celebrity said:
I have no idea how tort reform should work, so my only suggestion is to remember that malpractice suits are usually civil torts. The plaintiff needs to show a preponderance of the evidence in order to substantiate the claim that wrongdoing has been committed.
Alright, that's the case presently. The standard is preponderance of evidence in civil torts. I'm not clear whether you're saying that this is the ideal, or merely remarking that this is what actually is, but in either case, what you've said is what is true now.
Institutions, not doctors are held accountable for wrongdoing, so it's not sufficient to say that one doctor did something wrong to call a program into question. A doctor stands to lose her license and her job in malpractice. That won't do the community any good, unless it is truly malpractice. Showing that two doctors have committed wrongdoing would be more significant than one. Should hospitals be required to care for patients for better or for worse? If you have any amount of faith in the medical community, then doctors are already held to a high standard as it is.
celebrity said:
Adequate treatment from the patient's perspective is a matter of getting better or not. Where doctors are able to treat sickness, disease or symptoms should be reduced and healing should take place, right?
No, that doesn't follow. I am able to write articles of fine enough quality that they are published in professional journals (I have several such articles published). That doesn't mean that every article I write is accepted somewhere. I have a few papers that have been rejected. Ability does not imply any particular rate of success. If you go back far enough in history, that was the standard. Doctors were thought, by patients, to be claiming they can cure the disease, and if the patient didn't actually get better, the doctor would be fined, branded, or even executed. This was often the case in Renaissance Naples, for example. What happened was that doctors recognized, before anyone else, that treating disease is always chancy, and the doctors just left those areas or went into other professions.
None of this means that good or bad treatments cannot be identified. They have to be identified over populations, however, and cannot be indexed to a particular patient.
celebrity said:
Well, some doctors may just get lucky with an opportunistic, non pervasive disease, a tumor which turns out to be benign, or a wound which is not septic in a patient with a healthy immune system.
Yes. This further supports my point.
celebrity said:
It's easy to know what to look for if you can indicate one symptom in a patient who is otherwise healthy. The converse of death, is a patient who is not healthy at all. Ideally, doctors should have a way to show that they cannot treat a patient with medicine other than saying "he's as good as dead."
I'm not sure I understand what you're getting at.
celebrity said:
I use of unnecessary procedures is the problem from a financial or malpractice perspective. Someone doesn't have to get physically ill in order to receive a huge bill that's not covered by their insurance. Shopping among doctors might fix that, but negotiation on the government end would certainly change things as well. Otherwise, doctors who work for large hospitals essentially would have a monopoly on health coverage.
I don't think, for reasons stated above, that shopping among doctors will fix things. Ordinary individuals are unable to determine the skill level of a doctor (even medical review boards find it difficult). One thing that will fix at least the cost issue is single payer universal coverage. I'm not sure there is a way to fix the malpractice issue itself. Doctors are human beings, and they screw up sometimes. And sometimes, the way they screw up is they stop caring and become negligent, and in those cases, malpractice suits are warranted.