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H. Clinton and B. Obama on Malpractice: Worth Reading

H. Clinton and B. Obama on Malpractice: Worth Reading

May 25, 2006

This week's New England Journal of Medicine has an article by Sens. Hillary Clinton and Barack Obama attempting to create a progressive space on medical malpractice reform. I think their ideas and proposals deserve serious consideration. Click here for free access (thanks, NEJM for making this available).

The title says it all: "Making Patient Safety the Centerpiece of Medical Liability Reform." Phony malpractice reform, advanced by Pres. Bush, Sen. Frist, and the AMA, among others, says the malpractice "crisis" is all about irresponsible trial attorneys and "frivolous" lawsuits. This stance ignores the elephant in the room -- the epidemic of medical errors, poor quality, and bad care rendered to patients everywhere. Caps on non-economic damages -- advanced by the above -- discriminate against all victims of bad care except the affluent, and especially discriminate against those with middle to low incomes or no incomes.

Patients and consumer groups agree the current system stinks. Only a tiny fraction of the truly injured really get help. Bush/Frist/AMA reforms would only reduce that number. Hats off to Clinton and Obama for seeking a solution that helps physicians without screwing injured patients. Here's a sample:

In 2002, the University of Michigan Health System launched a program with three components: acknowledge cases in which a patient was hurt because of medical error and compensate these patients quickly and fairly; aggressively defend cases that the hospital considers to be without merit; and study all adverse events to determine how procedures could be improved. Before August 2001, the organization had approximately 260 claims and lawsuits pending at any given time. As of August 2005, the number had dropped to 114 (see graph). The average time from the filing of a claim to its resolution was reduced from approximately 21 months to less than 10 months. Annual litigation costs dropped from about $3 million to $1 million. The health care system has begun to reinvest these savings in the automation of its patient-safety reporting systems. Since the implementation of this program, the University of Michigan Health System has expanded the number of practicing clinicians and faculty members in high-risk fields such as obstetrics–gynecology and neurosurgery.

Let's figure out how to improve our awful liability system AND improve patient safety at the same time. That's a goal on which we can link arms. What say you, Mass. Medical Society? We're game...