Jeffrey Segal, MD, JD - Medical Justice

Tort Reform for Medical Malpractice System, Another Study Needed?

August 15, 2024September 7, 2011 by Jeffrey Segal, MD, JD

Michael Kirsch, M.D. – author, MD Whistleblower

Medical malpractice reform is in the news again. Of course, for the medical profession, the medical malpractice system is the wound that simply will not heal. For the plaintiffs bar, in contrast, the medical liability system is the gift that keeps on giving. I have argued that the current system fails on four important fronts.

Efficiency
Cost
Fairness
Quality Improvement

I admit readily that my profession has not been as diligent as it should be in holding ourselves accountable. We have not been forthright in admitting our medical errors, although can you blame us under the current medical liability construct? There is merit to the argument that tort reform is

Texas Enacts a New Patient Privacy Law that is More Stringent than HIPAA

August 15, 2024August 26, 2011 by Jeffrey Segal, MD, JD

Michael J. Sacopulos, Esq. Recently, Texas House Bill 300 was signed into law by Texas Governor Rick Perry. The new law, which will become effective on September 1, 2012, expands privacy rights of patients beyond those contained in the HIPAA privacy standards. The law was created in order to better secure patients’ protected health information … Read more

NEJM: The Numbers Are In: Doctors Are Sued A Lot

August 15, 2024August 18, 2011 by Jeffrey Segal, MD, JD

Jeff Segal, MD, JD, FACS

Imagine telling your patient the success rate of a surgical procedure you were planning was 20%. year after year. Most patients would hit the door. Unless the only other option – doing nothing – was far worse.

That’s precisely the conclusion drawn from Jena, et al. in a New England Journal of Medicine article released this week – Malpractice Risk According to Physician Specialty. Data was analyzed from a large national carrier covering time period 1991-2005. The researchers analyzed 230,000 physician-years of coverage.

Each year of the study period, 7.4% of all doctors had a malpractice claim. Only 20% of those led to payment – either by settlement or judgment. The majority of claims resulted in zero payment to the plaintiff. Remember, though, the typical claim lingers for about four years before final resolution.

More interesting was breakdown by specialty. Annual risk for being sued:

Affidavits of Merit, Are They Worthless?

August 15, 2024August 15, 2011 by Jeffrey Segal, MD, JD

Jeff Segal, MD, JD, FACS

Affidavits of merit, are they worthless?

Probably.

Ohio provides but one example of how well intended legislation can be diluted by judges.

Ohio introduced tort reforms in 2005. Among the reforms, plaintiffs were now required to prove they had done some homework before filing. The plaintiffs had to assert that a qualified expert had reviewed the case and determined the claims had merit. That Rule was known as 10(D)(2). What’s not to like? It’s like Mom and Apple Pie. Hardly controversial.

The steps are basic. The plaintiffs must give the relevant records to one or more qualified physicians to review. The physician must determine negligence may have occurred. Then, that physician must memorialize that conclusion in writing – the Affidavit of Merit. That’s it.

One would think that if nine different specialists were named in a single lawsuit, records would reasonably be reviewed by different specialists – penning multiple Affidavits of Merit. Such a process, if honored, would surely have the effect of deterring frivolous litigation against potential peripheral defendants. It would also neutralize shotgun lawsuits – where anyone whose name is on the chart is sued.

Ohio doctors report that more than one Affidavit of Merit is rarely filed. But lots of different specialists are corralled into single lawsuits.

In a recent Ohio case, a plaintiff sued six defendants; four practiced different specialties. A single affidavit was presented, signed by an out-of-state physician who didn’t practice in even one of relevant specialties. Read that statement again.

The doctors asked the court to dismiss the case, arguing that the Affidavit of Merit requirement – the bare minimum needed to initiate a case – was not met.

Here’s what the court replied:

Majority of Lawsuits Against Doctors Dismissed; But Not Quickly

August 15, 2024August 10, 2011 by Jeffrey Segal, MD, JD

Jeff Segal, MD, JD, FACS

An article in the July issue of Health Affairs detailed the natural history of malpractice claims in Massachusetts. Approximately 60% of these claims were abandoned by the plaintiff. But, this news came slowly to the doctor – who waited an average of 3 years after the claim was filed. During that time frame, costs were incurred to defend the case. And the doctor was burdened by a claim hanging over his or her head.

The study’s author, Dwight Golann, interviewed attorneys and insurance companies about the reasons for the abandoned claims.

Another Example of the Importance of Experts

August 15, 2024August 2, 2011 by Jeffrey Segal, MD, JD

Michael J. Sacopulos, Esq. Earlier this month a Galveston County Texas Judge dismissed a medical malpractice claim against Mainland Center Hospital. The malpractice action had been brought by Jim Howard, III. Howard alleged that the emergency room staff at Mainland Center Hospital broke his femur in March of 2009. Howard’s action was originally filed on … Read more

Major Development at Google Places and Handling of Patient Reviews

August 15, 2024July 29, 2011 by Jeffrey Segal, MD, JD

Tom Seery, CEO, RealSelf

First announced in the technology blog techcrunch, Google made a significant change this week to the way patient reviews of doctors (and all local businesses) get displayed in Google Places. This has important implications for online doctor reputations.

Prior to this week, reviews from 3rd party sites were used to develop an aggregate number of postings and star rating for a doctor. Ratings were pulled in from services like Vitals, RateMD, HealthGrades, Yelp and dozens of others. Most SEO experts had posited that the reviews aggregated in a Google Places listing impacted a doctor’s ranking in Google search results. Hence, many doctors instituted programs where they asked patients to add reviews to these rating sites.

Break Out The Champagne

August 15, 2024July 28, 2011 by Jeffrey Segal, MD, JD

Jeff Segal, MD, JD, FACS

If at first you don’t succeed, try, try again.

On July 25th, the North Carolina House of Representatives overrode the Governor’s veto of substantive tort reform. The North Carolina Senate overrode the veto last week. The bill will now become law.

This effort began decades ago and was finally realized this week. Most notable is the cap on non-economic damages. The law caps these damages at $500,000. This is considerably higher than other states that have passed reforms – such as California and Texas. But, it removes the uncertainty from what was previously the status quo – where the sky was the limit.

The bill was designed to balance the interest of injured patients with those of practicing physicians.

Survey Says and Says and Says

August 15, 2024July 20, 2011 by Jeffrey Segal, MD, JD

Jeff Segal, MD, JD, FACS

I doubt that lately, few subjects have been studied, discussed or argued as much as the effects that frivolous lawsuits have on the nation’s healthcare system. This summer, three more studies looked at this problem from various vantage points.

First, Jackson Healthcare investigated whether physicians working under contract with the federal government practice less defensive medicine than their private sector peers. As a reminder, as if anyone really needed one, defensive medicine describes ordering medically unnecessary tests, treatments or consultations to avoid malpractice lawsuits. The results?

+ More