William Sage, MD, JD recently wrote an editorial in JAMA that malpractice claims are not currently causing disruption of the healthcare system, and the number of claims and average payout for claims is lower today than 10 years ago. Paid claims declined from 18.6 to 9.9 claims per thousand physician, and median payments declined from $218,400 to $195,000. However, statistics show that the number and frequency of medical errors has increased over the same period, with up to 400,000 negligent deaths a year from malpractice not including severely injured patients. The article goes on to discuss the need to compensate injured patients, the use of dispute resolution methods, the Medicare and Medicaid liens that impact settlement costs and the time delay in resolving claims. The article goes on to comment negatively on the significant contingency fee compensation that plaintiff attorneys receive when representing injured patients.
Physicians disagree whether terminal illness patients should be informed that they are dying. A recent study in the British Medical Journal highlighted the thinking on both sides of this controversial issue. On the one hand is the patient's right to know the truth about his or her condition. Not telling a patient about bad news undermines the physician patient relationship and deprives people of the opportunity to put their lives in order. Decisions about finances, guardianships, and funerals may not be made, because patients do not understand their inevitable close at hand demises.
Surgery for breast cancer after initial diagnosis is taking longer. A study at Fox Chase Cancer Center in Philadelphia of women between 1992 and 2005 showed that the average time between diagnosis and surgery increased from 21 days to 32 days. The time from the first cancer related visit to biopsy also increased. This increased treatment delay was greatest for black and Hispanic women and people who live in large cities. Although it is unknown how much of a difference this delay is making, the trend is problematic.