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The CMG Voice

Statistics Show Decrease in Medical Malpractice Payments

Posted Monday, June 23, 2014 by Gene Moen

The National Practitioner Data Bank (“data bank”) is a federal system that keeps track of all malpractice payments made by liability insurance companies. It can be accessed by hospitals and others who employ physicians, but is not open to public access by patients or their attorneys. One of the major purposes of the data bank was to prevent doctors who commit malpractice from moving from state to state and avoiding knowledge of their malpractice by hospitals who would grant them privileges.

The 2013 information from the data bank has been released. For payments made by medical professional liability insurers for doctors, the number has decreased every year for the past 12 years, from 15,898 payments in 2001 to 9,205 in 2013, a reduction of 42%. Similarly, the total amount of the payments made to patients because of doctor error has gone down every year since 2004, from $4,424,050,000 in 2004 to $3,101,550,000 in 2013, a reduction of 30%, without any consideration for inflation.

Despite the propaganda put out by medical groups and malpractice insurance companies, there is no increase in malpractice litigation and no need for the draconian laws that have been pushed through many state legislatures. Even when those laws have failed, or have been held unconstitutional, the effect is to convince the public (and potential jurors) that there is a rash of frivolous medical malpractice claims that are driving doctors out of business and increasing health care costs. In effect, this legislative effort is a form of massive jury tampering with the goal of discouraging verdicts for injured patients when a case goes to trial.

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Google Glass in the Operating Room

Posted Monday, June 2, 2014 by Tyler Goldberg-Hoss

Some of us may have already heard of Google Glass, the eyewear that includes a computer for recording video, among other things. Inevitably, Google Glass has entered the operating room. Doctors are using the recording surgeries for teaching purposes, and for their own learning and consultation.

A recent article in the New York Times details this. Read it here:

Google Glass Enters the Operating Room

Not only can the video recording be helpful teaching and learning after the surgery, but in the operating room surgeons have found it to be helpful. This can include accessing a patient’s medical information without turning away from the patient, such as previous x-rays and CT scans, and also images taken laparoscopically during the same surgery. Prior to Google Glass, a surgeon would have to look on a monitor or screen across the room. Now the images can be right in front of you.

There are some risks to using the devices. This can include “perceptual blindness” or tunnel vision, where surgeons are more likely to miss key information outside of their focus. And as with any internet accessible device, a patient’s private medical information is potentially at risk. Internet connectivity should therefore be disabled while operating.

The article seems to intimate that the plusses of such technology outweigh the minuses, and it’s a matter of time before Google Glass surgeons will be part of the mainstream.

Ask your surgeon if Google Glass is right for you…

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Don't Believe the Hype: Medical Malpractice Tort Reformers rely on falsehoods for their arguments

Posted Thursday, May 29, 2014 by Tyler Goldberg-Hoss

A recent article published on outlines four myths that proponents of medical malpractice tort reform rely upon for their arguments that there should be more barriers to medical malpractice victims receiving just compensation for their injuries.

You can find the article here:

4 Medical Malpractice Falsehoods That Tort Reformers Need For You To Believe

The four falsehoods:

Medical Malpractice costs are crippling the economy. Not so, states the article. In 2008, “medical liability costs” totaled $55.6 billion, or 2.4% of the annual health care spending in the US. Of that, only $5.7 billion was paid for claims made on behalf of injured victims. The bulk of the rest was incurred as “defensive medicine costs,” which is certainly one way to frame it. Another would be that those are costs incurred practicing medicine in the public’s interest and to make patients safer.

Still, if those numbers are correct, then the $5.7 billion in claims paid amounts to less than .25% of annual health care spending. More “eh” than “yikes!”

Medical Malpractice Insurance Companies are burdened with high claims payouts. Nothing could be further from the truth. The article cites the recent Florida Supreme Court decision striking down caps on damages in medical malpractice cases. The number it cites is staggering. Not only have insurance companies in Florida not been losing money, from 2003-2010, their net income increased more than 4300%.

4300% Staggering.

We need caps to lower medical malpractice insurance rates. As you can see above, medical malpractice insurance rates aren’t causing insurance companies, at least in Florida, to go out of business. The article cities the Florida decision again: states with caps don’t show the premium rate drops that states without caps did. There is therefore no correlation between caps on damages and lower medical malpractice insurance rates.

States without caps will lose all their doctors to states with caps. Again, citing the Florida decision, this is simply not true.

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Health care will look very different in the near future

Posted Thursday, May 22, 2014 by Tyler Goldberg-Hoss

A recent article cites to a new book coming out called “The New Medical Malpractice” by Jim O’Reilly, professor at the University of Cincinnati’s College of Law.

You can find the article here:

In-Store Clinics, ’Telemedicine’ and the Death of Windfall Malpractice Judgments

The article offers a sneak peak into what Mr. O’Reilly believes will be the evolving state of health care following implementation of the Affordable Care Act.

First, O’Reilly believes that, with millions of new health care insureds, there will be increased competition among insurance providers, potentially driving them to cut costs. This, O’Reilly believes, will result in fewer doctor’s offices and more grocery and convenience stores with on-site clinics.

In Seattle, this is already occurring at places like Walgreens, Target and other retail stores.

O’Reilly also posits that there will be a rise in telemedicine – where doctors treat patients remotely.

I’ve already wrote on this subject and its perils for patients. Find my article here:

Tele-ICUs: The Future of Medicine is Here (Actually Somewhere Else)

Suffice to say, these changes can result in a decrease in the quality of healthcare provided. This can include prescription errors, failures in communication between providers resulting in treatment delays, and lower level providers such as nurses being asked to provide care once provided by a doctor. Such changes may also correspond to an increase in medical malpractice claims.

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Technology and Patient Safety

Posted Tuesday, May 20, 2014 by Gene Moen

For a decade or so, technology has made inroads into hospitals and clinics as a means of enhancing patient safety and efficiency in delivering care. The major development and the most apparent has been electronic medical records (EMR).

The use of electronic records has been mandated by the Affordable Care Act and almost all hospitals — and many clinics — now have almost all patient records in electronic format. The arguments for this are strong ones, but the practice has often been less than desirable. The use of pull-down menus and “check the box” clinical information often means that the nuances of clinical observation are lost. Many clinicians have trouble navigating the computer systems and do not access key information because it is cumbersome to use.

Other technologic tools are also becoming more prevalent. Physicians can now use their smart phones or tablets to access patient records and films and can use diagnostic apps to narrow down the potential diagnoses. Just key in the signs and symptoms, and get a list of possible or likely causes of the condition. Concerned about drug reactions? In the old days, a physician would rely on his/her memory or thumb through the Physicians Desk Reference. Now this information is readily available on hand-devices that can be accessed at the bedside.

A more recent use of technology involves bar codes, the ubiquitous device at the grocery checkout counter or the airline check-in. Bar codes have become common as a means of matching hospital patients with their medications, but the push is on to make them much more widely used in hospitals. Bar code technology can be used to verify the right patient, the right drug, the right dose, the right route, and the right time (sometimes called the five “rights”).

Because bar codes can now be at the bedside, many substances can be labeled with a bar code and verified at that point (examples include blood, stem cells, bone marrow specimens, etc.). This can avoid tragic mistakes, such as when a similar-looking bottle was used but which had a solution that could kill or injure a patient. Just swipe the bottle across the bar code and it is instantly verified as the correct one.

We are probably at the infancy of medical care technology, and the question is whether the technology will actually enhance patient care and safety or whether it will be one more obstacle to the exercise of old-fashioned concepts like listening attentively to the patient and thinking carefully about what the patient really needs. As anyone knows who has been in an examining room and watched the doctor or nurse focus on the computer screen rather than the patient, technology isn’t always the answer.

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