Utah Med Law

Part of the health care debate and the call for reforming tort law regarding medical malpractice is the claim that doctors practice in such a way that the cost of medicine is increased because doctors order tests and treatments to protect themselves from medical malpractice claims.  Of course the ordering of unnecessary tests and treatments increases the cost of health care overall and increases your health insurance premiums.  This practice of ordering unnecessary tests and treatment is called defensive medicine.

Imagine that you go to the mechanic complaining that your car's brakes do not seem to be work properly.  The mechanic looks at your vehicle and tells you that you need new brake pads and you expect the bake pads to be fixed and receive a bill for $300.  However, unknown to you, he also places new calipers and a new master cylinder fearing that if your brakes fail you will sue him. Your anticipated bill for $300 becomes a bill for $1000.  Welcome to the world of defensive automobile repair.  Would you accept and pay the bill?

Now doctors are supposed to be professionals.  Your doctor should not order unnecessary tests and treatment if he does not think the tests will reveal a treatable condition or rule out a threatening illness.  Treatments that yield no benefit should be foregone. An excellent example of how physicians have allowed erosion of their professional standards is the rise of Methicillin resistant Staphylococcus aureus (MRSA).  MRSA infections may have been driven in part by physicians' tendency to over-prescribe antibiotics to avoid being sued by disgruntled patients, according to a study published this past fall in the American Journal of Therapeutics. 

If we enforce "Best Practices" a patient demanding antibiotics for treatment of a condition which should not have antibiotics prescribed may not receive those antibiotics.  Costs would be reduced and the doctor would be acting professionally.  Doctors respond of course that the practice of medicine is part science and part art and that they must be allowed to practice without rigid guidelines. The pros and cons of guidelines or best practices is extensively discussed in KevinMD.com authored by Kevin Pho M.D.  My hat is off to Dr. Pho for writing about provocative issues of everyday health care and medical malpractice.  

Best practice guidelines, perhaps created by a respected panel of national physicians, should be the basis of health care treatment in the United States.  If a physician deviates from the best practice he should have a reason to do so - in both under-treating and over-treating the patient.  If the physician deviates from the accepted practice guideline or best practice then he should be liable for medical malpractice and any harm that visits his patient as a result of the deviation.  Medical malpractice lawyers could evaluate the guideline against what teh physician actually did and determine if a medical malpractice case is viable.  Guidelines and best practices exist - let's use them!  For example, look at the National Guidelines Clearinghouse or the Washington State Medical Treatment Guidelines.

It is time to enter the present doctors - let's get on board and start practicing medicine in a manner that benefits patients and not your antiquated notions of the noble pursuit of medicine.