What follows is opinion only.
It is important to understand this may not follow IMS positions and so is for discussion only.
In fact, you won't even know if I agree with these thoughts!
Reform of the med mal system must follow several rules.
First is justice. (This is important for several reasons. Justice is important in all 4 directions; see below. And it is awful hard to argue against!)
Next is public image. We need to see ourselves as others see us.
Final is a deep understanding of a med mal suit.
Justice must be the goal for the injured and the accused.
If not injured, no award.
If not guilty of injuring, no award.
These concepts, which seem so basics, are absent in our current system. The relationship between losing a suit and the presence of injury is random. It is really a lottery.
This cuts both ways; we must not lose sight of this. Real injuries are not compensated. Nonexistent injuries are compensated. The best docs lose suits; anyone really believe neurosurgeons and ObGyns are the dumbest and worst docs? And the worst docs don't get sued; don't go there, but we all know who they are. (Remember this last part for later.)
Money and race matter under the current system. The poor and dark skinned, with little net worth and little in lost income, can't get representation. Meanwhile, the sympathetic patient who looks like the jury gets a windfall.
And the bad docs keep practicing.
Med mal suits are criminal in nature. This is a tough concept and no one wants to talk about it, especially those sued. (Remember this point, too. Registers overloaded yet?)
When you lose most civil suits, you or your insurance pay (think auto) and you go about your way.
When you lose med mal, you are reported to a national database. You have to report this loss on any and all applications. You can be disqualified from many insurances. You wear the Scarlet M for the rest of your days. You are bad; you didn't do something bad, badness R you. This is what a criminal charge looks like.
First and foremost, give away the money. We lose when we forget this.
You have calculated the premiums into your business model. Putting more money into the pockets of the top 5% (1%?) is a losing position. At the risk of appearing politically incorrect (a risk I welcome) review the Tar Baby story in the Uncle Remus line. We are the Fox.
We get no sympathy when we cry poverty, when we say we need lower premiums. The general public would love to have our problem, making so much money that we need to pay less. This is prime.
Make justice first.
Instead, make a system that puts patients first. If they're injured, pay them. If they're not, done. If the doctor did noting wrong, don't award. If she did, award. Make the patient whole.
Make patient safety and system improvement the centerpiece. (This is very tough to combat.) Make a system that lets us report, without fear, the docs who needs "re-education." Borrow from then FAA and make a system that lets anyone report, anonymously, problems they find.
Consider a system like Worker Comp.
And forget sticking it to the lawyers. You're playing in their playground. Give them their money.
The other day Des Moines Register printed an editorial entitled “Iowa doesn’t have a malpractice crisis (Problems recruiting, retaining docs involve fatter salaries)". Recently, the Register printed the op-ed the Iowa Medical Society entitled "Iowa View: Medical liability reform is vital to Iowa" by Dr. Robert E Lee, IMS President.
CERTIFICATE OF MERIT
The IMS continues to pursue other opportunities across the state to spread our messages on tort reform:
- The goal of the proposed reforms is to improve upon both the medical malpractice system and the health care delivery system in our state.
- These initiatives are designed to offer long-term benefits to both physicians and their patients; reducing the time physicians must spend attending to meritless liability claims and reducing the length of time it takes a patient with a legitimate claim to receive compensation.
- States with favorable malpractice environments are better able to recruit new physicians and avoid physician shortages. Iowa does not have mountains or oceans; we must do all we can to continuously improve Iowa’s medical litigation environment to help recruit new physicians.
- As healthcare reforms move forward, we need a malpractice environment which encourages a focus on evidence based medicine and discourages wasteful defensive medicine.
- Iowa’s health care delivery system is changing. Our medical liability system must adapt to keep pace with the reforms in our care delivery system.