Monday, September 10, 2012

Malpractice Reform

Florida can take lead on medical lia bility

As a physician who has traveled the country speaking to my peers, I can tell you that doctors want to provide better patient care but are hindered by our inefficient system that drives a wedge be­tween physicians and pa­tients and leads to increasing health-care costs.

I was not surprised when a recent study found that $640 billion out of the coun­try’s $2.4 trillion total health­care costs are spent on med­ical tests, procedures or consultations of no clinical value. They are ordered merely to protect the pre­scribing physician from having an attorney attack the care as malpractice. It’s called “defensive medicine,” and it is a fear­driven practice that on average costs each United States citizen $2,084 every year.

Reducing malpractice costs has been imperfectly addressed by malpractice “caps,” which reduce the total payment that attorneys can collect. However, physicians who have been burned by attorneys never want to return to the court room, regardless of the “cap,” and will continue to practice defensive medicine.

Patients should be paid for medical in­juries, just as they should be paid when an injury occurs on the job. Adopting a similar approach to worker’s compensation in pay­ing patients for medical injuries would re­duce the exhaustion of litigation. More im­portant, physicians no longer would seek the false security of protection in defensive medicine.

How can such a change occur, to the ben­efit of patients, physicians and our econo­my? In the next legislative session, Florida will have the opportunity to adopt a solution that works — a Patients’ Compensation Sys­tem.

The Patients’ Compensation System fo­cuses on the patient’s need for both prompt recognition of a medical injury and prompt payment. The doctor is not blamed for the injury, and in fact we may recognize and learn from our mistakes without being sued. This removes the wedge between patients and their physicians, allowing the doctors to choose the best health care for their pa­tients.

Compensation under the Patients’ Com­pensation System would take 180 days, as opposed to the current system that can take up to five years, and there would be defined steps to ensure a seamless process and an­swer key questions:

» A patient advocate: How do I get my claim submitted?

» A medical review department: Is a medical injury present?

» An independent medical review panel: Is this an avoidable medical injury?

» A compensation department: What should be paid for the injury?

» An administrative law judge: Was the patient’s need and physician record re­viewed properly?

» A quality improvement department: How do we reduce preventable medical injuries?

The new system’s patient benefits in­clude access to justice for all patients; deli­vering more compensation to more patients faster; increasing patient safety; encourag­ing medical innovations; avoiding unneces­sary tests; and providing more access to physicians — as additional part-time physi­cians will practice medicine. Economic benefits include lowering health-care costs, lowering employer costs and creating more jobs, as well as decreased state and federal taxes.

Florida has the opportunity to take the leadership role in reducing the real driving force behind skyrocketing health-care costs, while extending patient care to compensate medically injured patients more quickly and compassionately.

J. James Rowsey, M.D., is a longstanding delegate of Florida Medical Association and board member of the Florida Society of Ophthalmology; he also recently served on U.S. Sen. Tom Coburn’s Medical Legislation team.