“Tis the season for … a new Medical Malpractice Briefing Book from the Center for Justice & Democracy! And that can mean only one thing – a brand new PopTort Pop Quiz, just in time to celebrate the holidays! (Knock this out fast before you get too liquored-up at the office party.)
Here’s a good one to start you off, especially if you’re a “USA is #1” enthusiast:
1. True or False: Compared to 10 of our favorite countries (Switzerland, Sweden, France, Germany, the Netherlands, Canada, the U.K., New Zealand, Norway and Australia), the United States has the fewest medical errors.
Answer: False. Unfortunately, the U.S. comes in at #2 – but not for the fewest errors. For the most errors! (So I guess that's technically 10 out of 11.) U.S. patients reported the second highest rate of medical, medication or lab errors over the past two years. Only Norway had more.
2. Continuing down the patient safety road, the Joint Commission, which accredits almost 80 percent of U.S. hospitals, revoked accreditation of what percentage of hospitals that were out of Medicare compliance?
a. 100 percent
b. 50 percent
c. 25 percent
d. Less than 1 percent.
Answer: Consider the first question a hint. It's “d.” Plus (according to the Wall Street Journal), “in more than 30 instances, hospitals retained their full accreditation although their violations were deemed by CMS so significant they caused, or were likely to cause, a risk of serious injury or death to patients.… A result is that hundreds of hospitals with safety problems could continue to display a ‘Gold Seal of Approval’ and promote their accredited status. The Joint Commission provides hospitals with an accreditation publicity kit, and a consulting arm of the organization sells ‘We Are Accredited!’ pins and stickers. A brochure it prepared for patients reads, ‘Whenever and wherever you receive health care, look for The Joint Commission Gold Seal of Approval.’" Ugh.
3. And while we’re at it, let’s not leave out nursing homes. Here’s a question: Between 2011 and 2015, the number of complaints that put nursing home residents in “immediate jeopardy”:
a. Decreased
b. Stayed constant
c. Slightly increased
d. Almost doubled.
Answer: As you may have guessed, the answer is “d” once again. According to the U.S. Department of Health and Human Services Office of Inspector General, which analyzed 2011 to 2015 data on the rate of nursing home complaints, their severity and how well states responded to those complaints, “Although the proportion of total complaints remained about 7 percent, the number of immediate jeopardy complaints almost doubled during this time, from 2,844 to 5,341.”
Now that we’re clear about how terrible things are for patients, let’s see how unpleasant the situation is for doctors. We’ll take a look at some of the things doctors most complain about: malpractice claims (through the roof, they say) and insurance (also through the roof due to all the claims and lawsuits).
4. Let’s start with the number of medical malpractice lawsuits in our civil courts today, which should give you some idea of the problem. According to the National Center for State Courts, medical malpractice cases represent what percent of all state civil caseloads:
a. 50 percent
b. 25 percent
c. 10 percent
d. Under 2 percent.
Answer: By now you should know where we are going. The answer is 0.17 percent, or “d.”
5. Forgetting lawsuits for a moment, let’s just look at claims.
True or False: With all these patient errors, malpractice claims must be going up up up!
Answer: That would be “False.” According to the industry trade publication Medical Liability Monitor, “[C]laim frequency remains relatively flat and near historic lows across the [medical malpractice insurance] industry….” Same according to industry consulting group Willis Towers Watson, which wrote: “In 2017, the national environment for [health care professional liability] continues to be mostly favorable for many reasons. The most notable one is continued low claim frequency.”
6. Along those lines, the cost of medical malpractice insurance for doctors is:
a. Up 25 percent
b. Up 10 percent
c. Up 2 percent
d. Down.
Answer: You guessed it – “d.” According to the Medical Liability Monitor, “The cost of medical malpractice insurance dropped 1.1% for three bellwether medical specialties in 2017, which would be the 10th consecutive year of decline except for a 0.2% increase in 2015…. The findings belie the notion of a medical liability crisis despite the continued push by Congressional Republicans and organized medicine to cap noneconomic damages in such lawsuits and enact other tough tort reforms. Insurance premiums continue to trail inflation for many physicians, some of whom pay less in unadjusted dollars than they did in 2001.”
7. So now, let’s get down to it. When 85 percent of AMA-affiliated doctors said in a survey that “fear of malpractice” was the top reason for overtreatment (i.e., too many tests or procedures), they are:
a. Wrong
b. Paranoid
c. Creating subterfuge for the AMA’s real political goals (i.e. “tort reform”)
d. All of the above.
Answer: We only know for sure that “a” is correct, but we suspect “d” is too. How else to reconcile the fact that “only 2-3% of patients harmed by negligence pursue litigation, of whom about half receive compensation” and that “paid claims have declined by nearly 50% in the last decade.”
Now I bet you could use some spirited eggnog - or not (especially if you're driving, or shouldn't have eggnog). In any event, think hard about all this, read up, get back to me in the morning, and have a wonderful holiday, PopTort fans!
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