Liability and the ER Doc: Location, Location, Location
Liability and the ER Doc: Location, Location, Location
"I don't want to miss badness when it presents in an unusual way." I recently read this quote on an emergency medicine discussion forum, and it got me thinking about the vulnerability of our specialty and the need for comprehensive tort reform. Working with limited information is what emergency medicine is all about, and when our initial information is limited and our ability to obtain additional information is restricted, the door to legal action opens wide. Unfortunately, with mounting regulation and increased scrutiny of our resource utilization on the horizon, our ability to "find badness when it's less than obvious" will be challenged. We will be forced to limit our work-ups based on evidence-based protocols and cost-benefit ratios. If our ability to diagnose and treat is restricted beyond our control by the government, we deserve to be shielded from litigation when bad outcomes occur. Simply put, the current medical liability system is not compatible with government-run health care rationing. We need tort reform. That being said, we won't see tort reform at the federal level anytime in the foreseeable future. For now, it will remain an issue for each state. As we examine tort reform at the state level, there is immense interstate variability. As we all know, some states have passed laws limiting plaintiff awards and attorney fees, and other states have developed laws regarding pretrial physician panels and patient compensation funds. As one would expect, these laws have directly affected health care costs and lawsuit frequency, and indirectly affected resource utilization, physician retention, and physician practice style. I've seen this on a personal level throughout my career, as I've now practiced in three states with drastically different liability environments: Illinois, Indiana, and Texas.
Which states have good medical liability environments, and why? Are any states particularly favorable for emergency physicians? Which states have passed EMTALA-related tort reform? Which states have established a gross negligence standard? State by state information on medical liability has been compiled many times, but data specifically on emergency medicine has been hard to come by — until now. I have constructed a medical liability state by state comparison — hopefully the most accurate and comprehensive medical liability database yet for emergency physicians.
Introduction
"I don't want to miss badness when it presents in an unusual way." I recently read this quote on an emergency medicine discussion forum, and it got me thinking about the vulnerability of our specialty and the need for comprehensive tort reform. Working with limited information is what emergency medicine is all about, and when our initial information is limited and our ability to obtain additional information is restricted, the door to legal action opens wide. Unfortunately, with mounting regulation and increased scrutiny of our resource utilization on the horizon, our ability to "find badness when it's less than obvious" will be challenged. We will be forced to limit our work-ups based on evidence-based protocols and cost-benefit ratios. If our ability to diagnose and treat is restricted beyond our control by the government, we deserve to be shielded from litigation when bad outcomes occur. Simply put, the current medical liability system is not compatible with government-run health care rationing. We need tort reform. That being said, we won't see tort reform at the federal level anytime in the foreseeable future. For now, it will remain an issue for each state. As we examine tort reform at the state level, there is immense interstate variability. As we all know, some states have passed laws limiting plaintiff awards and attorney fees, and other states have developed laws regarding pretrial physician panels and patient compensation funds. As one would expect, these laws have directly affected health care costs and lawsuit frequency, and indirectly affected resource utilization, physician retention, and physician practice style. I've seen this on a personal level throughout my career, as I've now practiced in three states with drastically different liability environments: Illinois, Indiana, and Texas.
Which states have good medical liability environments, and why? Are any states particularly favorable for emergency physicians? Which states have passed EMTALA-related tort reform? Which states have established a gross negligence standard? State by state information on medical liability has been compiled many times, but data specifically on emergency medicine has been hard to come by — until now. I have constructed a medical liability state by state comparison — hopefully the most accurate and comprehensive medical liability database yet for emergency physicians.
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