Interview: An 'awful' tort system, AMA

Sept. 1, 2006 at 1:42 PM
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WASHINGTON, Sept. 1 (UPI) -- In an exclusive interview with United Press International, William Plested III, president of the American Medical Association, says that limits on medical tort "pain and suffering" damages are not enough without comprehensive reform of the medical liability system.

Q: Medical tort reform at the federal level failed to pass earlier this year in the Senate. Are limits on medical tort "pain and suffering" damages going to be an issue for each state to decide from now on?

A: That's kind of a sad commentary on our federal government that that hasn't happened, but that's exactly what we're seeing. But the changes (at the state level) that we've seen are temporary fixes. The $250,000 (damages) caps that we've passed in the state of California stabilized (medical malpractice) premiums somewhat, but we still have this awful, awful system. This is a terrible system.

Q: So you're saying damages caps don't go far enough and that the whole medical tort legal system needs to be reformed. What do you think is the system's fundamental flaw?

A: (The present system) focuses on poor outcomes, not how those outcomes happened. A bad outcome is not necessarily negligence. You can do the very best you can and have the very best training and still have a bad outcome, the system puts you at risk for that.

Are we trying to give away money to people who have things happen to them, or are we trying to weed out negligence in care?

Q: So in your view, how does this system hurt the patient's access to care?

A: What would you do if you're a neurosurgeon and you understand neurosurgery better than anybody sitting a jury or a trial lawyer and you know this patient desperately needs you? But you know that the outcome (from a particular procedure) is terrible. So are you going to put your practice, your livelihood, your family and everything at risk by accepting this patient? Of course not. You're going to say, 'we can't do anything about this.'

Q: Why would health courts be a better alternative to the present system?

A: Health courts are a very attractive alternative. (Medical injury cases would be heard by) someone who understands what's going on to make a decision. We have a system where 60 percent to 65 percent of the money in the system goes to trial lawyers (and cases are decided by) juries that can't even pronounce the (medical terms), or understand what's going on. It's a contest between two lawyers; that's not a system of justice.

Q: Medical tort reform advocates point to obstetrics as one of the specialties that have been hardest hit. Any comment?

A: To practice obstetrics in the state of Florida costs $250,000 a year for malpractice insurance. There's no way -- delivering babies all day long, day and night -- that you can make that kind of money.

Q: Ken Suggs, head of the Association of Trial Lawyers of America, recently told UPI that doctors and lawyers should stop fighting each other and unite against the medical malpractice insurance companies who keep hiking insurance premiums to push their profits higher. How would you respond?

A: Do you have any idea what happened with medical malpractice insurance? It's almost totally in the hands of doctor-owned companies; doctors who put together their finances to get a company to give them insurance, because the for-profit insurers all ran. There is no profit in this; (the insurers) left it. And people who are not out to make a profit, they're just out to protect doctors (via) their own insurance companies, they're the one who are left.

Q: Suggs also said there is no medical malpractice "crisis." Any comment?

A: Well, do you want (a crisis)? If the message to American physicians is, this god-awful system will never be changed until you give us a crisis, what do you think we're going to say? We can't beat our heads against the wall trying to protect your ability to get care.

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