We invite those suspicious of a doc’s stand on the medical malpractice situation to take a read of the November 14, 2005 issue of The New Yorker. Surgeon and author Dr. Atul Gawande pens a remarkably candid piece, “Bad Medicine: Who Pays the Price When Patients Sue Doctors?" Check it out as he follows Barry Lang, a malpractice attorney who was a pediatric orthopedic surgeon for 23 years. Though the article is only available in the mag, Dr. Gawande sits down for a Q & A that’s available on-line. You’ll be surprised. Excerpt below.
What is the toll of malpractice on doctors?
.... Almost every case, when it’s settled, is sealed, and it can become hard to know what the patterns of failure in medicine are. In the airline industry, if there’s an accident, they can do an investigation and share information and figure out when there are certain patterns that suggest what things can be done to improve safety. We really haven’t been able to do that.
More [The New Yorker]
Those who appreciate Dr. Gawande's clear-eyed and thoughtful analysis of medical practice will be delighted to learn that the New Yorker is publicly posting two of his articles highly relevant to the concerns of this website.
The first, "The Bell Curve," discusses means of ensuring the quality of medical care -- other than malpractice suits -- and the obstacles to providing patients with information about relative quality of care, by physicians or institutions.
" . . . They had been told almost everything they needed to know in order to give Annie her best chance to live as long as possible.
"The one thing that the clinicians failed to tell them, however, was that Cincinnati Children’s was not, as the [parents] supposed, among the country’s best centers for children with cystic fibrosis. According to data from that year, it was, at best, an average program. This was no small matter. In 1997, patients at an average center were living to be just over thirty years old; patients at the top center typically lived to be forty-six. By some measures, Cincinnati was well below average . . . At Cincinnati, lung function for patients under the age of twelve—children like Annie—was in the bottom twenty-five per cent of the country’s CF patients. And the doctors there knew it."
http://www.newyorker.com/fact/content/?041206fa_fact
The second, "Piecework," subtitled, "Medicine's Money Problem," addresses the contribution of physicians themselves to the current crisis in our system of care.
"Physicians in the United States today remain better compensated than physicians anywhere else in the world. Our earnings are more than seven times those of the average American employee, and that gap has grown over time. (In most industrialized countries, the ratio is under three.)"
http://www.newyorker.com/fact/content/articles/050404fa_fact
Posted by: Lance Williams | November 12, 2005 at 12:28 AM