PDF Ebook The Medical Malpractice Myth
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The Medical Malpractice Myth
PDF Ebook The Medical Malpractice Myth
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About the Author
Tom Baker is Professor of Law at the University of Pennsylvania Law School and coeditor of Embracing Risk: The Changing Culture of Insurance and Responsibility, published by the University of Chicago Press. Baker has also worked as a consultant to insurance companies and law firms.
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Product details
Paperback: 222 pages
Publisher: University of Chicago Press; 1 edition (August 1, 2007)
Language: English
ISBN-10: 9780226036496
ISBN-13: 978-0226036496
ASIN: 0226036499
Product Dimensions:
6 x 0.6 x 9 inches
Shipping Weight: 9.6 ounces (View shipping rates and policies)
Average Customer Review:
3.6 out of 5 stars
19 customer reviews
Amazon Best Sellers Rank:
#923,637 in Books (See Top 100 in Books)
Excellent discussion of "the myth", that medical practice is overburdened with malpractice suits; ;not so good on the general anatomy of malpractice law.
This book is a must read for anyone who thinks that tort reform is a good idea. We've tried it in California. The effect has been to effectively immunize health care providers from liability by closing the courthouse door to claims of medical negligence. There is no incentive to improve the health care system or to address the systemic problems that cause most injuries and deaths.Medical negligence is a fact. Our government estimates that as many as 98,000 people per year die from preventable medical errors. The cost of these errors is enormous and, when our civil justice system is crippled by tort reform, those costs are often shouldered by the public through increased taxes and fees.Tort law is designed to do two things: to provide just and reasonable compensation to people injured by the negligence or carelessness of another and to discourage behavior likely to result in injury. When we "dis-incentivize" good medical practices by immunizing health care providers, we make it more, not less, likely that people will be injured as a result of medical errors.There is no evidence of which I am aware that these reforms have benefitted anyone other than big insurance companies. In California, it is increasingly difficult or impossible for patients who are injured by medical errors to receive "just and reasonable" compensation for the harm caused. The cost of litigating such cases is prohibitive in light of the 32-year-old MICRA cap which limits damages to $250,000 in most cases - even those involving gross negligence or the death of a child.
This book will displease a lot of physicians who have been brainwashed to think that the answers to their malpractice problems are tort reform and blaming the victims. Baker compiles an impressive bibliography of articles, reports and controlled studies to back up his assertions. He writes the truth and should be taken seriously by physicians, insurers and politicians -- many of whom are completely ignorant about the real causes and prevention of medical injuries and malpractice claims.
If MD's & AMA would read this excellent book & follow its advice, the US would be a better country. Until they do (if they ever do), you need to read it & be alerted to a widespread kind of problem with US media & medicine. That, too, would move this nation ahead.
From my standpoint as a physician, I found the objective data very provocative. However, I consider Tom Baker's conclusions and interpretations based on the data misguided and inflated. I consider that the book is useful to read, as it contains accurate data based on research. However, his interpretation and representation of the data to support his views that there should be more litigation and access to litigation than there is today against medical professionals only serves to promote his bias against medical professionals working in good faith in an imperfect world.
If Tom Baker came into my Emergency Department as a patient, he would almost certainly get MORE care (studies, procedures, consultations), but there is a very good chance that it would be worse for his health. However it would not be from malicious or punitive intent.Like nearly all outsiders, and unfortunately most physicians, Baker underestimates the impact of doing more medicine in order to be more careful. A fantastic literature is now emerging exploring the problem of overzealous medical care. See Shannon Brownlee's "Overtreated," Gilbert Welch's "Overdiagnosed," or the really superb "Hippocrates Shadow" by David Newman. It is the effect of the confluence of money, technology, consumers' expectation of immediate and complete satisfaction, and physicians' overconfidence in the salvific power of our craft.The problem is that despite the enormous contributions of technology, medical diagnosis is not nearly accurate enough, and as a result there will be increased cost in terms of risk (I'm not talking about money here) to pursuing earlier diagnosis. This has to do with the basic statistical notion of the FALSE POSITIVE. When diagnostic tests are less than 100% accurate then they will occasionally yield false results - this is obvious.What is not obvious is the paradoxical effect of applying imperfect tests to low-risk populations. When I have a test that is "only" 99% accurate, and I apply it to a patient group that has a 1% chance of having the condition in question, fully ONE HALF of those who have a positive test result will be FALSE POSITIVE. If the previous factual statistical statement doesn't cause you some psychic distress, then keep reading it until you begin to understand the implications.Most of the conditions that we in Emergency Medicine are interested in diagnosing are low-likelihood. Only about 5% of my chest pain patients are having a heart attack. Only about 3% of my trauma patients with neck pain have a neck fracture. Fewer than 1 in a thousand of my abdominal pain patients has the emergency aortic condition that killed John Ritter. When you cross a certain threshold, "being more careful" means creating more "false positive" than "true positive" diagnoses for my patients.I'm in my 12th year as a full-time board certified ER physician working at a large tertiary center helping to train the next generation of physicians. I can tell you, in the culture of modern American medicine, the pendulum has swung too far toward over-diagnosis. I truly fear that Baker's solution - more malpractice lawsuits to browbeat us into doing better will only succeed in causing us to do more .... harm that is.
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