Why are gynacoligists really getting out of the business?

[napi21]

I have been hearing about this for years! Why is it really??? Is it incompetence, greedy people, overly gratuitous juries, the laws, overly agressive attorneys....what is it?

[mr_hat]

1. Pro-life snipers?

[lovuian]

2. They are taking More Uninsured single Moms

Babies don't have insurance and Medicaid doesn't pay that much and very high Liability....why should they....

[skooooo]

4. Well..they could still practice their love...

...lol. W says so.

[napi21]

6. But that's not the reason for exhorbitent insurance rates!

I can see where Dr's make much less delivering babies of uninsured mothers, but that isn't the reason they give for leaving the business. There have been so many statements from all sides, I have to believe that their insurance rates have skyrocketed! WHY?

[KC21304]

19. Because the insurance companies are squeezing everyone

they can, because they can.

[Yupster]

52. I just looked up Prudential

just as an example.

In 2000, they reported a profit of 27 billion. In 2001 it was 27 billion. In 2002 it was 28 billion.

Return on equity was 7.8 % last year.

If they're squeezing, it's not showing up in their bottom line.

This is just the first company I looked at. Others may be quite different of course, but when I think insurance, I think of Prudential first.

[atre]

103. If they're passing the costs on to the doctors...

in the form of increased premiums... how would that show up in the income statement?

[barb162]

61. yes

the insurers maybe shouldn't be providing cover for the lousy docs.

[Warpy]

34. Two reasons.

First, OB-Gyn is considered a high risk specialty. Too many people think they're guaranteed an uncomplicated birth and a perfectly healthy infant, and life just aint like that. Some of them blame the doc for not picking up problems sooner, rightly or wrongly. Even lawsuits that have no real chance of being won can be settled out of court, and that costs.

The second reason is that insurance companies took a real beating when the dotcom bubble burst and decided to make up for lost investment revenues on the backs of doctors. All docs in every single specialty, even the low risk ones, have seen their premiums go up every single year, usually by double digit amounts.

Limiting recourse to the courts for people who are injured by negligent or incompetent physicians won't make up for the lost investment revenues that the insurance giants got used to, and it won't compensate people who think life comes with guarantees. Don't expect Idiot to notice either point.

[Yupster]

70. I can't find insurance companies

investment portfolios online yet, but they're invested overwhelmingly in bonds, not stocks. I have the info in my office. The little stocks they do have would likely be mostly preferreds.

I would think they've been hurt by the declining interest rate environment more than the stock market crash.

[barb162]

80. their rates go up, they charge you more

what's the problem. Would you love to see one of their income tax returns over the last few years and see if all the criping they are doing is true?

[RobinA]

117. They Can't

charge you more unless you don't have insurance, in which case you can't pay them anyway. Insurance companies set the reimbursement rates.

[kath]

109. Because insurance companies are greedy sumbitches!

[slojim240]

89. Women should go back to using mid-wives anyway.

Most nurses could serve as mid-wives. It would cost less and be just as safe. If there are so many suits against ob-gyns it must mean they are not that safe. Also, mid-wives would mean natural deliveries. Far too many women are using ceserian deliveries which are more dangerous. I think that is probably why there are so many legal suits. Pampered American women don't want to go through the pain of natural childbirth.

[Mushroom]

116. Women should go back to using mid-wives anyway

A doctor ordered a c-section for my niece on Saturday. Because she was treated humanely, she will be bringing home today a healthy, beautiful baby boy. Isn't that wonderful?

[kimchi]

118. I agree completely.

When I tell people I had my child naturally they look at me like I have 3 heads. Our bodies are built for it-evolution, baby. Unfortunately, the insurance company refused to pay the 2k it cost; although they would have had to pay over 7 in the hospital.

I have no problem with cesarian deliveries when they are needed. But there is a growing trend to schedule them voluntarily for convenience. But nature gets the last laugh: it takes much longer to recover from a major surgery than it does from a vaginal delivery.

I am of the opinion that the modern methods of childbirth are potentially more harmful to the child, because they interfere with the natural processes of the body. Pictocin to epidural to baby in distress to c-section could easily be avoided in many cases.

Of course, I am thankful that they are there if needed; but let us be honest--doctors want to speed up the process so they can deliver more babies and make more money and get back to the golf course. Then they wonder why they keep getting hit with lawsuits when something goes wrong. Just MHO.

[knitter4democracy]

126. True

I had both of mine naturally in the hospital, first with an Ob/Gyn (now out of the business due to malpractice costs--doubled to $100K in one year, the practice's doubling to half a million in one year) and the second with a midwife. People do act like I'm crazy, and some even say that.

Interventions lead to more interventions, but what can a doctor do when the patient asks for it? If he refuses, she can sue him later if anything happens. Also, the Ob/Gyn has to deal with "standard medical practice" in a lawsuit: the standard these days is all those interventions. If he doesn't use it, and something possibly goes wrong, he's up a creek. Ob/Gyns can be sued until the child is 21 in most states, 18 in others, which works better for the lawyers--a doctor in practice that long often has a bigger accounts receivable to draw from.

There are some doctors who speed things up for bad reasons, but the ones I know (my hubby's an internist) are honestly trying to do the right thing. They hate seeing a woman suffer and so try to help her out. Problem is, that's not how we're made.

[kimchi]

135. I'm convinced most doctors try to do the right thing.

But in the case of obstetrics, they rely too much on technology. It isn't their fault; that is what they are taught. I used a midwife, and herbs, I have a garden, buy organic; and try to be ecologically sensitive. Now if I could just learn how to knit; I'd be set in the event of an emergency!

O8)

[Maddy McCall]

94. Um, excuse me, but MANY MARRIED WOMEN have babies via Medicaid

[Bridget Burke]

119. Do you have any proof for that statement?

Is it really the fault of all those evil unwed mothers? And how can an OB be forced to take a patient?

Find a link or 2, please.

[brainshrub]

3. Blame the privatized system of health care in this country.

[Yupster]

29. A good question

In nationalized health systems like Britaim or Canada, how does malpractice lawsuits work?

Anyone know?

[cosmicvortex20]

92. You mean the mixed system...

Its hardly a purely unaltered system.

Real Medical Freedom
http://www.mises.org/fullstory.aspx?control=1588

[FloridaPat]

5. Nowadays, if there is anything wrong with the baby it's instant

lawsuit. So the insurance is sky high and few can't afford to pay insurance and eat.

[Gin]

7. I heard it's malpractice insurance......several hospital wings have closed

and OB-GYN doctors are getting out of the business.

[napi21]

8. How can the law be changed to stop this?

I've heard this as well. It's wrong. Sometimes things happen in a pregnancy that no one can control. How can the laws be revised to protect the competent Dr. while still giving freedom to a patient to sue in a case of incompetence, or malpractice?

I really can see both sides of this, and I think it's going to be at least a small part of this year's election.

[shraby]

9. Maybe new doctors are going into

a field that is more lucrative. Is there any proof that obgyn doctors are quitting?

[napi21]

11. I don't have proof, but it was an emergency in Fla when no one

would deliver any babies. I really don't think this is just a scam that doctors are portraying about the high cost of malpractice insurance. I've heard way too many speak of their premiums going from $30,000/yr. to $250,00/yr or more. Is this just another shread of proof that it's the insurance companies????

[merh]

32. And I don't mean to be crass, but I cannot shed a tear for doctor's

whose insurance rates rise. Sorry, my health care insurance is a huge portion of my salary. I have to pay it and I don't get to claim it as a business expense. If I am not mistaken, insurance necessary to conduct business is a business expense and can be claimed.

It is very rare that doctor's live modest lives and drive modest cars. Most of them live in huge, expensive homes and drive new, expensive cars. Where is it written that they are entitled to live better than the rest of society? If they are not clearing $250,000 or better a year, then they aren't happy. Waaaaa!

I say, pay the insurance or get together and form the self-insured pools that other industries have formed. Regulate yourselves. Don't blame the poor individuals that are damaged by medical malpractice for the fact that you have to live below the standards you think you are entitled to. Doctor's took an oath to treat the sick. They chose the occupation and they should look for other avenues to rectify the situation rather than blame it on the wicked plaintiffs and their trial lawyers. Physicians heal yourselves (and realize that insurance companies are not your buddies, they are robbing you).

[sendero]

35. Ok, I have to disagree with you...

.... doctors study for long periods of time to become doctors. The competition is fierce at every step.

A good doctor is pretty much on call ALL THE TIME. They make important decisions, stressful decisions, about your health every day.

I for one think most doctors deserve every penny of that 200K or so. My personal physician lamented that due to contract pricing cuts with insurance plans, he is barely clearing 100K a year. I made more than that programming computers.

I'm sorry, but most doctors earn their money. Where I would agree with you is when some specialists get paid a few thousand dollars for a couple hours of work. Heart surgery comes to mind. My brother got a hole repaired, and a bill for 5000 from the surgeon for an hour's work. That is total bullshit. But 200K a year? Most of them earn it.

[merh]

42. I am sorry, I cannot cry for anyone who barely clears 100K a year ...

there are tons of folks on call 24 hours a day, 7 days a week that barely make enough to make ends meet. Doctors have to realize that they are being played by the insurance companies, the pharmaceutical companies and the hospital associations.

Once they start taking the issue of regulating their own seriously, once they appreciate the fact that they chose their lives and there was no guarantee that they would clear over $200K a year and once they remember their oaths, maybe they will get a handle on all of this.

I know plenty of folks who have studied for years and live modest lifes. Their insurance costs are costs associated with their businesses and can be claimed, my insurance costs are just costs I am stuck with. Of course, I don't have to have hospitalization insurance, but if I don't I am screwed. These guys will charge me no matter what, they don't care if I can afford it or not. Who is at the disadvantage, me or them?

[leesa]

54. Heeellloooo...anyone home? They have to pay for health insurance too.

They don't deduct their own health insurance.

How are they supposed to get a handle on the out-of-control pharmaceutical and insurance companies who literally OWN our government. Why don't YOU get control of them?

[SharonAnn]

74. I think they do deduct it. Most have professional corporations that

provide benefits, like health insurance, to them. It's deducted as a business or employee expense, I think.

[merh]

81. They are the loudest voices when it comes to "tort reform". None of them

scream "insurance reform" and a good many of them believe that there is no need to reform hospital practices or costs.

The majority of doctors I know are republicans. They believe the republican party has their best interest at heart. They do not recognize the connection the republican party has with the pharmaceutical companies.

If they recognized that the democratic party is suggesting legislation to control prescriptions costs which will in the end help them, then maybe I would be more sympathetic to their plight.

If they recognized that republican senators that own hospitals or interests in hospitals are furthering legislation that protects the hospitals and their profits and not the doctors or the patients, then maybe I would be more sympathetic to their plight.

If they would stop battling state legislation that would provide for medical review boards that would review malpractice claims before the suits are filed, then I might be more sympathetic to their plights.

But again, I cannot cry too hard for them because they barely clear over $100K a year and live in fancy houses and drive fancy cars. Live modestly, vote for a party that wants to address and improve health insurance costs, then maybe I would see their situations as desparate.

[knitter4democracy]

122. Now wait.

My husband's an internist, and we have to live modestly. We owe $200K in med school loans (we both got through undergrad without any loans, so that's med school alone) and had to get by on credit cards during residency. Now we're staying in our $78K house longer, paying down the cards, doing what we can to stay afloat. When we went to the John Edwards rally in town last night, we saw many doctors there--as Dems and Kerry supporters, not hecklers or undecideds.

If you read Placebo Journal or even AMNews, you'd see that doctors do blame the insurance companies big-time. A lot are even going without insurance of any kind now, and that movement is growing. Doctors are concerned about all the things you mention, and there are a lot of them who are Democrats and battling for better accountability and more autonomy.

BTW, the fancy houses and all are often to placate the family, especially the spouse, imho. My husband during residency often worked 100 hours/week, and his hours are still pretty bad in practice (closer to 70, so it's better). Some of the maddest women I've ever met are doctor's wives: I always say I'm a single mom with the occasional live-in husband, and it's true. He barely made it to our youngest's birth because he couldn't get anyone to cover his call and carry the code pager that night for a long time.

[merh]

125. I am delighted to hear that there are doctors that recognize

that there is a need for insurance reform. I am even more delighted to learn that some will vote for Kerry/Edwards.

I know plenty of husbands who work two jobs or overtime at 70 or more hours a week, just to make ends meet and to take care of their family. They would love to make $100K a year but they don't make that amount and they cannot placate their wives or families with fancy houses, they just want to pay the bills and keep food on the table.

[knitter4democracy]

129. Been there

Yeah, we were in that boat when David was in med school. I was a Catholic high school English teacher who started at $18,600 gross a year (only teaching job I could get with no connections). David couldn't work due to being in med school (class six days a week, having to cover over 1000 pages of curriculum in 4-6 weeks for each section), so we had to make due. My families helped out, especially after we had our daughter, and I had to quit teaching (cost more to keep working, oddly enough). Med school loans covered the rest. Covering the bills during med school and residency was a constant circus act, trust me. I know so many doctors in debt up to their eyeballs because of their seven-plus years of training, one still paying his loans when his son went off to college.

We have both vowed never to forget how it felt to be poor and then technically middle class during his last year of residency. David's working hard on all his partners to vote for Kerry and realize how the GOP is screwing all of us, and I'm working for the campaign here too.

[merh]

133. God bless you and David!

thanks so much!

[yankeedem]

114. Thank you merh

Doctors can take care of their own occupational crises, they don't need us to vouch for them. Personally, I don't see doctors going to bat for us computer specialists when our jobs become "less viable". So why should I expend effort protecting their "right" to make 200k a year?

[merh]

120. I don't understand the caste system we continue to perpetuate.

Why is it certain professions are suppposed to live better than the rest of the society? I know folks with PhDs that live at poverty level, so don't tell me it is the education crap.

If I ever thought I could earn $100,000 a year, I would be delighted. To hear it in a whine that a physician is making "barely $100,000" a year makes me shake my head.

Who the hell said that doctors, lawyers, politicians, CEOs, et cetera are so much better than the rest of society that they are entitled to live cushy lives? Make that miserable $100,000 stretch. Don't buy a new merecedes every year.

[leesa]

50. But we are ALL being ripped off by the insurance companies

Between the greedy insurance companies and the greedy pharmaceutical companies, the medical care system is being destroyed.

[napi21]

67. WOW! You might have something there! Self insured pool!

I like that idea. It would get aall doctors to challenge their peers. If there was a successful suit, they would have reason to come down hard on that "comrad" who cost them all!

I like this!!!!

[merh]

131. Can you imagine if the AMA set up a self-insured pool for

the doctors. Part of the requiremenst to include that the phyisicans completed continued eduation and if complaints of malpractice are filed, then the complaint is actually investigated and has credence, the the doctor's license is suspended until he improves his skills.

Doctor's could then see what really affect the insurance rates (depending on the investment of the pooled money) and would have control over the situation.

It could work!

[Kanary]

79. I mostly agree with you, merh

Drs made a lot of decisions that are affecting their current situation @ insurance.

They made a HUGE stink about any suggestion of "socialized medicine", and wanted the companies to be in charge. Well, the got it, and now they need to live with it, or start putting their energy into changing a profession that ISN'T WORKING FOR ANYONE!

There is an organization they can join, along with other health care professionals, to work toward Universal, single payer care. That would not only solve their personal insurance problems, it would ALSO PROVIDE CARE FOR *EVERYONE*.

A big part of this they have brought on themselves....... it's time to stop complaining, stop trying to fin individual solutions, and work to make this society good for ALL of us.

Kanary

[barb162]

106. unless I saw their premium statement

I would never believe that 250,000 figure, UNLESS the doc has a whole bunch of claims, successful lawsuits, etc. Maybe the person is a lousy doc and the insurer wants to get rid of them. Tell me something, why are there obgyns practicing in this country if they are not making good money? There may be shortages here and there, but by and large aren't major metropolitan centers crawling with them?
Any you know NOT living in huge houses, driving expensive cars, etc.

[JerseygirlCT]

12. I've read that it's a really dangerous problem in many places -- women

can't find obs, and need to travel many hours just for regular pre-natal care -- not to mention deliveries.

I think the whole system is mucked up, but in all the GOP whining about trial lawyers, I see no mention of the insurance companies. I know in CT, malpractice insurance rates continue to rise, even though claims have not. Things that make you go hmmm...

The insurance companies bet badly on the market, and are trying to make it up while blaming lawyers and doctors. They've succeeded in getting many doctors to point the finger at lawyers, while ducking themselves. I think the doctors need to do a much better job policing themselves, and the insurance industry needs to be much better regulated. (They're mighty good donors to the GOP though).

[Yupster]

23. I'm a stockbroker

I have one client/friend who's an OBY/GN.

He quit delivering babies about two years ago. Now he just does gynecological work.

First, it's a very difficult life. You work in your office during the day, and spend many nights, including middle of the nights in the hospital delivering babies. You can't go anywhere without being paged, and often have to put down what you're doing and head for the hospital.

About five years ago he told me he would no longer deliver babies for unmarried teens. To paraphrase him 'They're pregnant mostly because of drugs and alcohol. They keep doing drugs and alcohol during their pregnancy, and then when there's a problem with the baby, it's an automatic lawsuit.'

Now he quit delivering all babies.

My friend/client is from South America. He's a brilliant man who has been in the US for 30 years, but still speaks with a thick accent, and slow tempo.

Let's assume there's a baby who is seriously disabled. Let's say the doctor did absolutely nothing wrong.

Let's say my friend goes on the stand to defend himself and the plaintiffs lawyer is someone just like John Edwards.

Who's the jury going to side with?

The insurance companies have seen this happen enough times so they just settle and raise the malpractice rates on the doctors.

My friend never had a case go to court, but his malpractice premiums cost him more than his office rent and salaries of his two office helpers.

It's just not worth it for him, or others like him.

[napi21]

31. I understand that. He's right. Why couldn't there be documentation

that the patient was advised not to take drugs and didn't listen. If the patient has had no prior treatment, why would the Dr. be responsible for her uncouciled actions?

I do think the Dr.s are being taken advantage of, and I have no problem with tort reform, as long as it doesn't protect incompetence or malpractice.

[Yupster]

55. Because it's not black and white

The lawyer will claim that regardless of the woman taking drugs, it was still a mistake by the doctor that caused the problem. Or he will argue that theire were mistakes made on each side. Then it's up to who has the best lawyer and what the jury believes.

[merh]

36. Sorry, if there was no action by your client that caused the damage

to the child, if he did everything within the standard of care of his community relative to the care provided the mother and the child, then the case would never have made it past summary judgment. His accent would have nothing to do with the legal issues involved.

If there is no relationship to the "harmed" or "damaged" child and/or mother and your client's actions or inactions, then it would never have made it to the courtroom.

It is not as easy as you think. If the insurance company settled, then it is possible that they decided some damage was attributable to the doctor. Insurance companies do not settle willy nilly - they have experts of their own that review the case and the defense lawyers hire additional experts. Insurance companies and defense lawyers love to fight claims, they don't like to settle if they don't have to.

[Yupster]

58. Whether there was action that caused damage or not

is not always a black or white affair.

A really good lawyer will be able to show a jury that the problem came from the doctor's action, or failure to act, whether there was any reality or not.

Yes, the baby already had trouble, but what if the doctor had seen it a few minutes earlier, or had tried one other test, or had warned the person of this extra risk one time more. These are the gray areas that good lawyers are expert at exploiting.

And doctors are not expert at defending.

[merh]

75. You are so wrong -

Doctors do not go into a lawsuit defending themselves, the insurance company hires defense lawyers that are experts in medical malpractice defense.

I don't know any lawyers that take medical malpractice cases that have no substance. The litigation involves more than walking into the courtroom and saying Dr. X messed up when he delivered the plaintiff's child. A medical malpractice case is very complicated and very costly for a plaintiff's attorney to take on. It is very difficult for a plaintiff's attorney to find a doctor who will testify as an expert against another doctor in a malpractice case. The defense attorneys, hired by the insurance company for the doctor, have greater resources available to them.

Don't be so naive to think that a good lawyer can walk into a courtroom and prove a malpractice case without evidence. Generally, if the facts do not support the claim, the matter is dismissed at the summary judgment level.

[juslikagrzly]

134. I must disagree a bit with this (rather long, sorry)

I don't have any solutions up my sleeve, I don't hate "trial lawyers", but something is seriously wrong with our society. I work in academia and I have experienced large corporate entities (university) in this case, settling just to avoid going to court. It's easier, it's cheaper for them in the long run, they avoid negative publicity (most settlements have gag clauses attached). The stinkiest part of all this, is that the truth of the situation is not part of the equation. They don't care if the doc screwed up, the student, whoever. "They" just want it to go away. Most of all, I guess I blame american society (myself included) where we have the most grotesque sense of entitlement I have ever encountered. And I'm not talking "social programs". We have convinced ourselves that "the pursuit of happiness" reads "the right to happiness". I'm as progressive as anyone, I truly believe that one of our purposes on earth is to care for and take care of each other. But our society plays the blame game much too much and it's always someone else's fault. Bad things happen--babies are born with serious problems, people get killed on highways, we get diseases for no known reason. SHIT happens to all us.

Now to play my own blame game, and as a professional formerly in private practice, I put much of the onus on insurance companies. We have no idea really how much they run the world. And if you really think about it, what is the purpose of insurance anyway. We've all gotten so used to it, that we assume it's a necessity of life. If it is, we've made it that way. Insurance campanies exist in our capitalist society to make money! That is the be all end all of their corporate existence. Isn't it rather absurd to assume that if anything goes wrong in your life, you can get compensation? And I'm as big a hypocrite as all about this. When I get a medical problem, or one of my children needs a doctor, I am grateful that I don't have to pay all of it. There should be a system (universal health care?) where money is not the issue.

Well, rant over.

[brook]

17. One of the major...

causes of 'misadventures' in pregnancy and childbirth is the lack of prenatal care. That's a direct consequence of clinic bombings, shooting doctors and terrorizing patients - these are women's health clinics - not abortion clinics - but the right has perverted the truth. Big surprise, eh? Not to be dismissed either is the money making neonatal specialty.

I'm not saying that expert neonatal medicine is not valuable - but like cancer, it's been exploited and misused sometimes. Children are 'saved' who will never have what might be considered a 'quality' life. This is touchy, I know- and I don't mean to offend anyone...but remove the emotional and personal - and look at the 'industry' which is relatively new and extremely costly. I know when my parents were dying, I thought that much of their cancer treatment was far more lucrative than pallative...more for the doctor's 'comfort' than ours.

[JerseygirlCT]

14. That's not necessarily the case. At the least, it's an exaggeration.

[likesmountains 52]

10. OB-GYN

The rising cost of malpractice insurance is the main problem for OB doctors. Some policies offer a lower premium if the doctor delivers fewer than a certain number of babies per year...but that is not much help because it just encourages the available OB doctors to take on fewer patients...and any doctor who has to take call and deliver patients who "just show up" without any prenatal care etc. really loses if those deliveries count toward his total.

[napi21]

15. I don't doubt that, but who is doing the suing and why?

I have heard a little about the suits John Edwards won in some of his cases. Now, most weren't OB-GYN, but the ones I heard were ligit!

Why are the risks to the ins. co's higher than they ever were? Is it unreasonable patients, greedy insurance co's????

[0007]

13. A man dedicated to medicine for the love of humanity

will work for nothing.

[knitter4democracy]

123. Not with over $200K in med school loans to pay back. nt

[Djinn]

16. don't know the situation in US

but it's been a whinge here for a while too - same thing - insurance too expensive blah blah blah - what they never tell you here in the various news features is that this relates ONLY to those working in the private field - and what they mean is that they can no longer make quite as much money because the insurance costs have risen a little - it's not like they're going broke.

No-one evers tells them to just accept it part of the operating costs of their business - my other halfs family owns a joinery company - as a proportion of their income they pay roughly 3 times what an ob/gyn does in insurance - there aren't many "whoa is me" stories in the media about poor starving manufacturers and snmall business owners.

Ob/Gyns also fail to mention that the reason people manage to GET malpractice pay-outs is because there HAS been malpractice (as opposed to 30 years in business without a single claim of negligence for the joinery) payouts only happen when the doc is incompetant and/or negligent.

Like I said - don't know the sitch in US but here it has more to do with the media power of the ob/gyn field than the realities of business.

[likesmountains 52]

22. OB Gyn

Well, I think the difference might be in what an OB doctor "bills" for a delivery versus what he gets paid by Medicaid or Indigent Care coverage...your relatives probably charge a fair price and get paid in full...not a fraction of the billed charge that is determined by Medicaid. In my state Medicaid pays less than $2500.00 for a normal vaginal delivery to the hospital for a 2 day stay..mother and baby....this is all supplies,procedures, drugs etc. I am sure that what they pay the OB doctor is not much more generous for all of the office visits (prenatal) delivery, and post natal care.

[Djinn]

48. like I said I'm not overly familiar with the US but

the fact is whatever my relatives (not actually related not married)charge (forced down by competition from developing nations...yeah free trade agreements) they are expected to factor in their insurance costs so are almost all other professionals, doctors aren't any different.

Oh and for Yupster - sorry but in almost ALL malpractice suits the doc (through his insurance company) has considerably better lawyers than the person suing.

[Yupster]

60. That may be true about the lawyers, and

if the lawyers went on the witness stands, you might have a lively debate, but when you put a doctor on the witness stand, a good lawyer will chew him up and spit him out.

[Djinn]

82. and the flipside being

when the doctors lawyers get to cross examine witness' and whoever it is that's suing then they also "chew them up and spit them out"

[Yupster]

93. You can't chew up and spit out

a grieving mother or a disabled child. The jury will kill you.

[Djinn]

95. really?

I don't know if you've been in too many courtrooms Yupster - happens all the time. They don't even need to be that brutal they just need to confound the jury, not hard when you have highly paid specialist lawyers (plural) compared to some "no win no fee" chump from Nowhere, Idado who's representing the claimant.

[Yupster]

107. Yeah right

On one side you have a grieving mother asking for money for her disabled son. On the other side you have a giant corporation or insurance company.

Who is the jury going to sympathize with?

So you would tell the corporate lawyers to brutalize the grieving mother? Yeah that would be fine lawyering.

My best friend is a lawyer who defends companies.

He says it's the hardest part of his job trying to question sympathetic people who have ridiculous claims or are saying ridiculous things. You have to be understanding and soft spoken to show they're wrong without being mean or sarcastic. As soon as the jury thinks you're being mean to the poor person you're sunk whether you're right or wrong.

[Yupster]

28. Sometimes the jury decision

goes to the side that's right.

But not always.

You take a complicated medical condition, and pit a seasoned lawyer who has been through hundreds of similar cases against a doctor who may be foreign born, and speak with a heavy accent, and if you believe the side that is correct on the merits will win almos t all the time, I'll kindly disagree with you.

I picture my friend being questioned by John Edwards on the witness stand, and my friend will lose every single time regardless of which side is in the right.

[PA Democrat]

41. To be fair, the insurance company does provide attorneys for doctors

It is in the insurance company's best interest to make sure that their interests are well-represented in court.

[atre]

44. What a silly exaggeration

You don't have a lawyer pitted against doctor. In virtually ALL such cases, you have a moderately experienced lawyer (paid on a contingency fee) pitted against a much, much more seasoned lawyer making much, much more money, hired by doctor's malpractice insurance company to represent the insured.

Your basic assumption is completely at odds with the facts. I've never heard of a malpractice insurance company throwing a doctor to the wolves by not offering legal help; in fact, the suggestion you offer is insanely ludicrous when you consider that virtually all such businesses are incorporated or use an LLC, LLP, etc. and the only payor in the case would be the insurance company.

I would say - without equivocation - that the vast majority of juries in malpractice cases reach the correct conclusions as to the verdict. I would say that with quantification of damages, they are much less successful. But that's the cost of doing business. I certainly don't know any starving doctors. Do you?

[Yupster]

62. No starving doctors here

I hope we never reach that point, because when I have brain surgery, I want a doctor who is not just a good guy, and maybe even above average. I want someone who is exceptional. If we want exceptional doctors, we have to pay for it.

I'm a stockbroker. I make a lot of money.

But if I screw up, people don't die.

If there are two college students and one is kinda smart, and one is brilliant, I want the kind of smart one recommending stocks and the brilliant one performing surgery. Not the other way around.

[atre]

97. Don't you think the financial incentives are already there?

Even with the relatively high price of malpractice insurance? I just don't buy that doctors are being repelled from the business because the financial incentives aren't there.

Compared to other areas which require comparable levels of intelligence, like the legal profession, doctors are actually faring quite well.

What I think may be forcing people from that profession is the same thing forcing people from the legal profession: the strains of 60 hour work weeks, sacrifice of family time, etc.

[Yupster]

108. I just know one doctor's story

Hardly a valid statistical sample. Yet, I know his story.

[barb162]

66. the doctors are using medmal specialist attorneys

and the average claimant is using a general practice lawyer. If the doc's lawyer loses, the doc was probably totally negligent and worse. often, even when the doc is totally at fault, these very smart specialist attorneys get them off.

[merh]

127. Your friend will not be alone in court, the insurance company

will provide him with seasoned attorneys.

[Julian English]

18. Why?

Generally, it is harder to get US trained physicians. Why? Doctors's salaries are going down while drug companies profits are up. Drug prices are way up, and doctors' salaries are down.
In numerous geographic areas and practice areas unless you have a meatball, mill approach due to downward pressure on fees, doctors' salaries are shrinking, hours are increasing, and doctors are leaving the field.

Top students are not applying as often to medical schools. When a first year lawyer or MBA from a better school can make more that a doctor with far more training, there is a problem in what the doctors are being paid. (If you can get into a US med school, you can get into a top drawer law or MBA program.) Job satisfaction can only do some much to make up for decreased income the medical profession faces.

Doctors are frustrated by this. Unfortunately, doctors don't say, "Let's regulate the insurance companies and have a total over haul of the system with a reasonable disability system that gets rid of the expensive tort system." Instead, the insurance companies and the trial lawyers (on both sides) are wedded to the unfair system of tort law for resolving medical issues. (Why is it unfair? The rewards are handed out randomly, with many injured people not being helped and assignment of blame being done arbitrarily.)

The insurance companies say it is the greedy plaintiff lawyers. The plaintiff lawyers say it is the doctors and the insurance companies. Neither side wants real tort reform where a decent disability system exists to take care of injured no matter what the cause is. That would kill both sides golden geese--even though it would be best for the disabled.

[napi21]

33. Whose golden goose?

I agree with most of your statements. I think it is at the point where everyone is pointing the finger at someone else, so mobody is to blame. I don't have a problem withtort reform and changing the whole system. It fact, it's necessary. The proposals, however, don't seem to be the answer.

Unfortunately, there are incompetent doctors, nurses, etc. AS an example...the little girl in NC who was given the wrong blood type heard transplant BY MISTAKE! They realized the error a few days later, and did another transplant, but the patient died. I hear shrub saying that the max damage award whould not exceed $250,000. Would you say that was right in that case?

My questions tonight are not against anyone. I'm really trying to find out what is really gong on. Somebody's wrong here, I want to know who!

[Julian English]

56. In any sort of complicated procedure mistakes can happen.

I am sorry to hear about the child's death. Mistakes such as you mention, while catastrophic and while they do occur, are rare. There is no reliable evidence that malpractice suits decrease these sort of errors, however. (And I don't know the facts of the case. There may have been a reason for the mismatch that may make the case far less eggregious than you claim.)

Bogus lawsuits happen all the time, too--far more often than mistakes in cross-typing organs.

You ask what is wrong. I answered that. What is wrong is the adversary system for solving this problem. The first goal should be to care for the disabled--no matter the cause. Suing doctors does little to achieve this goal.

Indeed, why should someone with a disability and winning lawsuit be rewarded for a putiative medical mistake while someone with a disability and a losing lawsuit not be provided for?

The present system of medical malpractice is dumb.

The answers Bush proposes do not remedy it. The disabled are not compensated and the adversary system continues.

[napi21]

72. Here is a link to the story I referred to.

http://www.cbsnews.com/stories/2004/03/29/60minutes/main609225.shtml


I understand this is rare. That's not my point. Somebody is benefiting here, big time! I haven't figured out who it is. It doesn't seem to be the Dr's, it isn't the hospitals, there's only 2 groups left! Lawyers and insurance companies!!!!

[merh]

20. It is not the lawsuits, it is the medical communities' failure to monitor

and regulate itself or reprimand the offenders. Examples of malpractice occur just about every day. In my community a jury just awarded the plaintiff 1.8 million because the surgeon mistakenly operated on his brain. Another fellow was supposed to have the surgery to remove the diseased portions of his brain, but a mistake was made, and the poor plaintiff suffered damage to his brain. The original guy died because the diseased portion was never removed.

The insurance companies and the defense lawyers also share the blame. That is the irony of the "tort reform" issue. Defense lawyers cannot politically say that tort reform is wrong, because if they do, then they will be out of work, their client's will fire them faster than you can say lawsuit. But, they do not want tort reform, because if you limit the lawsuits, what will the poor suits do to make a living? Defense lawyers milk the cases because they are paid on an hourly basis by the insurance companies. They also have limitless resources to defend the action, the insurance company's checkbooks.

Plaintiff's lawyers do work at a disadvantage. They generally take a claim and pay all the expenses for litigating the matter. If they are successful, the expenses and their percentage fee is taken out of the money recovered for the plaintiff, but, if they are not successful, they are out of the money the have spent on the expenses. If the insurance companies and their defense attorneys would offer reasonable settlements at the beginning, when a demand is made, the cost of the litigation would be limited. But, they would prefer to defend the action to the very end, in the hopes that they break the plaintiff and/or his attorney with the expenses of pursuing the action.

Insurance companies pass on their poor investments to their insureds and claim that the lawsuits have caused the premium costs to rise.

Yes, ob/gyn doctor's are considered higher risk to cover (as are neurologists/neuro surgeons), but it is not because the parent's of every baby that is delivered that is not perfect sue. The suits are only brought if their are links between the doctor's procedures and the damage to the child. Plaintiff attorneys cannot and do not bring lawsuit if there is no proof that the standard of care was violated by the physician and if there were no damages.

[carpetbagger]

39. I worked in a small town in WV for a number of years.

I watched our urologist have a 2 million dollar judgment awarded against him, based on total bullshit for a "botched vasectomy". The award was overturned when the "scarred for life" guy's trailer was found a-rockin thanks to private investigators, but funny enough the money never got back to his insurance company.

I watched my partner have a suit against her when she only sent out a couple of letters and made like one or two phone calls asking a woman to follow up on an abnormal pap smear which eventually became cancer after 15 years of being ignored.

I watched our town's oncologist shut his practice after losing a suit where a woman died from infection after chemotherapy. He used the same protocol that was used at most of the medical schools in the area, and had the chairs of those departments testify that they do the exact same thing (chemo as well as treatment of the complications), but lost to a plaintiff whose main expert witness was the director of a whiplash clinic two states away (I'm not kidding).

Those three were three of the best. They were not the ones we had to police. They were not the ones maybe we should have policed. They were doctors I sent my family and friends to.

[merh]

59. See post #25.

Did your partner's case go to trial? What was the outcome?
I am sorry your partner was sued. Did you realize that lawyers have to pay malpractice insurance too? Their rates have been going up as well, maybe not as quickly or as high as physicians, but they take risks too when they take on cases, not just insurance risks, but financial risks. When the case is a bogus case, they spend a fortune in litigating it and get nothing back in return.

Most lawyers I know do not take on frivolous lawsuits because they do not want to risk being sanctioned by the court and because they do not want to taint the community or the jury pool with the idea that frivolous lawsuits are common. They also cannot afford the costs associated with litigating the case. (To find a doctor that will testify against another doctor is difficult and expensive.)

It sounds to me that WVa has a legal problem associated with the standard of care issue. A physician from 2 states over could never testify to the standard of care in the state where the plaintiff was "injured" in most states that I am aware of and definitely it would not be allowed in most federal courts.

[barb162]

73. lawsuits are a cost of doing business

Okay the first case was overturned which is correct beyond a doubt. What happened in the second and third cases you mention. Were there any damages awarded at all in the second case? That sounds like a zero value deal. Did the doc in the third case have any insurance? Did he have an attorney that was drunk. Can you please give more specifics including rounded $ amounts.

[sandnsea]

105. Can't even find a lawyer to take a case

I know lots of babies whose heads have been permanently scarred from fetal monitors. No lawyer would take the case.

I know an 80 year old woman who fell on her face and had the entire side of her head blackened because the floor of the hospital was sticky. They didn't even admit her. She had complications and couldn't find a lawyer to take the case.

I know people who were treated by a quack of a pscyhiatrist and everybody knew he was a quack, but no lawyer would take the case because he was the only psychiatrist within 100 miles and they needed him as an expert witness.

I know a 70 year old guy who fell in the parking lot of a hospital because a light had burned out and he couldn't see the curb. No lawyer would take the case.

In fact, I don't know anybody who has ever gotten money from a malpractice suit. It doesn't happen very often. You must live in a town with incredibly crappy doctors.

[Julien Sorel]

21. It's a wedge being used to promote "tort reform."

That's all it is. Bush doesn't care about OBGYNs, Bush cares about taking care of his wealthy donors who hate lawsuits.

[0007]

24. On the lighter side - A gynacoligist joke!

A Blonde, Redhead and a Brunnete were waiting in the gynacoligists office,for there check-up.
The Redhead says,"I heard that the position you always have sex in determine the sex of your baby'.
Redhead continues"since I was always on top , I'm having a boy."
The Brunnete says,"so I was always on the bottom, I must be having a girl.
The Blonde was crying and the Brunnete asked"whats the matter?"
Blonde replied,"I'm having puppies!"

[kanrok]

25. There are two main factors:

One is the increase in malpractice premiums. The second is reduced reimbursements from the federal government coupled with reduced HMO payments. Doctors are getting squeezed on both sides simultaneously. On the income side, and the expense side. The real question is why are insurance rates increasing? Insurance companies and the republican party blame trial lawyers. Doctors have been co-opted by this misdirection. The truth is that lawsuits are not "increasing." The rate at which lawsuits are filed has remained steady and actually decreased in recent years. The one constant has always been that if the economy is bad, malpractice carriers increase their rates. Insurance companies do not make their money on premiums. They make their money from investments. The economy is cyclical. When the economy is humming, investment income is high. When the stock market is in the toilet, there has to be somewhere to make up the losses. Hence, raises in premiums. Look at the historical trends: every 10 years or so we hear the same mantra, juries are out of control, greedy lawyers, etc. But it really is the cyclical nature of the economy that is to blame. Lawyers are easy targets. Demonize them and hide the real reason for the problem. The truth is that medical negligence cases are extremely expensive to prosecute. Especially obstetrical malpractice cases. Plaintiff's lawyers just cannot take "frivolous" cases. Doctors win 66% of a trials nationwide. It's a fool's bet to take on a case that is a loser. Especially when you have to shell out up wards of 100k to take a brain injured baby case to trial. You better have all your bases covered. I feel bad for doctors. 95% of the malpractice is committed by 10% of the doctors. Yet all of them have their premiums go up when the economy falters. It's like having your car insurance premiums go up when your neighbor gets a DUI. Insanity. What we really need is insurance reform.

[likesmountains 52]

30. agree!

If we had a single payor system we could eliminate most of the insurance overhead...the CEOs with huge salaries..and eliminate most of the ridiculous billing hoops that providers are forced to jump through to get a claim paid.

[napi21]

40. Do you realize what you just said?

You said the AMA doesn't regulate it's doctors, and the insurance companies are penalizing all the doctors for the sins of a few.

If that's really what the problem is, why the hell are they trying to beat up on the lawyers????

[kanrok]

45. Yes, I realize what I said

First, the AMA is not responsible for regulating doctors. That is the responsibility of the state licensing boards, and to a lesser degree, the peer review committees at hospitals. Yes, they do an abysmal job at regulating doctors. Look at the facts. A Harvard study done a few years ago estimated that 98,000 people die each year due to malpractice. It seems as though doctors have misdiagnosed the problem. Further, insurance companies are penalizing all doctors for the sins of the few, and in addition, they are more concerned about their bottom line than patient care. Lawyers are easy targets. There is no grass roots organization devoted to people who are about to be injured. No one believes it will happen to them.

[napi21]

57. I don't mean to be snide here, but 98,000 die due to malpractice?

How did they determine that? My snide remark is "Medicine isn't called a practice for no reason". It really isn't an exact science. Malpractice, to me, is when a dr. removes the wrong leg, transplants a mismatched heart, or ignores common obvious symptoms wrong. I'm not a lawyer, so I don't know how you would control this situation. I only know I'm not alone in recognizing something is very wrong!

[kanrok]

65. Actually, the definition of "malpractice" is:

Failure to do what any reasonably well qualified physician would do in a given set of circumstances. In short, the standard of care is really no different for a doctor than what it is for us lay folks. If we drive through a stop sign and cause a car crash, we are responsible for the damage we cause. Similarly, if a doctor causes injury due to his negligence, he or she is also responsible for damages sustained. The only real difference between them and us is that a physician in the same line of work has to define the "rules of the road" under the circumstances of the case being prosecuted. In other words, the plaintiff has to present competent evidence, through an expert familiar with the standard of care, in order to bring the case to begin with. Lawyers don't determine standard of care, doctors do. With all due respect, the situation is well controlled.

[EST]

90. Actually, that figure, on further review,

has been revised upwards. The number of deaths caused by medical malpractice is twice that figure, or about 200,000 per year!

[SharonAnn]

77. Yes, any doctor or nurse can tell you which doctors to avoid.

They know who's bad.

There are doctors praticing who should've been sanctioned, had their licenses revoked, been fined, etc. But their state licensing boards and/or peer groups won't take action.

[PA Democrat]

49. Here is a source for that statement

Small Number of Dangerous Doctors Commit Most Malpractice
• Only 5 percent of doctors (1 out of 20) are responsible for 54 percent of malpractice payouts. (National Practitioner Data Bank, Sept. 1, 1990 – Sept. 30, 2002.)

• Only 8 percent of doctors (1 out of 12) with 2 or more malpractice payouts have been disciplined by their state medical board. (National Practitioner Data Bank, Sept. 1, 1990 – Sept. 30, 2002.)

• Only 17 percent of doctors (1 out of 6) who have made 5 or more malpractice payouts have been disciplined by their state medical board. (National Practitioner Data Bank, Sept. 1, 1990 – Sept. 30, 2002.)

http://www.citizen.org/congress/civjus/medmal/articles.cfm?ID=9125

I would highly recommend reading the entire article.

[Julian English]

69. take this stuff with a grain of salt

Plaintiff attorneys give much of these folks their funding.

[PA Democrat]

83. WebMD agrees with Public Citizen

Few Bad Apples Lead to Soaring Insurance Costs

By Daniel DeNoon
WebMD Medical News Archive Reviewed By Michael Smith, MD
on Friday, September 27, 2002


Sept. 27, 2002 -- Doctors are mad at lawyers over soaring malpractice insurance costs. But a new analysis of public data suggests physicians should heal themselves.


The data come from a public record called the National Practitioner Data Bank. It holds records of malpractice lawsuits since 1990. Analysis of this record by the consumer watchdog group Public Citizen shows that just 4.8% of U.S. doctors are responsible for 51% of all malpractice suits. These doctors cost their insurers nearly $21 billion in damages paid to patients.

<snip>

Who are these bad doctors? It's a secret. The Data Bank only identifies doctors by anonymous numbers. It's easy to see why they don't want to be identified:


Doctor number 94358, licensed in New Jersey, settled or lost 33 malpractice suits over improper diagnosis or treatment. New Jersey authorities took no action.
Doctor number 64625, licensed in Pennsylvania, paid 24 malpractice claims involving improper performance of surgery. Pennsylvania authorities took no action.
Doctor number 37949, licensed in Texas, settled or lost 13 malpractice suits over improper treatment or improper performance of surgery. In two of the cases, foreign objects were left in patients after operations. Texas authorities took no action.

[Julian English]

91. Hardly convincing data.

Web MD is not a primary source. Not the stuff used in the search for good data. Generally, if you want to get good data on stuff like this, you good to professional journals. Getting it from advocacy sites, such as Citizen.org or popular press are neither consider good research. Consequently, two cites such as that don't make it true. Primary source data are what carries weight--unless you're a Freeper. Then facts don't matter at all. I hope that here we use a higher standard.

I tried to look at the National Practitioner Data Base, but the site appears to be down. Even if the NPDB.com had been up, I would be curious to see what the sites says, as well as review the actual cases. After all, the SBVT showed us the value of affidavits. Having seen more than a few lawsuits close-up, I realize there are more than a few spurious lawsuits.

That, said I don't disagree with the theory that a few doctors are committing the bulk of the malpractice. However, the assumption is that physicians control the process of punishing doctors themselves is not realistic. Due to pesky ideas such as due process it has become really hard to pull licenses. Which is good and bad. Doctors who are not guilty have a safety net from spurious accusations--but at the cost of protecting the poorer doctors.

But all this is a sideline.

The real reason for the problem, the expense of malpractice, is that tort law is a bad way to solve the problem at hand. It is expensive and imprecise. The conflicts involved, such as sympathy for the disabled and the need to assign blame, result in a system where the primary problem of helping the disabled patient is not addressed. The current system is good for lawyers and insurance companies, but bad for the disabled patients and doctors. What patients need is a better disability system.

[atre]

102. Actually, unless you live in a foreign country

The medical industry IS self-regulated. It is an absolute canard to say that the medical industry can do nothing about bad apples.

[merh]

128. They don't do it!

So who is to blame?

[merh]

51. Thank you for this post! It is very insightful.

In addition to insurance reform, we need the physicians to properly regulate their own. If 10% of the physicians commit malpractice, then the AMA should be doing something to suspend their licenses and require that they obtain additional education to improve their skills before they are able to practice.

Several states have proposed laws that have set up a "medical review board" that reviews medical malpractice claims before a lawsuit can be filed. If there is legitimacy to the claim, then the plaintiff is allowed to file suit. If no legitimacy, then the suit cannot be filed. Do you know which association has fought against the proposed legislation? The doctors!

Makes you wonder, don't it!

[Julian English]

64. Exactly. And a better disability system is needed

Because the US has a lousy disability system, those who are disabled look wherever they can for a livelihood, and they look for deep pockets. Doctors and their insurers meet this need.

Further, any bad result can be claimed to be malpractice. Bad things happen to sick people, but it isn't always malpractice.

Disabled people need a better way of getting a livelihood than suing their physicians. They need a good disability system.

The cause of a disability (bad luck v. malpractice) should not affect a person's life. That is the most just way of looking at the problem.

Of course, the attorney--defense and plaintiff--don't want this, it would take away a valuable sourece of income. Same with the insurers.

[DubyaSux]

26. It's malpractice...

The problem isn't really doctor's leaving practice or not entering medical school. They're changing specialties.

The amount of malpractice risk is disproportionate to other areas of medicine. So, why bother? They can go into family practice or another specialty making them more money (internal medicine, etc) with a substantial reduction in the risk of a malpractice lawsuit.

It's a no-brainer. Why do it if you don't need to?

[salib]

27. In many ways it is not lawsuits or malpractice

It is the COST of malpractice (liability) insurance. OB/GYN's and other physicians are not leaving the profession (or medical students not entering specialties) because of lawsuits, nor are they because of jury awards. They complain SPECIFICALLY about the high COST of insurance.

Now, if anyone cares to look at the INSURANCE industry, i.e., the ones that determine those rates, one will see that these rates have jumped (and the insurance companies have laid off a number of employees) not because rates were too low or too high. Instead, the increase in rates was instituted because of a HUGE drop in these companies PRIMARY source of revenue: THE STOCK MARKET. When it crashed around mid 2000, they lost BIG. That has always been the primary source of income, since INTEREST on their HUGE amount of capital (that is the point of insurance, isn't it?) is where the money is for them.

Thus, it is the economy stupid! Not doctors, lawyers, or even insurers. Otherwise, it is another good smokescreen for removing one more opportunity to get a little justice in this country. And *'s backers just LOVE that idea.

[napi21]

46. Has this awalys occured when the market is down?

I have heard this argument before, and it may have some merit. Maybe everyone's insurance rates are going up dramatically for this very reason. Health insurance, Malpractice insurance, maybe all other lines have risen because the insurance co's aren't making $$ in the investment market?

Has this happened in past down markets? I don't remember this reaction happening in the past. There are down markets every 10 years or so, but something is different about this one.

If it's the insurance companies greed, or poor decisions, why isn't anyone in congress asking this question? Why is it always the lawyers?

[PA Democrat]

53. Past medical malpractice "crises" have corresponded to economic downturns

Insurance Industry Economics Have Caused the Premium Price Spike

• "For several years, insurers kept prices artificially low while competing for market share and new revenue to invest in a booming stock market. As the bull market surged, investments by these historically conservative insurers rose to 10.6% in 1999, up from a more typical 3% in 1992. With the market now in a slump, the insurers can no longer use investment gains to subsidize low rates." (American Medical Association Report 35 of the Board of Trustees (A-02), available at:
http://www.ama-assn.org/ama1/upload/mm/annual02/bot35a02.rtf.)




• Premiums charged do not track losses paid, but instead rise and fall in concert with the state of the economy. When the economy is booming and investment returns are high, companies maintain premiums at modest levels; however, when the economy falters and interest rates fall, companies increase premiums in response. (J. Robert Hunter, Americans for Insurance Reform, "Medical Malpractice Insurance: Stable Losses/Unstable Rates," October 10, 2002. See also: http://www.insurance-reform.org/StableLosses.pdf.)

http://www.citizen.org/congress/civjus/medmal/articles.cfm?ID=9125

[Yupster]

71. Just looked up Prudential's profits

In 2001 when the market was down 12 % they made 27 billion.

In 2002 when the market was down 22 % they made 27 billion.

In 2003 when the market was up 28 % they made 28 billion.

I don't think it's the stock market, especially when insurance companies invest overwhelmingly in bonds.

[atre]

99. Your numbers don't disprove the point

The fact that profits stay steady despite fluctuations in the economy does not mean that they don't pass on stock market losses onto the consumer via increased premiums.

Maybe there is some logic to your argument, but I don't see it.

[Yupster]

110. Well if an insurance company's main profits

come from the stock market, and the stock market shows a 50 % swing in two years, you would sure see a difference in company profits in that time.

Certainly the markets react too quickly to cover the gap with constantly raising and lowering premiums each quarter.

You can't see that logic?

It doesn't matter if you see the logic anyway because insurance companies do not in fact invest any appreciable amount of their assets in the stock market.

The measure ratings agencies use to quantify the safety of insurance company investments is the percentage of their bonds rated below investment grade. Stocks are not a blip on their corporate portfolio.

[Elginoid]

37. i 've heard that there are a lot of openings in that field...

:evilgrin:

[Pepperbelly]

38. Is the premise true or is it yet another gop urban myth? nt

[progressivebydesign]

43. In the affluent area where I lived...

a lot of doctors gave up private practice... they gave it up to do foresnic and litigation work, it's much more lucrative.

[Yupster]

68. The wealthies malpractice attorney in my city

is also a doctor.

He gave up his medical practice to sue other doctors and has won huge awards. He could see where the money was.

[atre]

100. I've never heard of a stockbroker that works in a small town

And only in a small town would a medmal solo practicioner be the "wealthiest malpractice attorney."

[Yupster]

111. I live in a city of 95,000

The lawyer doesn't just do medical malpractice though that's his specialty.

He's involved in a fairly known case right now where a teenage employee of the local stor in the mall drilled a hole in the dressing room and took pictures of women changing.

He's representing the violated women.

In our city, any case that has a potential big settlement will usually have this lawyer's name atached to it.

[Yupster]

112. Never heard of a stockbroker in a small town

Look up a company called Edward Jones.

They've made their business by putting brokers in towns of 5,000 people. They're doing just fine.

[leesa]

47. Greedy insurance companies.

[barb162]

63. hmmm, are they really getting out of the business

I hear this but don't know if I believe it. I have seen no stats on whether there are fewer today than 5 years ago or 10 years ago.

[napi21]

76. I only know that several states are in serious trouble.

I guess the Dr's arent getting out the business, bur moving to other states. I'm still having trouble figuring out why it's a problem in some states, and who's to blame.

[barb162]

84. I have seen these stories on TV, read of them

I could swear a lot of the times they are simply moving to richer areas of the country where they can charge whatever they want. Or they change ares of PRACTICE to more well-paying specialties. In the area I live, there are NO shortages at all of obgyns, they are crawling over each other trying to get business because it is a fairly wealthy county. Poor counties, you won't see too many obgyns I bet.

[barb162]

78. As an insurance type

I will give my take on this. The insurers are definitely stiffing the docs for the insurance, no question. The insurers are making PLENTY of money off of malpractice premiums. Society is suing about the same as always, believe it or not. Many claims never go anywhere, for whatever reason people don't sue when they have a really great case. There really are no poerty-stricken docs. If so, please let me know which one is working for free or a pittance. When docs march for malpractice limits it drives me nuts. Watch what kind of cars they are driving away in if they ae getting so hurt. look at the houses they are living in. If somebody killed a doc's kid in a car accident, they wouldn't want their damages limited, but they are trying to limit damage awards of their patients. People who are getting hurt by malpractice should have all of the benefits of the law available them.

[napi21]

86. Good point! So is it the Dr's?

I actually believe, after reading all the posts here, and all the BS in the media, that there is no ONE group to blame! It's partly the Dr's, partly the lawyers, and partly the insurance companies. Each has an objective! The Dr's don't police themselves, the insurance companies seem to rather settle a claim than fight for the truth, and partly the lawyers who take a chance on a suit to maybe get lucky. The loser in all of this is the American people!

[barb162]

88. you're not going to believe this

but I think the attorneys are the least to blame. Though there are some lawyers who will take cases on contingency, they want to make sure they have a pretty good case before they start spending money without a payback as it is not like they can get rid of a client once they agree to take a case. Most of the cases they take are winnable. Why are they winnable? Because the docs and/or hospitals screwed up, plain and simple. I remember sitting on a case where there was a 6 million settlement for a kid who was going to be messed up up his entire life...couldn't even feed himself. The hospital got nailed as the nurses didn't notify the MD the kid was ready to come out. The kid suffered serious brain injury. The doc got out but there was a big defense cost the insurer paid aNyway. The judge said it was a good settlement as that (6 mil)was the last offer made by the insurers for the doc and hospital before the case went to trial. 6 million was enough to take care of his physical needs the rest of his life and that was all. The kid was going to be a veg his entire life. Anyway, the docs don't police themselves. That is hard to do because if you try to go after a nother doc, you get sued. It's not a good system is it? I tink the most innocent of the bunch are the patients... most dont' sue and often don't when they can. If every patient sued who had a good case, the malpractice peremiums would be way higher.

[napi21]

96. From reading all the post here, it seems to me thtat there are 2 problems.

The MAM is at fault for not pulling the license of any Dr who is guilty, IN THEIR JUDGESMENT, of malpractice. I know all about protecting your own, but then you pay the price!

The other fault is unethical attorneys who persure claims that have no grounds.

I have read all the thread here, and it sure seems to me that the tort reform isn't the asnwer. The AMA, and the ABA are far more responsible, and so is the insurance industry! I do believe they are trying to make up inventment losses through increased premiums. Would that all business could mae=ke up losses like that!

[barb162]

104. tort reform (primal scream)

This keeps rearing its ugly head. When business or doctors or others call for tort reform, have you ever noticed they don't call for it for everyone? DO you know that most lawsuits in this country are business to business and that consumers who sue are only a small fraction of the lawsuits taking up all the court time in this country. I have never heard of business call for business on business tort reform because they sure don't want to limit the damages they can get if someone screws with their copyrights, patents, products, etc. They want it both ways; they want to be able to sue whomever, but they dont want to be sued by consumers.

Tort law as it is is one of the last "freedoms" we have as citizens to pootect ourselves. Listen to John Edwards on why the GOP hates trial lawyers. Because the trial lawyers are the only way consumers can really go after business and others.

[Bob Hannah]

85. Fear

15 years of school and student loans to pay

[Blue_Tires]

87. my dad's one (already semi-retired)

his retirement is being hastened by the ever-increasing costs of malpractice insurance (close to 40 grand per year)

[napi21]

101. What does your dad think the problem is?

I haven't had the courage to ask my PCP this question. But I will ask you. Who's wrong here? I have tried to follow the $$, but it's everywhere! The lawyers, the insurance companies, the patients, the doctors, even the drug companies. Where is the problem?

[Blue_Tires]

121. he personally blames frivilous lawsuits

the whole ordeal has pushed him a little to the right, politically

[Endangered Specie]

98. Imagine being Ann Koulter's OBGYN

:shudder:

[Algomas]

113. High incidence of tunnel vision...

sorry for the wise crack but the hour is late and I am bushed.

[Dem2theMax]

115. Forgive me,

was this a freudian slip? "I am bushed."

After reading *'s reference to OBGYN's and love, your "I am bushed" phrase just cracked me up. It's even later now and I'm bushed too. LOL. ;)

[Irishladdie]

124. They are getting sued like crazy!

My Brother who is an ER Doctor told me that no one wants to do it anymore because people sue them for anything. The Mother has a drinking problem, the doctor tells her to stop, she doesn't, the baby comes out deformed, the Doctor gets sued. People feel sorry for the Mom whose baby is deformed, doctor gets screwed. Trust me I believe in suing doctors who do Mal-practice but it is getting out of hand. Also my Brother tells me not one Ortho Doctor is on call at the ER anymore. They are getting sued like crazy too. People come into the ER with a bone sticking out of there arm and the doctor fixes it as best he can and they sue. Its actually kind of sad. These Doctors are getting screwed for the most part. Its sad because many wonderful Doctors are getting screwed because of a few lame ones. Its heart wrenching.

[Bridget Burke]

130. Anecdotal information

Do you have any hard facts for us to look at?

How can a lawyer prove that symptoms of Fetal Alcohol Syndrome were caused by malpractice? They're pretty cut & dried.

[northernsoul]

137. Really?

All the plaintiff's attorneys I knew tell me that they turn away 199 out of every 200 people who come to them in hopes of starting a suit. 95% of the cases that do get filed settle, and of those that don't 80% are "won" by the doctor's insurer at trial.
Here in Minnesota the CEO of United Health Group made $29 million last year and the total amount of judgments against physicians was $18 million - which one is a bigger cost to the medical system?

If a mother whose child's defects were clearly attributable to her own alchohol abuse came into my office I wouldn't waste five minutes of my time on her. On the other hand, if some woman came in who'd just undergone a double mastectomy for absolutely no medical reason because some physician couldn't diagnose correctly - I'd be happy to take the case and I'd try to get the biggest damages awarded that I could. Nobody should have to be at the mercy of an incompetent doctor.

[fob]

132. Besides "hearing about it" can you post any documentation of it?

The AMA website has an interactive map of "crisis" states and "in danger" states that blames this on medical liability.

Here is a link that takes that assumption on;

www.citizen.org/documents/ACF42D4.pdf

IMO, it's all a bunch of hooey, when Insurance companies take a big hit (hurricane/earthquake/terrorism) they cover their ass with rate hikes. On AAR several weeks back Franken cited bush* admin's OWN numbers that showed liability claims make up only 2% of the cost of premiums, there are many other factors that are way above 2% of the cost that should be addressed BEFORE libility "reform".

[ArkDem]

136. They have been ruthlessly driven out by the gynecologists.

[hunter]

138. Doctoring the "average" american is an ugly business...

Practicing medicine, at least the kind of medicine that actually helps people, and not the kind that caters to vanities of the wealthy, is a very poor career choice.

You see so many immigrant doctors for the same sorts of reasons you see so many immigrant farm workers. Most American citizens are not "willing" to do certain kinds of work. Taking care of "average" Americans with their crappy or non-existent health insurance, and especially delivering their babies, is very stressful work.