I read an interesting article this morning in the Citizen Times in Raleigh North Carolina reporting about the struggle in that state between medical regulators and physicians about the reporting of medical malpractice judgments and settlements to the public.  The essential question is whether judgments and settlements of medical malpractice cases should be made public at all and if so what are the criteria.

We need to discuss a little background first to fully appreciate both sides of the story.  First, what is the difference between a judgment and a settlement.  A judgment is that which is earned by the plaintiff in a court of law and awarded by the trier of fact.  The trier of fact can either be a judge or a jury but in medical malpractice cases the judgment is almost always determined by a jury.  A settlement, on the other hand, is a hard fought agreement between the plaintiff and the defendant that includes money compensation and usually other agreements about confidentiality to not disclose the terms of the settlement.  These confidentiality clauses are part of the overall settlement.

The legal system exists for a number of reasons and one of the main reasons is to educate the public about what laws exist and what happens when you break those laws.  Only by reporting the outcome of cases can the law inform the public about the law.  Not only does this mechanism serve to educate the public about what laws exist and how they a re violated but it puts the public on notice about societal problems that need to be addresses.  For example, if the general public does not know that deaths equivalent of two plane crashes daily are occurring every day in American hospitals they may continue down the path of ignorance and assume that all is well with the quality of health care in the United States.

I have blogged before and I reiterate here that there is no room for secrecy in the medical field.  I appreciate that doctors are not superhuman and are capable of mistakes.  I am capable of mistakes and so are you.  However, when you are dealing with people's lives those mistakes can have devastating consequences.  Doctors make a lot of money and I do not think that they are paid too much - at least in the current state of low supply but that is a matter for another post.  If a doctor makes a mistake and a patient is seriously harmed that result should be made known to the public.  There should be some criteria applied and I think that the North Carolina legislature is on the right track.  The amount of the settlement should be at least $50,000 in order for the settlement to be reported.  The reporting should be done on a web site under the control of the government or the courts.  All judgments should be reported regardless of the amount.  The names of the doctor and the name of the injured party should be made public as should be the names of the lawyers who represent each.

I do not make these suggestions lightly and am fully aware of the ramifications of making names public but in the wider interest of the public and in order to allow people to make knowing decisions about their health care should the perpetrators of medical malpractice be allowed to continue to practice with virtual immunity?

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