Malpractice History Repeats Itself

In response to the letter by John J. Overdyk, M.D., “ASA Needs to Bite the Bullet on Hired Gun Issue,” in the May 2003 NEWSLETTER, I’m afraid that weeding out the bad apples among the experts would not be easy (or possible) to accomplish. Many of the hired guns I know are retired physicians, not always anesthesiologists and thus virtually untouchable. Furthermore, it’s seldom that these people’s testimony is that far out of line, however far it may stray from reality.

What I think would be a better solution is one that’s been proposed for scientific testimony in the federal courts: a panel of experts from which the judge can draw. Rather than testifying for one side or the other, the experts testify for the court. This is much more likely to result in objectivity on both sides of the issue.

By the way, as a trial (not medical) lawyer pointed out to me recently, one of the major culprits in the malpractice crisis has hardly been mentioned. The increase in premiums is not (only) because of increased awards. It’s the result of the fact that the insurers have to cover the losses from their bad investments during the 1990s. A similar thing happened during the 1980s, and when the investment picture improved, the crisis vanished. Until now.

Sanford M. Miller, M.D.
New York, New York

Editor’s Note: The trial bar’s claim that increased premiums are the result of insurers’ bad investments is open to serious question. The Health Coalition on Liability and Access, of which ASA is a member, reports that 85 percent of the assets of medical liability insurers are invested in virtually risk-free treasuries and that state insurance regulations stricly prohibit insurers from raising premium rates to cover past losses. In 2001 for each $1 in premiums collected, medical liability insurers paid out $1.53; this data strongly suggests that the problem is radically increasing awards, not bad investments.

— M.J.L.

AMA: Clinging to a Bad Mother?

We recently received letters from our Society asking us to support the American Medical Association (AMA). The big question is why? What has AMA ever done to help us as physicians? They formulated the miserable DRGs, and they are a pathetic lobby that doesn’t focus on our needs but rather their own needs. I would consider AMA more like Aflac, a quacking duck that sells insurance, and they make sure I get an insurance flyer every month or so. An association is supposed to represent you and your needs and desires, not their own. AMA once represented medical doctors, but now I don’t know what they represent, and I don’t feel like giving them money. I think that AMA has progressed so far down the path of self-preservation that it is time to think of developing a new association to represent us, the medical doctors who originally made AMA. Nowhere is there an organization that represents medical doctors. Osteopaths and chiropractors have their own organizations and boards that we can’t join, but there is nothing for us medical doctors. Why? I don’t know. There are organizations that represent everything from rock climbing to stamp collecting. Are we not worthy of such an organization? Or is it that if we had our own organization that really represented us, we might actually have some power and influence and actually get something done?

AMA is not this organization, and it is time that it is dismantled and a new organization that represents us is created. Therefore, I realize that ASA feels it must “protect” its mother entity, AMA. But maybe it is time to severe the cord.

Scott M.W. Haufe, M.D.
DeFuniak Springs, Florida