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A Fear of Lawsuits Really Does Seem to Result in Extra Medical Tests

nytimes.com

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Re: A Fear of Lawsuits Really Does Seem to Result in Extra Medical Tests

#61
post #15

> Any law that limits the cases where patients can sue, or the amount of money they can collect, is likely to lower medical use in the hospital by less than the 5 percent they measured in their study. The telling thing about laws to address malpractice liability is that they typically are focused on capping large verdicts. But such laws are illogical: generally, large verdicts will be awarded where a doctor screwed u…

Large verdicts have been delivered where no or minimal injury was suffered.

As others have mentioned, John Edwards had great success as a lawyer suing over cerebral palsy, claiming that it was caused by actions during delivery. While possible, most cases are caused by other factors such as infections, IVF, or low birthweight.

At trial, you have a sympathetic plaintiff with large needs vs a "rich" doctor and hospital. They might have caused this, they have insurance. So you systematically get very large verdicts against defendants who are unlikely to have done anything wrong. Edwards was very good at theatrics and not good on science.

Trials that rely on science and math are not great to take to a jury. Even discussions here get emotional when you deal with subjects like appropriate risk analysis and tradeoffs. Saying that you have a formula to only fix defects that kill more than x people or cost less than y per life saved is a great way of losing at trial and getting destroyed in a thread. It's also how every company and government makes decisions around safety - where stop signs go, guardrails, drug approval, armor in tanks...

Getting tort law right is hard - you want true injuries to be compensated but discourage people that are looking for lottery tickets.

Re: A Fear of Lawsuits Really Does Seem to Result in Extra Medical Tests

#63

So make tests cheaper - sounds like an opportunity that gets a win for everyone without political miracles. (I don’t know the market I am talking about at all, but) Maybe they could incentivize cheap tests by capping the cost per test that can be administered without some large red tape process. The market will provide tests under that cap where possible, so they can be administered more frequently & frictionessly. P…

EXACTLY! I wrote about this here: https://news.ycombinator.com/item?id=17620197

Re: A Fear of Lawsuits Really Does Seem to Result in Extra Medical Tests

#64

Earlier quoted context omitted.

I don't really consider this a problem. Specialists are packed to the gills already and very expensive. Specialists don't want to spend time with patients who don't actually need specialized care and insurance doesn't want to pay specialists without first qualifying the issue.

I agree; however the first thing he did was to order a CT scan to confirm the diagnosis and get the exact location. So the family doctor visit was thus duplicative.

I hope the specialist didn't get a kickback from the imaging company

Re: A Fear of Lawsuits Really Does Seem to Result in Extra Medical Tests

#65

If a doctor is sued for malpractice, that means they made a mistake. If they are performing extra tests to avoid malpractice, that means they are performing extra tests to avoid making mistakes. That is a good thing.

It can also be a very expensive thing. Extra tests are unnecessary, hence why they are “extra”

Re: A Fear of Lawsuits Really Does Seem to Result in Extra Medical Tests

#66

If a doctor is sued for malpractice, that means they made a mistake. If they are performing extra tests to avoid malpractice, that means they are performing extra tests to avoid making mistakes. That is a good thing.

Not necessarily. Tests have costs and risks of their own. I would consider a test not justified in terms of cost and risk to be a "mistake". However doctors are far less likely to be sued for a thousand small mistakes than one big one, so they err on the side of too many tests.

Re: A Fear of Lawsuits Really Does Seem to Result in Extra Medical Tests

#67

If a doctor is sued for malpractice, that means they made a mistake. If they are performing extra tests to avoid malpractice, that means they are performing extra tests to avoid making mistakes. That is a good thing.

So if a physician were to do every test on every patient every time, could they expect to never be sued? Would that be a good thing? “1 of everything please.”

Re: A Fear of Lawsuits Really Does Seem to Result in Extra Medical Tests

#68

If a doctor is sued for malpractice, that means they made a mistake. If they are performing extra tests to avoid malpractice, that means they are performing extra tests to avoid making mistakes. That is a good thing.

If a doctor is sued for malpractice it means someone thinks there is a possibility the doctor made a mistake. After all, doctors win lawsuits sometimes too.

The doctors are ordering the extra tests to avoid the lawsuit being raised in the first place.

Re: A Fear of Lawsuits Really Does Seem to Result in Extra Medical Tests

#69

If a doctor is sued for malpractice, that means they made a mistake. If they are performing extra tests to avoid malpractice, that means they are performing extra tests to avoid making mistakes. That is a good thing.

There's an error in literally every sentence you just wrote.

1. A person can be sued without being guilty in a criminal or civil sense.

2. They are performing extra tests to cover their asses, not to avoid making mistakes.

3. It is clearly not a good thing as shown by the authors of the study.

Re: A Fear of Lawsuits Really Does Seem to Result in Extra Medical Tests

#70

If a doctor is sued for malpractice, that means they made a mistake. If they are performing extra tests to avoid malpractice, that means they are performing extra tests to avoid making mistakes. That is a good thing.

A friend of mine was a neurosurgeon (now retired) with a busy spine practice. He routinely had patients who told him they were grateful for his work and didn't feel he made any mistakes, but were suing him anyway because a lawyer convinced them they could receive a payout from his insurance company. His lawyers would settle for a certain amount which was less than the cost of defending a case in court.
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