Two articles in the December 2008 issue of Renal & Urology News add to mounting evidence of the need for medical liability reform, specifically no-fault compensation for medical injuries. 

The first article (“Doctor Blamed for Fatal Pulmonary Embolism,” page 28) details the death of a patient whose outcome might have been avoided if there were not a snafu in communications between a radiologist, primary care physician, and the patient. 

The second article (“Study: Most Docs Talk About Their Mistakes,” page 29) discussed a survey of 338 general practice physicians and residents. The survey showed that three quarters of physicians discussed their slip ups with colleagues to learn from those mistakes. Nine-one percent of respondents said they shared their mistakes because they wanted to know if their colleague would have made the same decision.

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In Scandanavia, compensation is provided by the government to victims of medical injuries based on the severity of the injury. Although patients can sue, this has not been reported for some time or is extremely rare. Physicians are evaluated objectively as an ongoing process. Payments for injuries are not part of the evaluation process. These payments are quite modest by American standards, but all significantly injured patients are compensated based on severity, compared with our “lottery” system. 

By having no-fault compensation provided by the state for serious medical injuries, along with objective physician report cards, the quality of patient care would improve. With the threat of lawsuits removed, physicians would not be afraid to publish papers that discuss treatment complications and failures, or discuss these with colleagues.

Physicians would be able to concentrate on delivering the best care possible rather than practicing defensive medicine. The only losers are the attorneys and insurance companies, but there is no perfect system when human beings are involved.

Basically, it is difficult in many injury situations for “experts” to determine whether negligence was involved. Quite understandably, juries tend to throw large amounts of money at some patients who have been physically or emotionally devastated by their injury. A system in which all victims are compensated fairly is more just than a system where a few injured patients hit the jackpot and the rest get zero.