Tort Reform Will Raise its Head Next Year
Oregon Health Policy Board appoints a 15-member medical liability task force
“We want both sides represented,” said Dr. Chuck Hofmann, who led the charge to create the medical liability task force. “It’s a cooperative effort.”
J. Michael Alexander, a Salem trial attorney, will co-chair the task force along with Dr. Joseph Siemienczuk, chief medical officer with Providence Medical Group in Beaverton.
Task force members include:
- Rick Bennett, government relations, with AARP
- Dr. Peter Bernardo, a general surgeon in Salem
- Jeffrey Bildstein, vice president of Western Litigation, Inc.
- Janet Billups, an attorney who represents Oregon Health & Science University
- Jim Dameron, executive director of the Oregon Patient Safety Commission
- Dr. Craig Fausel, president and CEO of The Oregon Clinic
- Scott Gallant with Gallant Policy Advisors, Inc.
- Dr. Robert Holland, a medical examiner in Grant County
- Josephine Mooney, an attorney who directs risk management at Sacred Heart Medical Center
- Laura Potter, district executive director with the American Cancer Society
- Dr. Christoffer Poulsen, with Eugene Emergency Physicians and Sacred Heart Medical Center
- Mark Stevenson, president and CEO of Capital Pacific Bank, and
- Lawrence Wobbrock, a trial attorney in Portland.
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As a surgeon, there is no love lost between me and the malpractice attorneys. Still, their argument against Tort Reform is strong, and succinct, and that is: If you look at states that have Tort Reform, versus those that do not, the cost of health care is no less. That is a hard fact to respond to as a physician.
In fact, if you make your state physician friendly enough, you will attract an excess number of physicians and that will drive up your health care expenditures. Quite a conundrum. Texas seems to have this problem right now.
Instead of lining up doctors on one side of the table, and lawyers on the other, why don't we try something new. The real cost of malpractice, is defensive medicine. Jury awards are only about $1 billion/year for medical malpractice. The cost of defensive medicine has been estimated at at least $200 billion.
How about this idea. As a physician, give me "Lawsuit Proof Criteria" for NOT doing a test? If that chest CT that I ordered for a cough, shows some very benign little nodules, then let me follow it with chest X-rays for the next two years, in stead of 2 or 3 more CT scans. It probably means that maybe one in a few hundred patients will actually see one of those nodules blossom into lung cancer, and a chest X-ray may not catch it as early as another CT. But if you tell me I did the "proper surveillance" under the guidelines, then I get a free pass for doing the right thing, instead of a lawsuit, for delay of diagnosis. These guidelines could be written for thousands of clinical situations where an expensive test would otherwise be ordered as a defensive strategy. And, we could actually base them in science and statistical probability, instead of the nebulous "standard of care," which seems to vary from expert witness, to expert witness.
I am sure there will be arguments from both sides why this won't work. And there will probably be another multimillion dollar campaign for and against Tort Reform, with radio and TV ads screaming about greedy doctors and lawyers, that make us all look bad. And medical costs in Oregon will continue to go up and up and up.
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