quasi Report This Comment
Date: July 21, 2009 08:30AM
DETROIT (AP) — When a treatment goes wrong at a U.S. hospital, doctors
usually fear they will be hit with a lawsuit.
At the University of Michigan Health System, however, lawyers and doctors say
admitting mistakes up front and offering compensation before being sued have
brought about remarkable savings in money, time and feelings.
"What we are doing is common decency," said Richard Boothman, the
health system's chief risk officer and a veteran malpractice defense lawyer.
The estimated $5.8 billion annual cost of malpractice claims nationwide has
drawn scrutiny as President Barack Obama and Congress plot an overhaul of the
nation's $2.4 trillion health care system. So far, Obama has spoken in broad
terms about shielding doctors from unwarranted lawsuits without capping damage
awards, but medical malpractice is an issue that deeply divides. Doctors,
hospitals, trial lawyers and patient advocates disagree not only on the solution
but the problem itself.
Is it the high price of malpractice insurance? The difficulty for victims of
medical errors getting justice? The cost of unneeded tests ordered by
lawsuit-wary doctors? The "burying" of medical errors that kill tens
of thousands of Americans yearly?
Officials at the University of Michigan say their approach addresses doctor,
patient and public concerns.
The willingness to admit mistakes goes well beyond decency and has proven a
shrewd business strategy, according to a 2009 article in the "Journal of
Health & Life Sciences Law" by Boothman and four colleagues at the Ann
According to Boothman, malpractice claims against his health system fell from
121 in 2001 to 61 in 2006, while the backlog of open claims went from 262 in
2001 to 106 in 2006 and 83 in 2007. Between 2001 and 2007, the average time to
process a claim fell from about 20 months to about eight months, costs per claim
were halved and insurance reserves dropped by two-thirds.
As a result, costs are down in part because admitting a mistake and paying up
can save money that would have been spent on lawyers, and because the size of
the compensation offered by the hospital can be less than an eventual court
Also, the fact that the hospital admits its mistakes and fights hard when it
claims to not have made one tends to discourage lawsuits.
Boothman said the health system learns of possible medical errors from doctors
themselves, as well as from patients or their lawyers. In any case, the
university conducts a peer review to see if there was an error and if changes
are needed to prevent a recurrence.
Equally important, health system doctors and officials offer to meet with
patients and their families, sometimes to explain that treatment was appropriate
and sometimes to admit a mistake.
The "saying sorry" movement has its skeptics, even among those who
agree it's the right thing to do.
The right of injured patients to sue health care providers and force them to
open up their internal records is a crucial part of reducing medical mistakes
and improving care, said Matthew Gaier, co-chairman of the New York State Trial
Lawyers Association's medical malpractice committee.
Harvard University public health associate professor David Studdert says a
review of published studies shows about 181,000 people are severely hurt each
year as a result of mistakes at U.S. hospitals but only about 30,000 file legal
Many people don't sue because they don't discover they are victims of
malpractice, Studdert and colleagues wrote in a 2007 article in the journal
"Health Affairs." The spread of disclosure, the article said, could
cause malpractice costs to rise from $5.8 billion now to between $7 billion and
$11.3 billion a year.
For "saying sorry" to work, doctors need protection from having their
own honesty used against them in court, said Jim Copland, director of the
Manhattan Institute's Center for Legal Policy and an advocate of curbs on damage
suits. Protection could take the form of a shield law that would exclude an
apology from admission as evidence in a malpractice suit. A number of states
have or are considering such laws.
"If you go out and say, 'Oh, we messed up, are you going to lose the
lawsuit? You need to give them some protection," Copland said.
quasi Report This Comment
Date: July 21, 2009 04:45PM
"I'm Tired" by Robert A. Hall
I'll be 63 soon. Except for one semester in college when jobs were scarce,
and a six-month period when I was between jobs, but job-hunting
every day, I've worked, hard, since I was 18 Despite some health
challenges, I still put in 50-hour weeks, and haven't called in sick in
seven or eight years. I make a good salary, but I didn't inherit my job
or my income, and I worked to get where I am. Given
the economy, there's no retirement in sight, and I'm tired. Very tired.
I'm tired of being told that I have to "spread the wealth around" to
who don't have my work ethic. I'm tired of being told the government
will take the money I earned, by force if necessary, and give it to people
too lazy or stupid to earn it.
I'm tired of being told that I have
to pay more taxes to "keep people in their homes."
Sure, if they lost their jobs or got sick, I'm willing to
help But if they bought McMansions at three times the price of our
paid-off, $250,000 condo, on one-third of my salary, then let the left-wing
Congress-critters who passed Fannie and Freddie and the Community
Reinvestment Act that created the bubble help them with their own money.
I'm tired of being told how bad
America is by left-wing millionaires like
Michael Moore, George Soros, and Hollywood entertainers who live in
luxury because of the opportunities America offers. In thirty years, if they
get their way, the United States will have
the economy of Zimbabwe, the freedom of the press of
China, the crime and violence of Mexico, the tolerance
for Christian people of Iran, and the freedom of speech of
Venezuela. Won't multiculturalism be beautiful?
I'm tired of being told that Islam is a "Religion of Peace," when
I can read dozens of stories of Muslim men killing their sisters, wives and
daughters for their family "honor"; of Muslims rioting over some
offense; of Muslims murdering Christian and Jews because they aren't
"believers"; of Muslims burning schools for girls; of Muslims stoning
teenage rape victims to death for "adultery"; of Muslims mutilating
genitals of little girls; all in the name of Allah, because the Qur'an
and Shari'a law tells them to.
I believe "a man should be judged by
the content of his character, not by the color of his skin.
" I'm tired of being told that "race doesn't matter"
in the post-racial world of Obama,
when it's all that matters in affirmative action jobs, lower college
admission and graduation standards for minorities (harming them the most),
government contract set-asides, tolerance for the ghetto culture of
violence and fatherless children that hurts minorities more than
anyone, and in the appointment of US Senators from Illinois.
I think it's very cool that we have a black president and that a black child
is doing her homework at the desk where Lincoln wrote the
emancipation proclamation. I just wish the black president was Condi Rice,
or someone who believes more in freedom and the individual and less
arrogantly of an all-knowing government.
I'm tired of a news media that thinks Bush's fundraising and inaugural expenses
were obscene, but that think Obama's, at triple the cost, were wonderful.
That thinks Bush exercising daily was a waste of presidential time,
but Obama exercising is a great example for the public to control weight
and stress, that picked over every line of Bush's military records, but never
demanded that Kerry release his, that slammed Palin, with two years as
governor, for being too inexperienced for VP, but touted Obama with
three years as senator as potentially the best president ever.
Wonder why people are dropping their subscriptions or switching to
Fox News? Get a clue. I didn't vote for Bush in 2000, but the media and
Kerry drove me to his camp in 2004.
I'm tired of being told that out of "tolerance for other
cultures" we must let Saudi Arabia use our oil
money to fund mosques and madrassa Islamic schools to
preach hate in America, while no American group is allowed
to fund a church, synagogue, or religious school in
Saudi Arabia to teach love and tolerance.
I'm tired of being told I must lower my living standard to fight global warming,
which no one is allowed to debate. My wife and I live in a two-bedroom apartment
and carpool together five miles to our jobs. We also own a three-bedroom condo
where our daughter and granddaughter live. Our carbon footprint is
about 5% of Al Gore's, and if you're greener than Gore, you're green enough.
I'm tired of being told that drug addicts have a disease, and I must help
support and treat them, and pay for the damage they do. Did a giant germ
rush out of a dark alley, grab them, and stuff white powder up their noses
while they tried to fight it off? I don't think Gay people choose to be
Gay, but I damn sure think druggies chose to take drugs.
And I'm tired of harassment from cool people treating me like a freak
when I tell them I never tried marijuana.
I'm tired of illegal aliens being called "undocumented workers,"
especially the ones who aren't working, but are living on welfare or crime.
What's next? Calling drug dealers, Undocumented Pharmacists"?
And, no, I'm not against Hispanics. Most of them are Catholic, and it's been a
few hundred years since Catholics wanted to kill me for my religion. I'm
willing to fast track for citizenship any Hispanic person, who can speak
English, doesn't have a criminal record and who is self-supporting without
family on welfare, or who serves honorably for three years in our military...
Those are the citizens we need.
I'm tired of latte liberals and journalists, who would never wear the uniform
of the Republic themselves, or let their entitlement-handicapped kids near
a recruiting station, trashing our military. They and their kids can sit at
home, never having to make split-second decisions under life and death
circumstances, and bad mouth better people than themselves. Do bad things
happen in war? You bet. Do our troops sometimes misbehave? Sure.
Does this compare with the atrocities that were the policy of our enemies for
the last fifty years-and still are? Not even close. So here's the deal.
I'll let myself be subjected to all the humiliation and abuse that was
heaped on terrorists at Abu Ghraib or Gitmo, and the critics can let
themselves be subject to captivity by the Muslims who tortured and beheaded
Daniel Pearl in Pakistan, or the Muslims who tortured and murdered Marine
Lt. Col. William Higgins in Lebanon, or the Muslims who ran the
blood-spattered Al Qaeda torture rooms our troops found in
Iraq, or the Muslims who cut off the heads of schoolgirls in Indonesia, because
the girls were Christian. Then we'll compare notes. British and American
are theonly troops in history that civilians came to for help and
handouts, instead of hiding from in fear.
I'm tired of people telling me that their party has a corner on virtue
and the other party has a corner on corruption. Read the papers-bums are
And I'm tired of people telling me we need bipartisanship. I live in Illinois,
where the "Illinois Combine" of Democrats has worked to loot the
public for years.
Not to mention the tax cheats in Obama's cabinet as well.
I'm tired of hearing wealthy athletes, entertainers, and politicians of both
parties talking about innocent mistakes, stupid mistakes or youthful
mistakes, when we all know they think their only mistake was getting
caught. I'm tired of people with a sense of entitlement, rich or poor.
Speaking of poor, I'm tired of hearing people with air-conditioned homes,
color TVs and two cars called poor. The majority of Americans didn't have
that in 1970, but we didn't know we were "poor." The poverty pimps
keep changing the definition of poor to keep the dollars flowing.
I'm real tired of people who don't take responsibility for their lives and
actions. I'm tired of hearing them blame the government, or discrimination,
or big-whatever for their problems.
Yes, I'm damn tired. But I'm also glad to be 63. Because, mostly, I'm not
going to have to see the world these people are making. I'm just sorry for my
Robert A. Hall is a Marine Vietnam veteran who served five terms in
theMassachusetts State Senate.