Norma Sherry: Pathology of Malpractice
Pathology of Malpractice
By Norma Sherry
Have you been to a doctor lately? If you have [and you live in Florida, USA] then you have seen the poster just about every Florida physician has prominently displayed in his or her office depicting a doctor with his hands bound with rope.
Florida is facing a medical crisis we are told. Governor Jeb Bush has made it his top priority. According to physicians malpractice insurance is a stranglehold on their ability to continue practicing and staying in business. Perhaps their verbiage is more accurate than they would like. Statistics clearly indicate doctoring in Florida rates among the lowest quality in the country. Only Wisconsin and North Carolina rate worse. So, perhaps "practicing" is not a misnomer but a sad truism. As for the business part, we, the patients, have long known being a physician is a very viable and productive business.
But I digress. The average doc claims he's working one week out of every four to pay his malpractice insurance. (My use of "he" is not intended as sexist or exclusionary, but for the purposes of expediency and clarity hereon in I shall use the male moniker. However, please know this applies to the she's as well.) They argue that there must be a cap of $250,000 per medical malpractice lawsuit.
Considering that more people have died at the hands of physician error or medical malpractice than AIDS, or Breast Cancer, and double the number of individuals that succumbed to an automobile accident, it would appear at this rate, our physicians must carry insurance. However, the audacity that they want to put a cap on the extent they are willing to be liable for a catastrophic or deadly error is unconscionable. In essence, in Florida, $250,000 is the value of a life. And if perhaps that patient is not so lucky as to die but, instead has to live a tortured existence because of a physician's malfeasance, this paltry sum, akin to a drop in the bucket, is supposed to last a lifetime of care?
Florida Physicians and the AMA (American Medical Association) have begun an expensive and expansive campaign to win the support of Florida patients and citizens. For many individuals the fear of losing their favorite doctor is all the motivation they need. They believe the half-truths of what is being perpetuated by this crusade of fear.
The true facts are these according to a report by Public Citizen, a national consumer advocacy organization, and its president, Joan Claybrook, "There is no medical malpractice insurance crisis. Rather, there is excessive doctor malpractice and an insurance industry profits crisis."
Consider this dear reader; has your homeowners insurance escalated? Has your health insurance remained the same? The answer to both is definitively obvious. Homeowners insurance has increased 15% and health insurance between 20 and 28%, an undeniable and significant stranglehold on the average household. In fact, health insurance is so expensive that according to the 2002 Census Report, 41.2 million Americans are uninsured. Eight million of which are children. (An increase of 1.4 million since 2001.)
American physicians are among the wealthiest individuals. Their complaint and in some cases, tear-driven argument, that they are being driven out of business is a shameful sham. The following incident occurred in 2001 to an individual on Medicare when he went to his physician to have a cyst removed. He entered the doctor's lavish office, took his seat among the throng of waiting patients, filled out the pages of questions and turned in his insurance card for the record. When the doctor finally came into the examination room (45 minutes after the scheduled appointment because he was so overbooked), he began with a tirade. He told his unwitting patient that Medicare was ruining him. That Hilary Clinton and her liberal lot were going to force him to give up his practice and compel him to begin selling real estate. He told the patient he couldn't afford to remove his cyst for the measly sum Medicare would pay him, but that he would this one time since he was already there.
The poor patient now humiliated and concerned the doctor would further take his frustrations out while excising his cyst, opted not to have the procedure. He left the office somewhat bemused, somewhat shocked and a bit angry. As he got into his elder model Chevrolet he couldn't help noticing the brand new Mercedes with a physician insignia in the window parked next to his jalopy.
This was not a rare happenstance. Unfortunately, doctors by the droves are turning away patients on Medicare. The world-renowned Mayo Clinic sent out notices to all their patients last year that come January, they will no longer do the paper work for Medicare. They further stated that patients would have to take care of the forms themselves and furthermore that they would have to pay Mayo their fee, and that they, the patient, would have to wait for Medicare reimbursement.
Considering that Medicare was devised for our retired and elderly community living on a fixed income, this is a hardship to be sure. Certainly Mayo Clinic is not hurting financially, most especially with its record-breaking increase in patients, up 96,000 in Jacksonville alone last year. The message Mayo Clinic is making perfectly clear is that their preferred clientele is the wealthy client.
The additional difficulty to the new Mayo system is that the paperwork is burdensome and confusing to the average senior patient. Without assistance the difficulty is too much to handle. Their pride oftentimes doesn't leave latitude for asking for help. Mayo and other healthcare physicians and offices know this all too well. Again, the message is very clear, only patients with abundant and secondary insurance are welcomed.
The truth of the matter, however, regarding physicians and malpractice insurance, is that there is an insurance rip-off, a clear case of chicanery at its worst. Here are the statistics, you decide.
Doctors working in Jacksonville pay $28,769 for a policy that costs doctors in Georgia $6,283 from the same company - even though Georgia's average malpractice payout in 2002 was 31 percent higher than Florida's. Florida physician's malpractice insurance has increased 20 - 25% each year, with Gynecologists paying among the highest premiums of nearly $200,000 a year.
Florida Today suggests the problem lies in the insurance industry's inability to set aside reserves. In the 1990's there were 40 insurance companies in Florida writing and competing for the malpractice insurance business. Then there were some very large awards to well-deserving patients, but little reserves were set aside. Today there are only 6 companies writing medical malpractice insurance in Florida; the theory is they are trying to replenish the cache.
There are many contributing factors for this sad state of affairs - many more than space will permit. But here's a few for your bonnet. Our legal firms have fought for and won Tort Reform, which if any of you has sought legal recourse for a transgression knows all too well, has made doing so virtually impossible - or not cost effective. Disreputable physicians and hospitals alike have double and triple billed the Medicare and Medicaid systems nearly bankrupting them. The overseers of right and good have neglected their duty. Hospitals allow questionable doctors to continue performing; the boards created to protect patient's rights and patient care are disreputable and worse than lenient when it comes to monitoring and penalizing their own.
So, dear reader, that leaves us, the patients in a quandary. We must send a clear message to our representatives that we are not gullible; that we have an astute understanding of how the system and the business of business is manipulating the situation.
As patients we have the right to insist our doctors perform expertly and if they don't they need to pay the consequences. Perhaps then the inadequate will be filtered out and the cream will rise to the top. As customers we have the right to insist on excellence and timeliness and courtesy. Doctors who overbook and stockpile patients 4 to 6 for the same hourly appointment don't deserve our business. We need to tell them so. Can you imagine any other business in which such a disregard for you, the customer, would be acceptable?
And furthermore, we need to let the insurance industry know we are on to them - and that we are not going to take this anymore. Not only for the excessive rates for our physicians, but what about us?
It is time, dear readers, that we express our right to excellence in every regard.but particularly when it comes to our lives.