As a physician who has traveled the country speaking to my peers, I can tell you that doctors want to provide better patient care, but are hindered by our inefficient system that drives a wedge between physicians and patients and leads to increasing health care costs.
I was not surprised when a recent study found that 25 percent of all medical costs have nothing to do with patient care. The study showed that $640 billion dollars out of the country’s $2.4 trillion total health care costs are spent on medical tests, procedures or consultations of no clinical value. They are ordered merely to protect the prescribing physician from having an attorney attack the care as malpractice. This $640 billion is called “defensive medicine” and is a fear-driven practice that costs each United States citizen $2,084 every year.
Reducing malpractice costs has been imperfectly addressed by malpractice “caps,” which reduce the total payment that attorneys can collect when the patient does not get well. However, physicians who have been burned by attorneys never want to return to the courtroom, regardless of the “cap,” and will continue to practice defensive medicine, which is the real problem with our skyrocketing health care costs.
Patients should be paid for medical injuries, just as they should be paid when an injury occurs on the job. The Workers’ Compensation system pays for job-related injuries. Workers are paid promptly without blaming the employer or going to court. Adopting a similar approach to paying patients for medical injuries will similarly reduce the exhaustion of litigation. More importantly, physicians will no longer seek the false security of protection in the $640 billion in defensive medical costs.
How can such a change occur, to the benefit of patients, physicians and our economy? Why should such a leadership change occur in Florida, and why now? This legislative session, Florida will have the opportunity to adopt a solution that works for patients, physicians and our economy – a Patients’ Compensation System.
The Patients’ Compensation System focuses on the patient's need for both prompt recognition of a medical injury and prompt payment. The doctor is not blamed for the injury and may recognize and learn from his or her mistakes without being sued. This removes the wedge between patients and their physicians, allowing the doctor to choose the best health care for their patients.
The Patients’ Compensation System would take 180 days, as opposed to the current system that can take up to five years, and includes five steps to ensure a seamless process and answer key questions:
- A patient advocate: How do I get my claim submitted?
- A Medical Review Department: Is a medical injury present?
- An Independent Medical Review Panel: Is this an avoidable medical injury?
- A Compensation Department: What should be paid for the injury?
- An Administrative Law Judge: Was the patient need and physician record reviewed properly?
- A Quality Improvement Department: How do we reduce preventable medical injuries?
The new system’s patient benefits include access to justice for ALL patients; delivering more compensation to more patients faster; increasing patient safety; encouraging medical innovations; avoiding unnecessary tests; and providing more access to physicians – as additional part-time physicians will practice medicine. Economic benefits include lowering health care costs, lowering employer costs and creating more jobs, as well as decreased state and federal taxes.
This year, Florida has the opportunity to take the leadership role in reducing the real driving force behind skyrocketing health care costs, while extending patient care to compensate medically injured patients more quickly and compassionately.
J. James Rowsey, MD, is a longstanding delegate of Florida Medical Association and board member of the Florida Society of Ophthalmology; he also recently served on U.S. Sen. Tom Coburn’s Medical Legislation team.
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