HealthLawProf Blog

Ezra Klein on Medical Malpractice

Ezra Klein has a great piece posted on Slate.com concerning medical malpractice and the two different ways the political parties claim they plan to solve the problem.  Here is a brief excerpt:

The Republican answer to runaway health-care spending is to cap jury awards in medical malpractice suits. For the fifth time in four years, Senate Majority Leader Bill Frist tried and failed to cap awards at $250,000 during his self-proclaimed "Health Care Week" in May. But this time, the Democrats put a better idea on the table.

Sens. Hillary Clinton and Barack Obama also want to save on health care. But rather than capping jury awards, they hope to cut the number of medical malpractice cases by reducing medical errors, as they explain in an article in the New England Journal of Medicine. In other words, to the Republicans, suits and payouts are the ill. To the Democrats, the problem is a slew of medical injuries of which the suits are a symptom. The latest evidence shows the Democrats' diagnosis to be right.

He continues by praising Professor Tom Baker's book, "The Medical Malpractice Myth."  Mr. Klein states,

The best attempt to synthesize the academic literature on medical malpractice is Tom Baker's The Medical Malpractice Myth, published last November. Baker, a law professor at the University of Connecticut who studies insurance, argues that the hype about medical malpractice suits is "urban legend mixed with the occasional true story, supported by selective references to academic studies." After all, including legal fees, insurance costs, and payouts, the cost of the suits comes to less than one-half of 1 percent of health-care spending. If anything, there are fewer lawsuits than would be expected, and far more injuries than we usually imagine.

As proof, Baker marshals an overwhelming array of research. The most impressive and comprehensive study is by the Harvard Medical Practice released in 1990. The Harvard researchers took a huge sample of 31,000 medical records, dating from the mid-1980s, and had them evaluated by practicing doctors and nurses, the professionals most likely to be sympathetic to the demands of the doctor's office and operating room. The records went through multiple rounds of evaluation, and a finding of negligence was made only if two doctors, working independently, separately reached that conclusion. Even with this conservative methodology, the study found that doctors were injuring one out of every 25 patients—and that only 4 percent of these injured patients sued.

The entire piece provides a terrific overview of where various political parties and others stand on medical malpractice and how to reduce medical errors.  Kudos to Professor Baker for his excellent book.  [bm]

 

Lawyers and Happiness

Ezra Klein has a post concerning research on laywers and depression.  He cites to an article in the New York Magazine which states, 

Lawyers are 3.6 times more likely to be depressed than members of other professions, and it’s not just because their jobs are more stressful. For most people, job stress has little effect on happiness unless it is accompanied by a lack of control (lawyers, of course, have clients to listen to) or involves taking something away from somebody else (a common feature of the legal system).

 The entire article is an interesting read as long as you don't let it make you re-think too many of your life choices.  [bm]

Our Fear Priorities

The LA Times has an interesting article by Daniel Gilbert, a professor of psychology at Harvard University and the author of "Stumbling on Happiness," who discusses why humans fear certain unlikely events, such as the potential for another terrorist attack in the immediate future, while ignoring more likely events, such as the destruction of global warning.  Dr. Gilbert writes,

No one seems to care about the upcoming attack on the World Trade Center site. Why? Because it won't involve villains with box cutters. Instead, it will involve melting ice sheets that swell the oceans and turn that particular block of lower Manhattan into an aquarium.

The odds of this happening in the next few decades are better than the odds that a disgruntled Saudi will sneak onto an airplane and detonate a shoe bomb. And yet our government will spend billions of dollars this year to prevent global terrorism and … well, essentially nothing to prevent global warming.

Why are we less worried about the more likely disaster? Because the human brain evolved to respond to threats that have four features — features that terrorism has and that global warming lacks.

First, global warming lacks a mustache. No, really. We are social mammals whose brains are highly specialized for thinking about others. Understanding what others are up to — what they know and want, what they are doing and planning — has been so crucial to the survival of our species that our brains have developed an obsession with all things human. We think about people and their intentions; talk about them; look for and remember them.

That's why we worry more about anthrax (with an annual death toll of roughly zero) than influenza (with an annual death toll of a quarter-million to a half-million people). Influenza is a natural accident, anthrax is an intentional action, and the smallest action captures our attention in a way that the largest accident doesn't. If two airplanes had been hit by lightning and crashed into a New York skyscraper, few of us would be able to name the date on which it happened.

Global warming isn't trying to kill us, and that's a shame. If climate change had been visited on us by a brutal dictator or an evil empire, the war on warming would be this nation's top priority. . . .

Read the rest of the article here.  It provides an interesting explanation for why our priorities may need to be adjusted.  Thanks to the Washington Monthly for the heads-up on this article.[bm]

Help For Science Teachers

Erza Klein posts a plea for assistance to a challenge by Scienceblogs to help provide assistance to science teachers to fund educational projects for their students. As Erza states, "The projects on which they’re focusing, in conjunction with DonorsChoose.org, don’t require huge donations—just a little bit here and there to help public school teachers to provide the books, equipment, and field trips to, as Mike the Mad Biologist says, make science come alive for kids."  A list of challenges may be found here.  [bm]