COMMENTARY

Doctors Badmouthing Other Doctors Incites Patients to Sue; More

Wayne J. Guglielmo, MA

Disclosures

August 20, 2013

In This Article

The Number-One Malpractice Risk for Primary Care Physicians

It's a medical cliché that just happens to be true, perhaps more so today than ever before: Primary care doctors are on the frontline of medicine. Their job is to identify the risks before they become problems -- to spot the symptoms before they morph into full-blown syndromes. Failure to do so poses risks of its own, however, as a team of Irish researchers has shown in its study of the epidemiology of malpractice claims in primary care, published online last month on BMJ Open.[4]

The team conducted a computerized literature search of malpractice studies that were focused on primary care, based on original data, and written in English. Of the 7152 studies searched, 34 met investigation criteria, with 28 containing claims-related data and 6 containing survey data. The plurality of the studies came from the United States (15), followed by the United Kingdom (9), Australia (7), France (2), and Canada (1).

Topping the list of primary care-related problems was failure to diagnose, which represented a range of 26%-63% of all claims examined by the selected studies. In adults, cancer and myocardial infarction were commonly missed; in children, meningitis was commonly overlooked.

Medication error was second on the list of primary care-related problems, representing upwards of 20% of the claims examined by the studies.

When researchers examined studies centered in the United States and Australia, they found that primary care specialties were among the 5 clinical disciplines that had the most malpractice claims, although "the majority of claims were successfully defended."

Raise California's Medical Liability Cap by 400%?

The battle to raise California's medical liability cap -- which has been set at $250,000 for nearly the past 4 decades -- heated up in July, as a story posted on the Website of the Los Angeles Times makes clear.[5]

On July 25, proponents of raising the cap officially submitted their ballot initiative to the state attorney general's office for review. To qualify for the November 2014 ballot, the initiative must garner more than a half-million signatures from registered California voters.

Supporters want to see the cap adjusted to reflect the rise in inflation during the intervening years; in current dollars, that adjustment would lift the $250,000 ceiling to approximately $1.1 million. Initiative proponents are also calling for the cap to be adjusted annually, based on the rate of inflation.

Opponents of the measure have already sent out a call to action. Poised to defeat the measure, should it qualify for the ballot, they've formed a campaign committee that includes leaders of the California Medical Association, the California Dental Association, and the California Hospital Association. The coalition also includes Planned Parenthood, typically a supporter of Democratic campaigns.

Whatever the potential for infighting among traditional allies, the coalition says it's prepared to spend more than $50 million to see that the initiative goes down in flames.

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