Rick Jackson

Radical Solution needed to Eliminate Defensive Medicine Costs

 

I am disturbed by our recent findings that a quarter of every dollar I spend on my medical care is considered medically unnecessary by my physicians.

 

Why? Physicians can’t trust they won’t get sued for tests and treatments they have not done.  So they order more than is needed purely for documentation, so that they don’t lose everything they have.

 

This is unfair to my physician and me.

 

Did you know that physicians are personally financially liable for their medical decisions? Contrary to what most Americans believe, physicians are NOT legally protected through their business, employer or insurance.   Their career, reputation and personal net worth are at risk each day.

 

The reality is that costs go up while quality and access go down when physicians are under the constant fear of lawsuits.  Traditional Tort Reform will not eliminate defensive medicine. In fact, our research shows that in “Tort Reform” states, physicians practice the same amount of defensive medicine. We need something more radical. Our workers’ compensation system appears to be a great model to solve this problem. 

 

The solution to saving $650 billion per year and ELIMINATING defensive medicine requires three steps:

 

1. Protect physicians from being personally financially liable for unintended errors. (Physicians in many countries like Canada, England, and Sweden do not hold Physicians financially liable for malpractice.)

 

2. Medical Review Boards would review and determine if negligent treatment  has been provided to the patient.  

 

3. Non-medical compensation boards would award consistent fair compensation  to patients.

 

Imagine what our care would be like if our physicians felt free to do what was in our best interest, as patients. Our research shows that 90% of physicians think patients have the “right” to compensation if negligently treated.   I believe this system would promote more transparency around mistakes physicians make and, not only increase the number of patients getting compensation, but free physicians to learn from each other and foster an environment of best practices.

 

Imagine how $6.5 trillion in savings over the next ten years could be used to cover the uninsured.  Imagine how much faster patients could be compensated with a workers’ comp style system in place. We don’t have to wait 10 years to “bend the cost curve.”  We can save $650 billion a year NOW!

 

I’m interested in what you think.  Can a Workers’ Compensation style model work?

 

Richard Jackson is Chairman and CEO of Atlanta-based Jackson Healthcare. Jackson’s staffing and technology companies serve more than two million patients in nearly one thousand hospitals each year.

Comments

[Hugh Moore]

Go, Rick, Go!!!

[Chuck Bennett]

Astonishingly good, common sense. My prayers are with you in succeeding where so many others have failed in fighting the trial attorneys.

[Larry Powell]

This is a fascinating idea. I hope our elected representatives have the integrity and insight to take it seriously.

[Michael Weinberger, MD]

There is a second component to cost, other than testing and evaluation and admissions, etc, and that is time...which is another of our precious resources that translates into time...the extensive and unnecessary dribble in documentation. Some cases have drastic underdocumentation but meet "billing criteria" without adequately documenting the complexity of the case. MUCH more frequently we are held documenting 5-10 precious minutes on a chart that is medically frivolous purely for the sake of coding and to ensure that we can be compensated for the work we do...
Lets face it, a healthy 10 yo who twists her ankle on a softball field with a neg x-ray and discharged with extensive instructions and prescription analgesics or even narcotics, truly requires a 2 line history, 2 point review of systems and about a 1 sentence exam....barely 4 lines of charting, but if that is all you do, you cannot bill anywhere near the level for the level of care that the medical complexity dictates. More than half of my time in patient care is spent in documenting such dribble...with nary enough time to truly document the 1-2 pages required of a seriously injured trauma pt or sick medical patient!

[curtiss mull M.D.]

That idea was one of the few good ideas with the Clinton Health care reform effort. The big problem rests with the politicians, many if not most of whom, are lawyers and who are the benificiaries of the money provided by the trial lawyers. Like everything else in Washington, true experts do not make the laws, aides to congress persons and senators come up with the legislation and many are concerned with their reelection, not what is best for the country or the people. How we get to health reform is a complcated process. Most physicians would be able to come up with alot of good ideas of what should be done but it is unlikely they would be adopted.