Madison and St. Clair Counties during the period from 1992 to 2005.

"The Illinois tort system does not appear to be the cause of the undisputed fact that doctors' liability insurance premiums showed dramatic rises," Vidmar concluded. "It is time to consider other causes."

In light of the importance of the ongoing legislative debate and apparent lack of a factual basis for evaluating competing claims, ISBA President Ole Bly Pace III submitted copies of the report and summaries of its findings to all members of the Illinois General Assembly.

"Some proposals under consideration could have far-reaching implications," Pace noted, "not just for future victims, but also for the public's necessary perception that our justice system provides an equitable means of deciding between the rights of all parties."

Vidmar's study, titled "Medical Malpractice and the Tort System in Illinois," also disputes claims that doctors are leaving the state, or certain areas of the state, as a result of jury awards.

Vidmar cites a steady increase in the absolute number of total patient care physicians in Illinois, from 25,514 in 1993 to 30,264 in 2003, the latest year for which American Medical Association figures are available.

With some year-to-year variations, an upward or steady trend was found for Ob-Gyn specialists and neurological surgeons, two practice areas experiencing steep insurance premium increases.

The study also says that American Medical Association statistics through 2003, the latest year available, do not support claims of a loss of doctors in Madison and St. Clair Counties.

Vidmar, a recognized researcher and author on the subject of medical malpractice litigation, is the Russell M. Robinson II Professor of Law and Professor of Psychology at Duke.

He is the author of the 1995 book, "Medical Malpractice and the American Jury: Confronting the Myths about Jury Incompetence, Deep Pockets and Outrageous Damage Awards," published by University of Michigan Press.

Among other findings in the study:

* For Cook and DuPage Counties, the data show no upward trends in malpractice claim filings or in filings per 100 treating physicians from 1994 through 2004, when adjusted for population growth.

* There has been no increase in jury trials or in plaintiff win-rates between 2001 and 2004 in Cook or DuPage.

* For Madison and St. Clair counties, there have been only 11 jury verdicts favoring plaintiffs in medical malpractice cases since 1992. Only two of these cases were in excess of $1 million, and one of them was overturned on appeal.

* There is no evidence to support the perception that medical malpractice jury trials in these counties are frequent or that jury verdicts for plaintiffs are outrageous.

An analysis of data from Cook and DuPage counties revealed that a proposed $500,000 cap on non-economic damages would have resulted in a minimal reduction in overall payouts to plaintiffs and would be unlikely to affect doctors' liability insurance premiums.

But such a cap would result in significantly reduced compensation for some individual plaintiffs who suffered catastrophic injuries due to medical negligence.

Pace also pointed out that detailed records on all closed medical malpractice claims have been collected by the Illinois Department of Insurance, but to date, those records have not been disclosed publicly or to the General Assembly.

Legislation capping non-economic damages in medical malpractice cases and providing regulation of insurance premiums was passed in the waning hours of the session May 30. (See Capitol Chronicles)

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