QUALITY/PHYSICIANS: When war is declared it’s hard to find a middle way

In Friday’s NY Times there’s an article called In Texas, Hire a Lawyer, Forget About a Doctor?. The article features a database online called DoctorsKnow which allows doctors (for a fee of course!) to find out which of their patients has sued any doctor. The logical conclusion to this is that anyone who has ever sued a doctor cannot get any care. As this behavior starts up for real rather than just as a philosophical debate in Medrants, it strikes me that we are getting to the point at which war is starting. Many doctors might say that the trial lawyers have already been at war with them and they’re just responding. Most of you know that I’m on the physicians’ side in this battle, but believe that averting the war is a much more desirable outcome than fighting it (which reminds me of the Iraq situation!).

Matt Quinn, who some of you may suspect is on the lawyers’ side captures my feelings in this note:

    This article speaks to the need for someone to be a moderating force in this debate: of course, all trial lawyers aren’t bad, all doctors aren’t bad, and all people who sue for malpractice aren’t bad. Perhaps the government (CMS?, AHRQ?, ???) could convene the AMA, ATLA and other entities to come together to propose a centrist solution that provides justice for all. That would require both of those organizations to set aside some of the immediate narrow self-interests of their memberships and work together for a sustainable solution that solves the problem – something that would benefit all stakeholders involved, including (last but not least) the thousands of people who are harmed each year by malpractice. Not likely in an election year.

Unfortunately Matt’s right. While this fight get politicized it cannot be changed into a sensible peace settlement. Unless of course organized medicine breaks away from the mainstream "tort-reform" movement that’s really a part of corporate America wanting to pursue unmitigated bad behavior, and proposes a different tack in cooperation with moderate voices for sanity in medicine like the IOM.

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