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Doctors right to fight for malpractice reform - as a first step

October 10, 2004|by TIM ROWLAND

I wish I had the doctors' optimism.

After a meeting with Gov. Robert Ehrlich this week, they backed away somewhat from the threat of a work slowdown that would affect elective surgery beginning in mid-November.

They have stated, and they are probably right, that a slowdown is the only way to get lawmakers to enact reforms to combat through-the-roof medical malpractice premiums.

But now doctors say the slowdown may be unnecessary because they "believe the governor is sincere." I'm sure he is. He's sincere about slots, too. But the General Assembly may not be. And frequently, the only language the legislature understands is a crowbar over the head.

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The doctors' wavering is understandable, and even admirable. They're caught between the necessity to play hardball and their default instinct to heal people who come to them for help. Unfortunately, failure to show iron resolve in Annapolis is often interpreted as an invitation to trample all over the petitioner.

Getting lawmakers' attention and getting lawmakers to act are two different wings of the asylum.

Not too many reasonable people with no financial interest in the proceedings will argue that malpractice awards haven't gotten silly.

In the past, lawyers could always plausibly argue, "How can you cap the value of a human life; how can you limit the value of a person's pursuit of a quality existence?"

The answer has always been "You can't." But as awards have ticked into the millions and people file suit at the drop of a stitch, the answer has shifted to, "You must."

Lawyers are advocates for their clients, and quite honestly, it would be a dereliction of their duty not to pursue every penny that the system allows. But such limitless pursuits lead to excesses, and when excess becomes the rule and not the exception, it's time for reason to step in.

But there is another matter to be discussed. It took a hearty flesh wound to their own wallets for physicians to become morally outraged enough to take a stand against the system. What they appear to ignore, conveniently or otherwise, is that it's not just the malpractice side of the medical ledger that is out of whack.

The entire health-care system is a shambles. People have to schedule an appointment weeks or months in advance. They have to sit around in a waiting room, and then get hustled through the visit because other people are waiting too. They see bills that say they saw two doctors when they only saw one, or discover a charge for an "extended visit," which in fact lasted only 10 minutes. They see ridiculous, Pentagon-toilet-seat-like prices for an Ace bandage. They have to resort to the emergency room for strep throat because they are uninsured - and then are made to feel as if they are wasting everyone's time because they haven't been shot.

They have to file multiple claims, or spend months and even years trying to convince an insurance company that they are really sick. Sometimes they must choose between medicine and food.

Doctors paint lawyers as the only ones wearing the black hats. But let me say loud and clear, all the public relations firms in the world cannot convince the general public of something they know through personal experience not to be true.

Anyone who has dealt with the health care system knows what a nightmare it can be - and you can't peg that on the lawyers. Of course you can't peg it on the doctors either, but their PR problem is this: The public will see them taking a mighty stand against the system when their own finances are affected - after years of ignoring serious health care flaws as they apply to the finances of everyone else.

Of everyone involved in the system, doctors are blessed with the moral high ground. They are seen as, in fact they are, the one group with a righteous mission. They do not feed on others' misfortune, or sit around all day crunching numbers in the relentless pursuit of profit.

They may be the only ones high enough in stature to take a stand - not just on litigation, but on a system that at every turn preys upon people who are sick and makes them more miserable than they already are.

The doctors are correct to seek malpractice reform, even if they have to use strong-arm tactics to do it. But if they want the public solidly on their side, they need to finish the sentence. They need to say, "We are going to take a stand against outrageous lawsuits for our benefit, and we are going to take a stand against injustices in the health care system wherever we see them for the public's benefit."

True enough, this isn't, and shouldn't have to be, the doctors' job. But no matter how "sincere" a politician may sound, doctors may be the only ones who can do it. If they frame the debate thusly, there will be a ton of Americans out there eagerly flocking to their side, public relations firm or not.

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