[gas_dr]

Greetings from a call-room in Florida where I am a physician. The malpractice crisis is deep and widening. The problem is this -- as I have read through this thread there has been little discussion of what medical malpractice REALLY is. Many have said doctors make errors. Many have said that there are bad doctors, but this does not equal medmal.

In order to be civilly guilty of medical malpractice, the perponderance of the evidence must show that the physician committed the act of NEGLIGENCE, which is to say HE VIOLATED AN ACCEPTED STANDARD OF CARE. An error is NOT a necessarily a violation of the standard of care. Have I made an error in my practice? Sure, medicine is still an art, and that means that things do not always happen as you would hope or necessarily expect.

Like many have suggested, tort reform is an excellent point to begin solve this problem in the free market. Many physicians are being forced to go without insurance, and that is a horrible position for us to be in. We all went in medicine to deal with sick patients and help to remedy their situation, and to touch a life. Nonetheless, on a routine basis, people come to us without insurance, and ROUTINELY receive the best medical care in the world, and then tell us they will not pay us a thing -- it is their right to be treated. But if there is even the least unexpected turn in their care, then we get sued for real damage, punitives, etc.

Finally, the big scare in private practice is currently that the government will nationalize health care. Then you will see the exodus of many fine physicians from our healthcare, and we will have lost the best health care industry in the world.

[Steve Eisenberg]

In order to be civilly guilty of medical malpractice, the perponderance of the evidence must show that the physician committed the act of NEGLIGENCE, which is to say HE VIOLATED AN ACCEPTED STANDARD OF CARE.

If I understand this correctly, gas_dr considers doctors who violate an accepted standard of care to be properly considered guilty. If so, the doctors responsible for most of the great medical advances in history stand guilty of malpractice.

To take a specific example, let's say a patient comes in with massive injuries to a leg so that the standard of care says to amputate. But the doctor has a hunch, may be from a few words the patient said before going unconcious, that the patient would rather risk his life if there is a chance to save the leg. In this case, even without any written directive from patient or family, I would want my doctor to be able to ignore the standard of care if he saw fit.

The problem is not that malpractice awards are too high or too frequent, but that the whole idea of medical malpractice is based on a unrealistic idea of medical perfection, and on the idea that medical care is properly static, when it should always be in the process of rapid improvement.

[Mini-14]

I once talked to an anesthesiologist in Florida who had to give up his practice after a lasik surgeon damaged the vision in both of his eyes. The lasik surgeon mis-aimed the laser (decentered ablations), and mis-aimed the microkeratome which caused decentered flaps.

The anesthesiologist continued working for some time while he was visually incapacitated.