Vail Valley letter: Some clarifications
Vail, CO Colorado
VAIL, Colorado –Although I don’t disagree with Kei-th Spero’s main contention that tort reform will do little to reduce the cost of health care, I believe there are a couple of points that need further clarification.
Spero oversimplifies the concept of what is an accepted standard of care, particularly where complex medical cases are involved. Disease-specific standards of care are not the simple textbook look-ups that he suggests. In malpractice cases, both plaintiff and defendant bring expert medical wit-nesses to testify. The reason is often related to differing opinions of the appropriate standard. When there are multiple disease processes at work, there may be no single overriding set of treatment protocols but multiple standards that may conflict with one another. But, to Spero’s point, it is not lawyers who determine whether a patient was treated appropriately.
A topic that Spero does not address is that physicians are often sued not because of negligence or poor quality of care but because of poor outcomes. Good medical practice does not guar-antee good outcomes. As the “small print” often states, a very small per-centage of patients are going to expe-rience severe side effects to various treatment modalities. A wild card in this situation is patient compliance. Did the patient keep wearing the com-pression stockings for the recom-mended period of time, or did the blood clot develop because the patient did not comply? Noncompli-ance is often difficult to prove.
I do fully agree with Spero’s assess-ment that only a very small percent-age of physicians order or perform unnecessary services, and those who do may well be more interested in augmenting their incomes than pro-tecting themselves from a malprac-tice case.
– Jim Cameron Avon