Health Care Providers, Advocates Recommend Proposals To Address Medical Malpractice Issue
"President Bush's decision to put malpractice reform near the top of his domestic agenda" and the "fact that Congress is deadlocked over Bush's specific proposal" for a $250,000 cap on noneconomic damage awards have "opened the door for consideration" of other reform proposals, the Los Angeles Times reports. A growing number of health care providers and patient advocacy groups are advocating for reforms that would encourage hospitals and doctors to voluntarily disclose medical mistakes; provide appropriate compensation and apologies to those who have been harmed; and eliminate "some of the emotional pain and rancor that are part of the present system," according to the Times.
One option would replace the present system with new courts in which judges with medical expertise would hear cases and determine awards based on uniform payment guidelines. Advocates have said this system would expedite the process, bring greater equity to malpractice payouts and reduce anger that sometimes motivates plaintiffs in such cases. However, according to the Times, "finding judges with the requisite medical background and setting up processes for handling cases could take several years."
As another alternative, the University of Michigan Health System is trying a system of arbitration in which health care providers admit errors up front, express apologies and negotiate settlements with patients and families. Since UMHS adopted these reforms to its system in 2002, the number of open malpractice cases has been reduced by more than 50%; the average time it takes to close a case has fallen from more than three years to less than one; and legal costs have been cut in half. However, payouts have not declined, in part because some cases that predated the rule changes have been settled since the changes took effect, the Times reports.
Dennis O'Leary, president of the Joint Commission on Accreditation of Healthcare Organizations, said, "There is so much noise around the heated debate over caps that people are not looking beyond their noses to the broader picture." He added that with Bush's cap proposal moving slowly, "there is a willingness to see how ... other ideas might work around the country. I see a period of experimentation."
David Studdert, a professor of law and public health at Harvard University, said, "Caps are sort of a Band-Aid approach. They do absolutely nothing about the problem of medical errors and making health care safer." Studdert added, "There are a lot of preventable deaths, and the malpractice system ought to be contributing something to reducing medical errors" (Alonso-Zaldivar, Los Angeles Times, 4/5).