Greedy Trial Lawyer
Seeing Clearly Now
Justice Clarence Thomas, Seething Black Conservative Hero Tells Us How Bad It Has Been
Category: Seeing Clearly Now
There have been more than a few voices expressing, in various ways, discomfort, surprise or puzzlement over the tone and substance of the Clarence Thomas media blitz publicizing the Justice's newly published book. A good example:
Is Clarence Thomas Playing the Race Card Again?
When I watched the Clarence Thomas confirmation hearings many moons ago, I was more than a bit surprised to hear him fight back with a claim that the Anita Hill allegations of the hearings were, in his words, a "high-tech lynching for uppity blacks."Judge Thomas once again walks down the road of blaming racism for the sexual harassment investigation.
Eric Turkewitz, New York Personal Injury Law Blog
My reaction to the Justice Thomas "Still Mad As Hell" book tour is that he has had ample time to put the past behind him and focus on performing the 40 year job he has been given by the American people, both black and white, liberal and conservative. Yet, he wants to relive every offense against his inner goodness so we can appreciate his triumph over evil.
None of us should be pleased to learn a Supreme Court justice continues to seethe over issues magnified by his need to brood about his perceived black victimhood and to polish his self image as the heroic, unbowed TRUE BLACK CONSERVATIVE. As I have stated before, Justice Thomas is the most persuasive argument for a reasonable term limit for all Supreme Court justices. Twenty years of warped judicial insight should be more than enough for our country to endure.
The Elaborate Ritual Improving Medical Care
Category: Seeing Clearly Now
Over at Bad Science Ben Goldacre discusses the placebo effect.
Now as I have said so many times before, the placebo effect is not about a sugar pill, it's about the cultural meaning of a treatment, and our expectations: we know from research that two sugar pills are more effective than one, that a salt water injection is better for pain than a sugar pill, that colour and packaging have a beneficial effect, and so on. Interestingly, there has even been a trial on patients with arm pain specifically comparing a placebo pill against a placebo ritual involving a sham medical device, modeled on acupuncture, which found that the elaborate ritual was more effective than the simple sugar pill. "Placebo" is not a unitary phenomenon, there is not "one type of placebo".
Ben provides some of the results of a recent study of the benefits of acupuncture for patients with chronic back pain. From his point of view the study has more to say regarding the placebo effect than acupuncture per se.
Firstly, 27% of the medical treatment group improved: this is an impressive testament to the well known healing power of simply "being in a trial", since medical treatment hadn't helped these patients for the preceding 8 years. Meanwhile 47% of the acupuncture group improved, but the sting is this: 44% of the fake acupuncture group improved too. There was no statistically significant difference between proper, genuine ancient wisdom acupuncture, and fake, "bung a needle in, anywhere you fancy, with a bit of theatrical ceremony" acupuncture.
Ben got me to thinking. If an elaborate ritual can work for patients might it also work to improve the conduct of doctors? If we could devise an elaborate ritual with a significant cultural meaning could we use it to upgrade the quality of medical care dispensed by the medical profession?
Then, it struck me - we already have such a ritual. It is called the medical malpractice claim.
Is The Tooth Fairy Causing Increased Hospital Infections?
Category: Seeing Clearly Now
Are hospital infections actually rising by over 7 percent each year? Or, is the apparent increase just a mirage resulting from hospitals doing a better job?
Upward Trend In Frequency And Cost Of Infections In US Hospitals
A new review of inpatient data from US hospitals shows that the number of infections caused by a common bacterium increased by over 7 percent each year from 1998 to 2003. The attendant economic burden to hospitals increased by nearly 12 percent annually. The research is published in the November 1 issue of Clinical Infectious Diseases, now available online.Staphylococcus aureus (also known as staph) is a significant cause of a wide range of infectious diseases in humans, ranging from minor skin infections to life-threatening diseases such as pneumonia and meningitis. In 1998, US hospitals reported a little more than a quarter-million staph infections and slightly over 7 percent of those patients died. By the final year of this study, 2003, hospitals reported nearly 390,000 infections, representing 1 percent of that year's inpatient stays.
The authors suggest one possible reason for the increase in infections is the documented increase of a particularly dangerous type of antibiotic-resistant staph infection known as MRSA (methicillin-resistant Staphylococcus aureus). A more benign possibility is that doctors and hospitals have improved their infection detection and reporting practices.
The third possibility is that the tooth fairy is not washing her hands as she makes her rounds through the wards.
Post-Claims Underwriting Makes Insurance Coverage Disappear
Category: Seeing Clearly Now
By the time you are 50 years old your medical history is beginning to look like a lengthy novel. But, unlike a novel, it is not neatly written in a single bound volume. It is scattered throughout the country in the records of various health care providers, hospitals, health insurance companies and laboratories. It is also poorly recorded, with major league errors and omissions, in your cluttered memory.
All of this is well known to the insurance industry. It is the underlying corporate rationale for the industry's post-claims underwriting. Your filing of a significant health insurance claim is the trigger for the medical sleuths in your insurance carrier's underwriting department to roll up their sleeves and find something, almost anything, you failed to include in your insurance application. Then, comes the announcement: If we had known this fact we would not have provided this coverage to you. Sorry. Your refund check is enclosed.
It is this despicable business practice that is the subject of an article at Law.com.
Plaintiffs Await Ruling on Canceled Health Insurance Policies
William Shernoff says he has been bringing lawsuits over canceled health insurance policies since the 1980s. Lately, however, that part of the Southern California plaintiff lawyer's practice has exploded: Last year, Shernoff filed about 70 lawsuits for people who have gotten stuck with hefty medical bills when an insurance company revoked their coverage by claiming they falsified or omitted important details on their applications. He's on pace to file about the same number this year.So far, Shernoff says, litigation over the insurance companies' practice -- often referred to as post-claims underwriting -- hasn't led to any significant case law. He said most cases end with dismissals or confidential settlements, adding that the settlements can be substantial, a point disputed by lawyers for insurers.
But next week, the Santa Ana, Calif.-based 4th District Court of Appeal will hear arguments in a closely watched case that challenges Blue Shield of California's practice of rescinding coverage based on inaccuracies in an application. If the challenge in Hailey v. California Physicians' Service, G035579, succeeds, plaintiff and defense lawyers say more cases may wind up in trial -- or lead to more lucrative settlements.
Blue Shield argues...it can rescind coverage when someone's made a misrepresentation material to the company's decision to offer them a health plan.
Plaintiff attorneys in the field contend...that a showing of willful misrepresentation is required before yanking coverage...
From Law.com
The difference between a misrepresentation and a willful misrepresentation is one that matters a lot to the insurance industry. It knows finding the former is a relatively simple and frequent occurrence. But, finding the latter...that is far from easy.
Greedy Trial Lawyer Fixer - Using Blame For Good
Category: Seeing Clearly Now
As a greedy trial lawyer who has sought just compensation for those who have suffered because of bad medical practice, I don't have a lot of time to involve myself in other social causes. It takes major-league time and effort to get medical providers to do the right thing. Only an occasional doctor has announced during his depostion, "I blew it." The rest have waged all-out war to defend really stupid actions. I have been forced to go into surge mode in just about every claim.
Despite my decades of operating in a hostile environment, I believe making the healthcare system acknowledge its mistakes and compensate the victims of incompetence has been a worthwhile personal crusade.
After reading an article by Trisha Torrey I now recognize how much I have helped my clients and the medical profession by being a Fixer.
Blamers and Fixers: Which One Are You?
I've put the people who write to me about medical errors they have suffered into two categories: The Blamers and the FixersThe Blamers are those who [are] livid-angry, and they ask me to do things that will help distribute their anger further. They want me to help them write letters to doctors or hospitals or others who have wronged them. They want me to help yank a doctor's license to practice, or help them sue a provider, or participate in whatever form of punishment they believe is appropriate.
Their anger is just so palpable. And I get it! I was there! After my misdiagnosis, I talked to anyone who wanted to listen in hopes it would somehow diffuse my anger.
The Fixers are a step beyond. Fixers are people who have been hurt by the system, and have turned that bad experience into something else more positive.
Among my advocate-colleagues, you'd be amazed at how many of us are fixers. Very few have just chosen to take up the cause of patient advocacy out of the blue. Instead, their children have been killed by bad surgeries, or they've lost a spouse or parent to a medical error, or a diagnosis has been missed (or misdiagnosed all together) and someone they love -- or they themselves -- have been treated incorrectly.
The Fixing itself becomes the catharsis for the anger, and it is extremely powerful.
From Every Patient's Advocate
I know there will be some who want to tag me as a Blamer, but sometimes you've got to throw some blame around to fix things.
Is Your "Financial Adviser" Over-Titled?
Category: Seeing Clearly Now
The free lunch you ate at the recent noon financial planning seminar may give you or your family severe indigestion.
Investment Pitches Prey On Elderly
Government officials worry that unscrupulous financial advisers are preying on retirees by calling themselves senior experts, using fancy titles to lure the elderly to marketing seminars and then locking up their savings in investments that carry high commissions and withdrawal fees.Federal regulators and authorities in seven states are set to release the results of an investigation of firms that run "free lunch" investment seminars, which draw large numbers of retirees. The results, said Securities and Exchange Commission Chairman Christopher Cox, are "deeply disturbing" and have produced multiple law enforcement referrals.
SEC leaders and their state counterparts will host a day-long summit Monday to discuss a nationwide approach to combating bogus yet official-sounding titles that salesmen use to curry favor with older investors.
From the washingtonpost.com
Tomorrow I am going to cancel my upcoming meeting with my Financial Analyst, Financial Adviser, Financial Consultant, Financial Planner, Investment Consultant, Mutual Funds Expert, Insurance Guru and Wealth Manager. My time may be better spent with a dart board.
ER Doctors May Have Less Experience Than You Think
Category: Seeing Clearly Now
Why you may want to ask your ER doctor this question: So, doc, have you sutured any wounds lately?
A questionnaire was designed to assess junior doctors' experience of performing common practical procedures. Six procedures commonly performed in the emergency department were selected following discussion with the emergency department consultants as follows:*Colles fracture manipulation
*Dislocated shoulder manipulation
*Suturing wounds
*Exploring wounds
*Abscess drainage
*Chest drain insertion
A perceived reduction in experience was noted for all listed procedures between the junior doctors in 2005 and those in 2006. The decrease in experience of performing shoulder manipulation, suturing and exploring wounds was statistically significant.
Emergency Medicine Journal 2007;24:657-658
Crocs Eat Flip-Flops For Lunch
Category: Seeing Clearly Now
In the midst of our national debates over Iraq and Health Care there has been the ongoing footwear controversy: Are Crocs better than flip-flops? The latest salvo:
Flip-flops causing slips and trips -- and serious injuries
This summer has been the season of the flip-flop, particularly among women ages 25 to 35, said Harold B. Glickman, DPM, past president of the American Podiatric Medical Assn.The ubiquitous footwear, once only seen at the beach or pool, has become acceptable workplace attire, Dr. Glickman lamented.
"They really give no support to the foot and ankle. They are dangerous in the sense that if caught in an intersection with the light changing and having to run, you can fall, slip and really injure yourself," he said. "And not just your foot and ankle, but the rest of your body, too."
Stubbed and broken toes and ripped-off toenails have been seen too often this summer. "A lot more discretion should be used in wearing them," Dr. Glickman said.
As for that other shoe of summer, Crocs, there is good news. Despite news stories about the soft, often vividly hued, plastic shoes getting caught in escalators, they are generally regarded as safe and certainly better than flip-flops. "I don't know that I would wear them 24/7," Dr. Glickman said, "but I do wear them around the house and for garden work."
They provide good traction and may even be a good substitute for sneakers because they aren't as confining, Dr. Glickman said.
Shades of the boxer-brief debate!
"Unlawful" Is As "Unlawful" Does - The Bush Doctrine
Category: Seeing Clearly Now
Do you see a difference between aliens and illegal aliens? We now have evidence that the Bush Administration may not.
AP: WH Urges Judges to "Look Beyond the Letter of the Law"
The AP reports "The Bush administration argued Friday that discrepancies between the nation's new terror law and the way it is being carried out should not stall one of the Pentagon's first terrorism trials."Arguing before the newly formed U.S. Court of Military Commission Review, government attorneys urged judges to look beyond the letter of the law when deciding whether the military undermined its terrorism tribunals at Guantanamo Bay.
The case hinges on a single word: unlawful. Before terror suspects can be prosecuted before military commissions, the law requires they be deemed "unlawful enemy combatants." But Guantanamo Bay tribunals have simply been calling them "enemy combatants."
Lawyers for Omar Khadr argue that's a fatal flaw in the government's case and that Khadr can't go before a military commission. If the three-judge appeals court agrees, it could force the Pentagon to redo tribunals for dozens of detainees.
Frankly, I am surprised the government didn't just designate the suspects as evildoers and be done with it.
The Health Benefits Of A Short Ambulance Ride
Category: Seeing Clearly Now
After you read the results of this important study published in a respected medical journal I have an observation to make.
We aimed to determine whether distance to hospital was associated with mortality in patients with life-threatening emergencies.Conclusion: Increased journey distance to hospital appears to be associated with increased risk of mortality.
Emergency Medicine Journal 2007;24:665-668
My observation: I suspect the time of the journey may actually have been the culprit and not the distance. Of course, it could have been the speed of the ambulance or its size. But, that would require another study.
Bullet's Path Should End This Matter
Category: Seeing Clearly Now
This news story falls in the No Harm No Foul category. I believe all charges and accusations against both men involved should be forgotten and they should have a beer together to celebrate the good luck that allowed both to live another day.
Trooper under scrutiny for alcohol levels during shooting
CHARLES CITY (AP) -- The state trooper who shot a man for allegedly trying to run him over is being investigated after tests showed he had alcohol in his system during the incident last winter.Trooper Mark Domino was the key witness in the trial Tuesday against William Filippo Jr. of Cedar Falls, who is accused of driving his vehicle at Domino during a chase Feb. 16 south of Charles City.
Filippo was initially charged with attempted murder after his arrest. Prosecutors changed the charge to assault with a dangerous weapon, eluding and drunk driving, in exchange for Filippo dropping the request for a jury trial. His blood-alcohol level was 0.2 percent, more than double the legal limit.
Officials said the chase began when Domino tried to stop Filippo and question him about a hit-and-run earlier in the day.
During the chase, both vehicles ended up in a snow-filled median along U.S. Highway 218. That's when Domino got out of his squad car and Filippo drove at him, officials said.
Domino fired his gun, one bullet hitting Filippo behind his left ear, and exiting near his right eye. He was hospitalized for about a week.
Doesn't this bullet trajectory tell us these could be two of the luckiest humans on earth? Shake hands, fellas, and go hug your wives and children.
Bacteria Have To Be Laughing At Us
Category: Seeing Clearly Now
I need to mount my soap box for this post.
It may be hard to believe, but Corporate America has been manufacturing and selling a product that serves no useful purpose and is, itself, harmful.
Antibacterial Soap May Render Antibiotics Less Effective And Is No More Effective Than Plain Soap
Antibacterial soaps show no health benefits over plain soaps and, in fact, may render some common antibiotics less effective, says a University of Michigan public health professor.In the first known comprehensive analysis of whether antibacterial soaps work better than plain soaps, Allison Aiello of the U-M School of Public Health and her team found that washing hands with an antibacterial soap was no more effective in preventing infectious illness than plain soap. Moreover, antibacterial soaps at formulations sold to the public do not remove any more bacteria from the hands during washing than plain soaps.
Because of the way the main active ingredient---triclosan---in many antibacterial soaps reacts in the cells, it may cause some bacteria to become resistant to commonly used drugs such as amoxicillin, the researchers say. These changes have not been detected at the population level, but e-coli bacteria bugs adapted in lab experiments showed resistance when exposed to as much as 0.1 percent wt/vol triclosan soap.
Physician Mindsets Create Greedy Trial Lawyer Mindsets
Category: Seeing Clearly Now
Richard L. Reece, MD, posting at MEDINNOVATIONBLOG, has identified what he calls five Physician Mindsets.
Five Physician Mindsets and Trends
Mindsets work like fixed stars in our heads. Holding on to them, our mind drifting like a ship in an ocean of information, finds orientation. They keep it on course and guide it safely to its destination.Physician Mindset Number One - Physicians on the ground prefer incremental changes through expanding coverage through tax incentives and market-driven changes rather than through a single-payer system.
Physician Mindset Number Two - Physicians are adapting to downward pressure on their incomes and harassing rules and regulations by becoming hospital employees.
Physician Mindset Number Three - Physicians regard consumer-driven care with skepticism and tend to be reactive rather than proactive in adapting to change.
[For Mindsets Four and Five you will have to read Dr. Reece's original article.]
One Physician Mindset observed by me (and probably every other trial lawyer who has ever deposed a defendant physician in a medical malpractice case) is: Physicians do not believe anything they do is ever a breach of the accepted standard of care. They believe whatever they do or fail to do is just part of this thing called the practice of medicine.
This leads to a Greedy Trial Lawyer Mindset: Greedy trial lawyers believe many defendant docs are arrogant bastards who are incapable of admitting a mistake.
Why You Wait Longer And Get More Prescriptions At Your Doctor's Office
Category: Seeing Clearly Now
If your doctor is classified as a heavy prescriber it is likely 25 drug company representatives a week drop in for a chat bearing gifts. What does this mean for you? Even more pills are prescribed and your waiting time gets longer.
Nationwide, there are an estimated 90,000 to 100,000 reps; each calls on eight to 10 physician offices a day. Some practices may get only two to four visits a week. However, in 2005 and 2006, primary care physicians deemed as "heavy prescribers" were called on by an average of 29 reps a week, according to Health Strategies Group, a research firm that tracks the pharmaceutical industry.How those visits break down hints at the possible strain on physician practice: In 2005, 85 percent were drop-ins, 5 percent were appointments, and 10 percent were lunch dates.
From Medical Economics
AMA Awakens To Insurance Scam Of Unprompt Payments
Category: Seeing Clearly Now
The American Medical Association (AMA) is beginning to believe health insurance carriers are intentionally complicating and delaying the payment of claims. Has the AMA been brain-dead for the last 20 years?
AMA To Congress: Stop Unfair Business Practices Of Health Insurers
"The AMA urges Congress to pass legislation that will:-- Establish a strong federal prompt pay standard;
-- Protect more robust prompt pay state laws by ensuring the federal standard is the "floor"
"Small physician practices have limited leverage relative to large insurance companies since antitrust laws prevent physicians as a group from addressing payment and other contract terms on a level playing field."The ability of physicians to address unfair payment practices continues to diminish with the increasing consolidation of health insurers. In the majority of Metropolitan Statistical Areas, a single health insurer dominates the market.
"The growing disparity in negotiating positions has created an environment where insurers are able to evade prompt payment laws with little, if any, adverse consequence. This has a financially debilitating effect on small physician practices and could limit patient access.
"When one side has all the market power, more efficient market mechanisms are hampered. A common problem confronted by many physicians is insurers paying claims late. Even if a claim includes all the appropriate information, insurance companies often find reasons to delay or deny payment. This is tantamount to small physician practices extending interest free loans to large insurance companies.
"In addition, this, seemingly intentional behavior by the insurer, creates an onerous administrative burden. Physicians and their staff must spend hours on the phone pursuing payment of unpaid claims. In fact, growing numbers of physician practices have been forced to hire office staff dedicated solely to collecting late payments."
Texas Judges See No Need For Tort Reform
Category: Seeing Clearly Now
Judges have a front row seat in the civil justice system. They also are presumed to be impartial as between the plaintiff and defense bar. Their observations about the fairness of the jury system and the need for more tort reform might be worth knowing.
Tort Reform: Straight From the Horse's (or the Judge's) Mouth
For years, Texas residents have been hearing about runaway juries, frivolous lawsuits, and the need for tort reform. But most of the stories in the popular press and thrown around by tort reform groups are anecdotal; there has always been a question of how to best gather data to measure whether jury awards are excessive or suits are frivolous....for the last two years, the professors have conducted a survey of Texas District Court Judges to get their views on the "litigation crises." After receiving responses from an astounding 78% of Texas district court judges, the results of the survey were released in the Baylor Law Review in an article titled Straight From the Horse's Mouth: Judicial Observations of Jury Behavior and the Need For Tort Reform.
Because the article is not yet publicly available, we don't want to provide too many details. But we will say that among the results were findings that substantially more judges thought juries had awarded too low of damages than judges that thought juries had awarded too much. And well over 80% of the judges did not think there needed to be additional "reform" to address frivolous lawsuits.
Outpatient Surgery - Do Risks Outweigh Benefits?
Category: Seeing Clearly Now
A surgeon is supposed to inform a surgical candidate of the risks and benefits of the surgical procedure. This information, when provided, enables the patient to give an informed consent to the surgery.
In at least 31% of scheduled surgeries there also is a need for a discussion of the risks and benefits of using the particular surgical facility.
The spotlight grows on outpatient surgery
[R}isks...exist when a patient chooses to have surgery outside a hospital and far from emergency medical services, says Lee Fleisher, chairman of anesthesiology and critical care for the University of Pennsylvania Health System in Philadelphia.Fleisher has studied those risks and says that as the number of outpatient surgical centers blossoms, it's key for patients to learn the benefits and drawbacks of non-hospital-based surgery. Of the 50 million surgeries performed annually, he says, 31% occur at free-standing ambulatory surgical centers (ASC) where no hospital or emergency department is attached and patients go home the same day
Fleisher is concerned that as more older patients and people with multiple chronic conditions choose surgery at outpatient clinics, adequate postoperative and emergency services may not be at hand.
Minorities and older patients with multiple medical problems are more likely to require postoperative emergency care, several studies show. "We're concerned that as more ASCs perform more surgeries on older, higher-risk groups, those people will not be close enough to emergency services if they need them," Fleisher says.
From USA Today
Since outpatient surgical centers are frequently owned by surgeons, just how often are the risks of using the facility mentioned or properly presented? And, while we are on the topic, just how often is the surgical patient told who owns the facility? Just wondering.
Doctor Errors Are As Common As The Air We Breathe
Category: Seeing Clearly Now
A reasonable assumption is that every doctor has made mistakes in patient care. I mean, if 92% admit making mistakes we have to conclude that the remaining 8% are lying or oblivious to their mistakes.
Doctors are Human, too [Would the better title be, Doctors Are Too Human?]
A report from the AP last week, and reported by the Washington Post, Fox News and others, describes a survey of more than 3,000 doctors in both the US and Canada about their reactions to their own mistakes.The survey was developed and issued by the Joint Commission (JCAHO), the body that accredits hospitals and other health care facilities. It asked doctors whether they had affected any near misses, minor medical errors, or serious medical errors which may have caused permanent or potentially life threatening harm.
92% admitted they had been involved in errors. And those involved also reported that after they made the errors, they felt increased anxiety about the potential for future mistakes, less confidence in their abilities, they reported sleep problems and a loss of job satisfaction.
The number is huge -- 92% !! We all make mistakes, granted, but our mistakes don't usually cause harm to other lives. That's 92 of every 100 doctors. We know that translates to almost 100,000 deaths per year, too. I don't know how to do that math, but those numbers are huge.
So perhaps the biggest takeaway from this report is that we patients need to internalize is the sheer numbers of doctors who make mistakes. And we patients need to practice defensive treatment seeking.
Because at least 92% of our doctors are making errors and we are the ones paying the price.
Posted by Trisha Torrey at EVERY PATIENT'S ADVOCATE
Malpractice Settlements Fairer To Medical Providers Than To Patients - Honest
Category: Seeing Clearly Now
Our fair and balanced president, George W. Bush, has explained ["I am the Explainer"] how medical providers are regularly extorted into paying outlandish sums to settle meritless malpractice claims:
Doctors and hospitals realize... it is expensive to fight a lawsuit even if it doesn't have any merit. And because the system is so unpredictable, there is a constant risk of being hit by a massive jury award. So doctors end up paying tens of thousands, or even hundreds of thousands of dollars to settle claims out of court, even when they know they have done nothing wrong.
The truth, not surprisingly, is quite different.
The Fairness of Malpractice Settlements
Is this claim [let's call it the Bush Extortion Theory] correct? The strongest empirical support for it comes from the 1996 findings of the researchers who directed the Harvard study of New York hospitals. They concluded that the merits of a malpractice claim have no bearing on the likelihood of a settlement. They even suggested that the entire adjudicative process is "an expensive sideshow" in which settlement is really driven by damages, not negligence.The widespread reliance of both tort critics and the mass media [and the Explainer] on this single prestigious study is unfortunate. Its findings are decidedly inconsistent with the substantial body of empirical data accumulated over the past several decades.
Those studies demonstrate, contrary to the Harvard study, that settlement outcomes are directly correlated with the strength of the plaintiff's case.
Over the past quarter of a century, more than a dozen studies have collected data on malpractice settlements. With only one exception, they have consistently shown that plaintiffs with strong cases are more likely to receive a settlement payment than plaintiffs with weak cases. When strong cases settle,
the average payment is substantially larger than the average payment in weak cases.Moreover, the data on malpractice settlement strongly suggests that liability insurers possess a palpable advantage in bargaining power. On average, malpractice claims settle for less than their expected value. The most likely sources of that bargaining power are the defendant's superior risk tolerance,
better access to information, more experienced attorneys and insurance representatives, easier access to expert witnesses, and the incentive to fight low-odds claims vigorously. Defendants probably gain additional bargaining power from trial lawyer awareness that malpractice claims are very hard to win at trial, even with strong evidence of negligence.The overall performance of the settlement process should be reassuring to those physicians who are willing to listen. Quality of care drives settlement outcomes. To the extent that settlement outcomes depart from the merits, the discrepancies usually favor malpractice defendants. Although physicians may find it hard to believe, it will be hard to design an evenhanded adjudicative process that treats them much better.
From an article by Philip G. Peters, Jr., University of Missouri-Columbia School of Law
Message From Earth To America's Ayatollah
Category: Seeing Clearly Now
David Brooks of the New York Times has just returned from a pilgrimage to the White House where he had an audience with Ayatollah Bush.
I spent the first four days of last week interviewing senators about Iraq. The mood ranged from despondency to despair. Then on Friday I went to the Roosevelt Room in the White House to hear President Bush answer questions on the same subject. It was like entering a different universe.Far from being beleaguered, Bush was assertive and good-humored.
I left the 110-minute session thinking that far from being worn down by the past few years, Bush seems empowered. His self-confidence is the most remarkable feature of his presidency.
His self-confidence survives because it flows from two sources. The first is his unconquerable faith in the rightness of his Big Idea. Bush is convinced that history is moving in the direction of democracy, or as he said Friday: "It's more of a theological perspective. I do believe there is an Almighty, and I believe a gift of that Almighty to all is freedom. And I will tell you that is a principle that no one can convince me that doesn't exist."
Second, Bush remains energized by the power of the presidency. Some presidents complain about the limits of the office. But Bush, despite all the setbacks, retains a capacious view of the job and its possibilities.
Unfortunately, as is often the situation in theological matters, on the other side of the world are other ayatollah's who are convinced their Almighty has provided other gifts.
If we could get our American Ayatollah to take off his robes and actually perform the job of President of the U.S. it is possible the power of his office could actually accomplish something beneficial during his final year in office.
Deployable Troops To Run Out At Just The Right Moment
Category: Seeing Clearly Now
I have not been to Iraq. I am not a military expert. I have never served in the military. However, I can spot a coincidence when I see one. See if you can spot one too in this excerpt from a New York Times article.
U.S. General in Iraq Speaks Strongly Against Troop Pullout
BAGHDAD, July 15 -- An American general directing a major part of the offensive aimed at securing Baghdad said Sunday that it would take until next spring for the operation to succeed, and that an early American withdrawal would clear the way for "the enemy to come back" to areas now being cleared of insurgents.Maj. Gen. Rick Lynch, commanding 15,000 American and about 7,000 Iraqi troops on Baghdad's southern approaches, spoke more forcefully than any American commander to date in urging that the so-called troop surge ordered by President Bush continue into the spring of 2008. That would match the deadline of March 31 set by the Pentagon, which has said that limits on American troops available for deployment will force an end to the increase by then.
"It's going to take us through the summer and fall to deny the enemy his sanctuaries" south of Baghdad, General Lynch said at a news briefing in the capital. "And then it's going to take us through the first of the year and into the spring" to consolidate the gains now being made by the American offensive and to move enough Iraqi forces into the cleared areas to ensure that they remain so, he said.
The new American motto: We will fight until we run out of troops available for deployment. This will strike terror in the hearts of terrorists.
Keep Your Eye On The Genome
Category: Seeing Clearly Now
Mankind is still evolving, but not necessarily in the direction of perfection. Any serious presidential candidate or greedy trial lawyer should follow this research.
Recent Changes Discovered In The Human Genome
A Cornell study of genome sequences in African-Americans, European-Americans and Chinese suggests that natural selection has caused as much as 10 percent of the human genome to change in some populations in the last 15,000 to 100,000 years, when people began migrating from Africa.In the latest study, the researchers identified 101 regions of the human genome with strong evidence of very recent selection. These regions include genes that control proteins that help muscle cells attach to surrounding cells (mutations of this gene lead to muscular dystrophy), receptors that relate to hearing, genes involved in nervous system function and development, immune system genes and heat shock genes.
"It is important to emphasize that the research does not state that one group is more evolved or better adapted than another," said co-author Carlos Bustamante, a Cornell assistant professor of biological statistics and computational biology. "Rather as humans have populated the world, there has been strong selective pressure at the genetic level for fortuitous mutations that allow digestion of a new food source or tolerate infection by a pathogen that the population may not have faced in a previous environment."
My own study of the human race, American subtype, also shows environmental pressure causing genome change. Although my full report is not quite ready for publication I can already say with certainty Americans are evolving in the following ways:
1) Shorter attention spans for anything complicated or nuanced.
2) An emotional need for almost continuous cellphone conversations.
3) More primitive, mystical religious beliefs.
4) Enjoyment of less understandable song lyrics.
What does this mean for those of us who seek to communicate effectively with our fellow Americans? (This applies equally to trial lawyers and presidential candidates.)
It means the most effective vehicle to get a message across would be to do it in a one minute rap-like chant of easily digested but garbled sound bites beginning with the words, Before the Rapture, broadcast to the jury or to every potential voter by Sprint.