Patient Advocates Raise Concerns Over AMA President-Elect’s Comments on Medical Malpractice Lawsuits

The election of Donald Palmisano -- a New Orleans physician and lawyer who founded a company to advise doctors on "how to avoid" medical malpractice lawsuits -- as the next president of American Medical Association has received criticism from patient advocates who have say that the AMA has become "focused too heavily on legal strategy and not enough on good medicine," the Washington Post reports. Palmisano, named president-elect last Saturday at the AMA's annual meeting in Chicago, established the risk management company Intrepid Resources to help physicians "minimize their chances of being sued." In "A Primer on Malpractice Law," which appears on the company's Web site, Palmisano wrote, "Although the physician may aspire to give the best of care, the law does not require the best. ... The law requires a minimally acceptable level of care." He also wrote in a separate part of the Web site that compassion can serve as a "bulletproof vest" against malpractice lawsuits. Many patient advocates and several doctors have "expressed dismay" at the AMA's election of Palmisano. "There's always some risk in choosing a president who has such visible stands on such controversial issues," David Blumenthal, director of the Institute for Health Policy at Massachusetts General Hospital, said, adding, "This is a time when the AMA and all physicians want to be accountable to patients and society, working to improve the quality of care -- not sort of crouched down in a defensive mode." Sidney Wolfe, director of the Health Research Group at Public Citizen, added that the AMA "should be promoting excellence in medicine, rather than as little as you can get away with."

However, several doctors said that Palmisano's advice on malpractice lawsuits "accurately reflects the current legal system." Robert Berenson of the Academy for Health Service, Research and Health Policy, said that the advice "is perfectly reasonable" and that the "real problem ... is that malpractice concerns are dictating medical decisions." Palmisano said that he has "devoted [his] life to providing excellent health care and wouldn't dream of advising a physician to do anything less." He added that his advice helps to "keep the physician in the examining room caring for the patient" and "avoid encounters in the court room" (Connolly, Washington Post, 6/15).