Malpractice reformers get grants, but fear of lawsuits remains ER scourge

A New York judge's unusual technique — listening to the families of injured people, knowing something about medicine — for dealing with difficult medical malpractice cases will be among 20 explored with $3 million grants as part of the health overhaul, The Associated Press reports. The judge, Douglas McKeon, said, "I don't discuss settlement offers with families right away. … I just say, 'Tell me a little bit about your loved one.'" The grants are meant to "find answers to such problems as getting hospitals and doctors to acknowledge mistakes, rather than cover them up, and protecting clinicians who follow best practices and still have something go wrong."

In New York, the pilot will work like this: "Cases that aren't settled by the hospitals will go to a special courtroom staffed by judges trained with a curriculum McKeon helped develop and calls 'Medicine for Judges.' Plaintiffs don't have to settle; they can insist on a jury trial at any point" (Alonso-Zaldivar, 6/21).

The Associated Press, in a separate story: One thing at stake in the current malpractice system is that fear of lawsuits may lead doctors to overtest and overtreat, especially in emergency rooms. "The fast ER pace plays a role, too: It's much quicker to order a test than to ask a patient lots of questions to make sure that test is really needed. … Patients' demands drive overtesting, too. Many think every ache and pain deserves a high-tech test. … Refusing those demands creates unhappy patients. And concern that unhappy patients will sue remains the elephant in the emergency room."

All that leaves "ER physicians … among the top 10 specialists most likely to be sued for malpractice, according to leading doctor and insurers groups." One Texas physician said, "when all hell is breaking loose [in a busy ER], not a lot of doctors feel they can take the time to sit down with the patient [to build trust]." The AP explains, "[t]he result can be extra costs, and potential harm — including side effects from unneeded drugs and increased chances for future cancer from excessive radiation" (Tanner, 6/21).