malpractice lawsuits doctors patients

How doctors can reduce medical errors, lawsuits, and …
ama obamacare medical insurance tort reform property tax shift easton school district parking pass

How Easton's Schools Can Balance The Budget

If medical care and/or insurance is to be public, can it be funded the way schools are? We trim, blend, and append four 2012 articles, three on medical costs from: USA Today, (1) Jan 17 on errors by K. Pho (a primary care physician in Nashua NH); (2) Jan 18 on ObamaCare by M. Siegel (physician, professor at NYU Langone Medical Center, and author of The Inner Pulse); (3) Jan 22 on torts by G. Ciolli (emergency physician with more than 30 years of experience); and (4) Easton Patch, Jan 29 on schools by J. Geeting.

by Kevin Pho, by Marc Siegel, by Glenn Ciolli, and by Jonathan Geeting

Ask doctors what concerns them most, and chances are they'll say, "medical malpractice." A recent New England Journal of Medicine study found that 75% of doctors who practice psychiatry, pediatrics, or family medicine will be sued during their career. Neurosurgeons, orthopedic surgeons, and obstetricians have it worse, as virtually all of them will be sued before they finish practicing medicine.

The medical malpractice debate often pits physicians -- who say the threat of lawsuits pushes them to order expensive, unnecessary tests -- against lawyers who believe that lawsuits are needed to hold doctors accountable.

Obviously, no one wants medical mistakes. And no one, perhaps with the exception of lawyers, wants lawsuits, which put the victims, their families and the doctors involved through wrenching affairs.

How can physicians avoid the courtroom? If an error was made, many insurers advise physicians not to talk to patients. That's wrong. Physicians should disclose their mistake, apologize and, when appropriate and through mutual agreement, compensate injured patients.

For more than a decade, the University of Michigan Health System has used such a program, and its incidence of malpractice claims has since dropped 36%.

At least 36 states have passed legislation protecting apologies from being used against doctors in court.

Doctors also must create and maintain open lines of communication with patients, which is critical to preventing lawsuits in the first place. Doctors have to better explain, and patients better understand, that not all adverse outcomes are due to physician errors. Although the Institute of Medicine's 1999 seminal report, "To Err is Human," concluded that medical errors caused up to 100,000 patient deaths a year, 90% of those deaths were attributed to systemwide procedural failures at medical institutions.

In June 2009, when President Obama attended a "white coat" ceremony at the American Medical Association headquarters in Chicago, and this organization of physicians (roughly 17% are members) went on to deliver its endorsement of the president's legislation, physicians had a nagging question: Did we agree with the AMA's position, or was the organization taking us for a ride?

Doctors traditionally have been unhappy with insurance mandates because third-party payers, whether public or private, represent a seemingly unnecessary interface between us and our patients. Many doctors today prefer to accept cash, even at a great discount, rather than having to deal with the burden imposed by insurers.

We're two years into the ObamaCare experiment, and the realities of the law -- more regulations, more patients with low-paying insurance, higher costs but lower payments to doctors -- are sinking in.

Dr. Marc Siegel is absolutely on target with his piece on ObamaCare. I agree that many physicians are going to "pull up lame" because the shortfalls of the program are not being addressed.

Specifically, without tort reform, we will continue to waste billions of dollars a year on defensive medicine that does nothing to improve the quality of care. The money saved by tort reform could help cover the uninsured.

Washington needs to start listening to the doctors who are working in the trenches instead of the brass of the American Medical Association.

To see the whole article, click here .

JJS: While the doctors did look deeply into the issue, left unsaid are some key points. Should doctors’ salaries be so out of line with patients’ salaries? Should doctors compete more among themselves and with other health practices? Should cleaning up the environment from the tons of carcinogens and reducing stress from work that’s too much or too little but often stultifying become part of healing? Whether the cost of medical care must be high or can be low, if the care becomes publicly provided, how would government fund it? Perhaps the best way that some districts fund their schools?

...while also helping Easton's economy in the process.

The Easton Area School District (EASD) is in for another tough budget season this year, staring down a $7.6 million deficit.

Fortunately, there are ways to balance the budget that could even help the local economy.

One possibility would be for the School District to sell monthly parking passes to students and staff to park in school parking lots.

Free parking at school is a subsidy to people who choose to get to school by car. Students who get to school by walking or taking the bus or public transportation do not receive this subsidy. This is a regressive transfer from low-income families to higher-income families.

The school district is paying for the land now being used as parking lots. If fewer students and staff decided to drive to school because parking prices rose, some of the land now used for parking might be freed up for academic or recreational uses.

Another option: With a simple tweak, EASD could convert its regressive real estate tax into one of the most progressive taxes there is. Lots of PA municipalities and school districts have made their real estate taxes more progressive by taxing land at a higher rate than buildings, or totally doing away with the tax on property improvements. This is called a two-rate tax, or land value tax.

People with more unimproved land would pay more, and people whose properties occupy less land (think attached houses and working class neighborhoods with small lawns) would get a tax cut. When the city of Allentown moved to the two-rate tax in 1996, three out of four taxpayers saw their tax burden go down.

This would shift more of the tax burden to vacant lot owners, people with blighted properties, and people who own large tracts of unimproved land.

To see the whole article, click here .

JJS: Just as land rents could fund public schools, so could they in part fund public clinics, along with rents from using the ecosystem as a dumpsite (pollution charges) and rents for professional licenses that let the licensees monopolize the field and reduce competition; e.g., a foreign doctor with a better record of success may not legally practice elsewhere, even in a place with worse rates of medical failure! If you like irony, maybe some of the above will make you laugh and live healthier since laughter is the best medicine.

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Editor Jeffery J. Smith runs the Forum on Geonomics and helped prepare a course for the UN on geonomics. To take the “Land Rights” course, click here .

Also see:

The safest strategy to avoid a courtroom appearance
http://www.progress.org/2011/doctors.htm

Land Dues Keep Many Up Yet Make One Happy
http://www.progress.org/2010/beauty.htm

Night pollution helps many see the eco-light
http://www.progress.org/2011/darksky.htm

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