About 6 years ago, a woman who was parallel parked, pull from her spot and in to the side of my car. The damage was little more than paint scrapping, but 3 years later I got sued for $25,000 for her life altering injuries. My insurance company gave her a few thousand dollars to go away.

Under loser pays, this never would have happened and all our insurance rates would be lower.

It seems that the political alliances, in all cases, override the well-being of the system. Both sides support their arguments with anecdotes over substance, and constant obfuscation on both sides, with the only hard facts coming out of extremely involved parties and thus questionable, make it impossible to gain a clear picture of what is really needed to solve the problem.

Personally, I think some serious changes in the medical/legal area need to happen, but a system of arbitrary caps as is usually proposed doesn’t really seem like an elegant or appropriate solution.

An Examiner analysis of the 15 firms on the National Law Journal’s “2008 Plaintiff’s Hot List” shows that for 2009, their employees have contributed $636,305 to federal politicians and PACs. Only $4,875 of that amount has gone to Republicans, meaning that the nation’s top trial lawyers are giving more than 99 percent Democratic this year. The PAC for the American Association of Justice, the top trial lawyer lobbying group, has been marginally more balanced, giving Democrats a mere 96 percent of its $627,000 in contributions.

These trial lawyers are especially concentrating on the Senate. Members of those same 15 firms have given $236,000 to the Democratic Senatorial Campaign Committee this year. And trial lawyers know that the Senate is controlled by one of their own — Senate Majority Leader Harry Reid, D-Nev., who faces a potentially difficult re-election. Reid has taken in some $54,000 from the top 15 firms. According to OpenSecrets, he has taken $978,000 from the legal industry as a whole.

More here.

Perhaps they should ask a clinical pathologist’s opinion. There are three major reasons for excessive ordering of tests and imaging studies.

1. To save time. Example: The patient’s history and symptoms may narrow the diagnosis to one of five diseases. Additional questioning and examination could narrow the diagnosis to two diseases, and a single lab test could provide the final diagnosis. However, the doctor will get no extra money for the additional time spent with the patient, and there are other patients waiting. Therefore, the doctor orders a bunch of lab tests to cover the five possible diagnoses. Are these unnecessary tests? Not if they save time (physician time is worth more than most tests) and allow more patients to be treated. To me, this is a legitimate use of lab and imaging resources.

2. To gain unneeded certainty. Example: Based on history, symptoms, examination, and simple tests, the doctor is 85% certain of the diagnosis of a minor medical problem. But, for reasons unknown, the doctor wants more certainty. This usually requires a battery of expensive tests performed by a distant reference lab. In almost all such cases, the doctor should just prescribe appropriate therapy. Only if the therapy fails should the patient be subjected to more lab testing. (One caveat: If the therapy has a high risk of nasty side effects, then the certainty of the diagnosis needs to be very high.)

3. To hit the duck with a shotgun pellet. Example: A mediocre doctor has no clue what’s wrong with the patient. Instead of admitting this and referring the patient to someone else, the doctor orders a zillion lab tests (and possibly a bunch of imaging or ultrasound studies). The doctor hopes that the test results will yield a diagnosis. They rarely do, but some will be ‘abnormal’, and the doctor will order more tests related to the abnormal one. This process can go on for weeks or months, and the doctor just hopes that the patient gets better with time.

What’s important from the political viewpoint is that doctors gain no direct profits from ordering unneeded lab tests unless they own a laboratory. Otherwise, ordering lab tests is an added administrative expense and an added task for the doctor (who must review and interpret every lab result on every patient).

if we were to take today’s modern demands of absolute safety and perfection and send it back in time 100 years or so, what would the world look like today? for starters, there’d be no cars – people *die* in car crashes. the manufacturers should have foreseen this. there’d be no airplanes – ditto. no computers – they sometimes crash and lose data. penicillin? uh-uh. some people are allergic. and on and on.

yes, mistakes do happen. that’s why they’re called “mistakes”. or “accidents”. the national urge, fueled by scummy lawyers, to criminalize all mistakes and accidents is why we’ll end up a failed nation, sooner or later. no risk – no reward. in medicine, you’ll see docs simply refusing to practice risky disciplines. it’s already happening right now: there are big chunks of the country in which obstetrics docs are in critically short supply. they’re walking away from it, tired of being sued every time there’s a complication with a birth. i’d imagine surgeons will be next. what’ll we do then? take lots of placebos? will we be able to sue the placebo manufacturer if there’s no instant cure? as for docs being reluctant to hand over documents showing they made an error, welcome to the world. *everybody* does that. cops won’t gladly provide written proof of their malfeasances. neither will lawyers. neither will news-gathering organizations. government will just classify evidence of *their* screwups. lawyers understand the risk-reward relationship extremely well, BTW. it’s why they fight any notion of a “loser pays” system tooth and nail.

no accidents or screwups are allowed in america today – except by lawyers. nice work if you can get it.

I’ve had contrary experience. Providers, at least in Illinois, were not so accommodating in releasing my deceased spouse’s records. Perhaps that was because the records I sought for that showed blood culture results (positive for gram negative) available at 7AM were not provided to the physician until 7PM.

AVOIDABLE DREADFUL FATAL MISTAKES DO HAPPEN.

That’s already the case. If you want your records, all you need to do is ask. Help yourself.

suggesting something you know cannot pass is not much of an offering.