Re the Nov. 25 In Response letter on how managed care destroys medicine:
Although physicians, and now the public, accept that managed care has been detrimental to the quality and cost of American medicine, Robert D. Brown makes certain assumptions that are groundless and hence undermines his argument that the current liability crisis has nothing to do with our tort system.
He seems to approve of physicians’ current practice of ordering a multitude of tests to make a diagnosis. Many of these diagnostic studies are clearly done to minimize exposure to litigation, and most physicians will tell you that most of their treatment plans are based on their clinical experience, not a series of tests whose outcome can often be predicted. This is a large part of wasted healthcare dollars.
Second, he makes a blanket statement that overzealous lawyers are rare. The current output of attorneys from our nation’s law schools necessitates that they be aggressive simply to make a living. So any poor medical outcome is subject to possible litigation regardless that many outcomes are doomed from the beginning due to the nature of the underlying problem. That is not malpractice, just unfortunate. Our society needs to understand the difference.
Finally, the requirement of a signed affidavit from a specialist simply means that the plaintiff’s attorney needs to go out and find a ”hired gun” physician. This is easy as there are a multitude of websites and published listings dedicated to providing that service. Many of these doctors do not even practice medicine and make a living doing just that.
Consequently, many physicians are now going without insurance — or worse, leaving the state because the insurance companies can no longer afford the risk and must pass this on to their physician clients. Already this has happened to large degree in Nevada, Pennsylvania and West Virginia.
It is beginning to happen in our state, and the logic presented in Brown’s letter must be refuted if we are to have any chance to preserve decent healthcare here.
ALEJANDRO BADIA, MD
Miami
