Malpractice

Scary article--from both a patient care perspective as well as from a medicolegal perspective--which will make you think about always checking that potassium level before making a decision about skipping dialysis..."Young Mother Dies After Missing Dialysis Treatment".

In order to be found guilty of medical malpractice, a physician must demonstrate "The Four D's": a "dereliction of a duty directly causing damages."

According to this site maintained by the Kaiser Family Foundation detailing malpractice rates by state, there were approximately 17.1 malpractice claims paid for every 1,000 active non-federally employed physicians in the U.S. in 2005. Taking all comers, that means there was a 1.7% chance of any given physician having to pay out as a result of a lawsuit during that one year. 1.7% may not seem like a big number, but considering that (a) a 1.7% annual chance multiplied over the course of a 35-year career starts to get pretty high, and (b) this does not factor in all the unsuccessful lawsuits, which can result in substantial legal fees and time investment, it's high enough.

President Obama will be discussing the possibility of including major medical malpractice reform as part of the overall health care reform package being developed. It will be interesting to see what he has to say about this, and the reaction from both parties.

Recent NY Times article in which the notion that tort reform would lower health care costs is disputed can be found here.