Give Me All The Defensive Medicine You've Got
Category: Seeing Clearly Now
Day BY Day Happenings posts a fairly balanced view of tort reform. The last line quoted is one that brings to mind the claim that doctors practice defensive medicine because of the threat of being sued. I, too, want a doctor who is fearful of making a mistake in his diagnosis and treatment of my medical problem. And, I would choose more tests, more observation, more attention and more care rather than the bare minimum. Maybe that makes me both a greedy trial lawyer and a greedy patient.
I get angry every time I hear government mention "tort reform" and "frivolous lawsuits". I have been on both sides of the coin with this one and I must say that I get torn.
On one hand, over the years, being in the business we are, we have been threatened with suits for stuff we did not do or were the fault of the person making the threats. Sometimes justice prevailed, other times it has not. It gets frustrating when people expect something for nothing or want someone else to pay for their own mistakes.
On the other hand, If my husband or child were crippled or killed due to someone's negligence, I would want to make them pay as a way of punishing them. I do not want the government protecting them by capping off what they may have to pay.
People say that if we allow reform our courts will not be filled with frivolous lawsuits, people will see swifter justice and doctors will be more affordable and will not have to move away from our area because they cannot afford their insurance.
Personally, I prefer our doctors be fearful, they will be more careful.
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There is something you should know about called "decision theory" before you "choose more tests" and that is, more tests mean more false positives and false negatives. Let me guess, that wasn't covered in Torts or at any other time in Law School. It is a reality doctors deal with everyday and whether we like it or not decisions must be made knowing that statistically there will always be a chance that we may be wrong. I think it takes more courage to be a doctor than a lawyer. If a lawyer makes a mistake the client might get angry. If a doctor makes a mistake the patient may never get the chance to get angry. It is difficult work and I realize you will never understand that point. By the way, doctors who are fearful are not more careful they are just more fearful. Doctors who are fearful practice defensive medicine and order more tests, so if you want your doctor to be more fearful I recommend you take a quick course on "decision theory". When you understand decision theory you will realize the practice of medicine is not at the Six Sigma level, yet.
Posted by: TraumaOne at February 18, 2006 11:09 PM
TraumaOne offers the interesting concept that having too much knowledge is a dangerous thing. I have confronted this absurdity in medical malpractice litigation. Carried to its logical conclusion I am not sure why any doctor ever performs a physical examination. After all, each finding opens the door to more potential potential diagnoses which the doctor has to fit into his thinking.
It may or may not take more courage to be a doctor than a lawyer, but it certainly takes more arrogance.
Posted by: GTL at February 19, 2006 07:08 AM
By definition false positives and false negatives are more "knowledge". The problem is they are inaccurate forms of knowledge that are perceived to be true and that is precisely what makes them "a dangerous thing". Practicing as a doctor is not about generating more potential diagnoses it is about generating the right diagnosis. It was once pointed out to me that "doctors are more concerned with right and wrong and lawyers are more concerned about winning and losing". We view the world and function in it using different models because our end points are different. Doctors seek truth and lawyers seek justice. I think both are necessary and noble causes.
Posted by: TraumaOne at February 19, 2006 11:50 AM