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When Death Approaches

The Medical Malpractice Crisis: Coming to Your Hometown Soon

Imagine a day when you, your daughter, or neighbor is pregnant and there is no one left who is willing to provide care for pregnancy or delivery. Imagine a day when the wait in the emergency room is 12 hours and you hope you don't need a specialist, because they no longer take care of emergencies or ER patients. Imagine a day when only a few people have their own doctor, and those who do see a doctor who is anxious and ordering far more tests than seems necessary. Imagine a day when pursuing a career in medicine attracts only the below-average students.

This day is coming without radical changes to our medical liability system. Every day, we hear stories of how access to healthcare is worsening for you, our communities, and the medical profession. Physicians and other healthcare providers are rapidly leaving medicine, or changing their practice in order to lessen their liability exposure. We are all losing access to healthcare.

Two days ago, I spoke with a former mentor of mine, a brilliant physician who is now nearing 50. I recall his passion for medicine and commitment to his patients. He has been a great teacher through his years, but he revealed to me that he has been named in two malpractice suits. He described these suits as having little to do with his care. It was merely the usual lawsuit net being cast wide. He was dropped from both suits, but has now been informed that if he is named in one more, he likely will not be insurable. In other words, he will be unemployable. He is now embittered and his passion is all but gone. He no longer tries to get close to his patients. He is not sure which one might end his career. My friend counts the hours and years until he can afford to quit. In the community of medicine, we all have heard this story repeatedly. He is only one of many.

Yesterday morning, a nurse midwife in our community announced that she cannot afford the tripling of her malpractice rates and she must quit. She is the second nurse midwife to do so in recent months. In the past year, all of our community's family physicians were forced to cease obstetric care for similar reasons. They were paying more money out than they could charge for pregnancy care and delivery. Who is going to deliver tomorrow's babies? None of us know.

Let me tell you some chilling statistics. One in 6 physicians will be sued in the coming year. This number is far greater for orthopedic surgeons, obstetricians, neurosurgeons, and emergency physicians. In my specialty of emergency medicine, an average of 1 in every 6,000 patients files suit. In the past 12 months, many of your community's emergency physicians have cared for 6,000 patients.

The malpractice crisis is a complex issue with people on all sides, each with their own special interests and viewpoints. I am sure that all agree that the ability to file suit against wrongdoing is one of the more important rights we have in this country. It helps give each of us a say and holds accountable those who are in positions of power.

However, as with anything in life, extremes are dangerous. To make any system work well, we must seek balance where the incentives and restrictions allow optimal performance. In the malpractice environment, the balance is falling to one side and our system is crumbling.

The current malpractice culture is doing the opposite of its original intent. Wouldn't you hope that holding someone accountable would lead to improved service? Not so in most of the ways medicine is changing due to the fear and reality of malpractice. Physicians and other healthcare providers are leaving medicine in record numbers. Medicine is no longer popular at student career nights. Physicians are severely limiting their practices, they are no longer providing emergency services, and they are weary of their commitment to society and are more reluctant to go the extra mile. This is ruining the once sacred relationship between a patient and his or her physician and eroding our entire society's access to healthcare.

Discuss this crisis with your peers and your political leaders, and speak out in favor of access to quality healthcare and malpractice reform. The health of our country is at risk.

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