Originally posted August 11, 2009
Jeff Segal, MD, JD, founder and C.E.O. of Medical Justice, was invited to debate Alan Rirpka, (of Napoli, Bern, Ripka, LLP) a medical malpractice trial lawyer, last week. Dr. Segal was the clear winner of the debate, as he accurately and deftly kept to the subject; the flawed system of medical liability that forces doctors to practice defensive medicine. Meanwhile, the trial lawyer seemed to get bogged down at a soft spot in his position, and there he remained, wheels spinning pointlessly. (We could probably be more diplomatic, but why sugar-coat it?) We here at Medical Justice couldn’t be more proud of Dr. Segal!
What follows is a transcript of the debate. We look forward to hearing your thoughts.
LOU DOBBS TONIGHT
Aired August 6, 2009 at 7:00 p.m. ET on CNN:
LOU DOBBS, CNN ANCHOR: Good evening, everybody. Up next, the rising skyrocketing costs of medical malpractice, will it destroy our health care system and defensive medicine. That’s the subject of our “Face Off” debate tonight.
DOBBS: The Congressional Budget Office found that caps on medical malpractice lawsuits could save more than $4 billion over the next decade. Are malpractice lawsuits destroying the health care system? That is the subject of our “Face Off” debate tonight. Joining us, Dr. Jeffrey Segal — he’s founder and CEO of Medical Justice — and Alan Ripka, a medical malpractice attorney. Good to have you both with us.
DOBBS: In numbers medical malpractice and if we — let’s show these numbers — medical malpractice
claims and insurance premiums make up just about one percent of total health care costs but the AMA
estimates that so-called defensive medicine, a direct result of those malpractice lawsuits costing us $151 billion. Let me start, if I may, with you, Dr. Segal. What’s your reaction?
DR. JEFFREY SEGAL, CEO, MEDICAL JUSTICE: My reaction is that number, 150 billion, may actually be an underestimate. I can tell you that next year, 50,000 doctors will receive a letter stating, hey, look, you’ve been sued. Once you’ve been sued, that will change the doctor’s behavior from then on.
And what is the cost? The cost is anywhere between 100 to $200 billion of unnecessary tests just to keep the doctor from sitting in a witness chair ever again. That amount of money would allow us to purchase a health insurance policy for every uninsured American, pay for health information technology, and have some change leftover.
DOBBS: All right, Alan Ripka, your thoughts.
ALAN RIPKA, MEDICAL MALPRACTICE ATTORNEY: I completely disagree. When we talk about defensive medicine, we’re talking about saving lives. They’re calling it defensive medicine, but what it really is, is doing the appropriate tests so that doctors and nurses and health care providers could be checking on all the possibilities that may be going wrong with the patient. And they’re not going to know unless they do those tests. And the reason medical malpractice exists is because those tests aren’t done and people die. And you’re not talking about death here. You’re talking about money. And obviously lives are much more important.
DOBBS: You couldn’t quarrel with that, could you, Doctor?
SEGAL: Well, I think patient safety is really important, but most of the tests that are being done related to defensive medicine provide absolutely zero value to the patient. They keep the doctor out of the witness chair. A small amount of testing will improve the patient’s condition and a small amount of testing paradoxically will actually make the patient even worse than before you started. But by and large, defensive medicine is exactly that just…
DOBBS: May I interrupt you? Did you just say testing could make the patient worse off?
SEGAL: Exactly. Imagine sticking a needle in the patient just because you’re curious to make sure – just 1,000 percent sure that you’ve not missed anything. Once you stick a needle in the patient’s body anything can happen. The lung can drop, bleeding, infection, the list goes on and on.
