This is going to be one of the most challenging chapters in this book and one that I have anticipated and struggled with in writing for a long time. Medical malpractice is a subject that has stirred the medical community for a long time now and we have heard very little from doctors about this issue. We have all listened to the TV commercials that say if you have been the victim of medical malpractice call our office for a free consultation. The sheer volume of these ads leads one to believe the problem is rampant. As I have alluded to earlier in the book this is far from the truth. I want people to hear the physician’s side of the story when it comes to this subject. I feel I am very well qualified to speak out about it because I have unfortunately endured the process. But I also speak as a physician who has sworn an oath to do no harm, which I do not take lightly, nor do the vast majority of my peers. Medical malpractice is, simply put, accusing a doctor of negligence which results in harming a patient. This is, in essence, what it means to accuse a doctor of malpractice. Very few physicians deserve that kind of a label and, yet, it has been allowed to fester and bring down the profession from the respectability it once had and deserved. Just the thought of harming a patient is disturbing to me and it should be for all involved. There is a huge difference between a physician who through negligence is guilty of harming a patient and the more frequent scenario where a patient experiences a legitimately accepted complication of a treatment or surgery by a physician. Medicine, as I have explained earlier, is not an exact science and yet we are all too frequently held to that standard. Despite a physician’s all good intentions, everything does not always work out to the result we or the patient would like. That does not equate to the fact that someone did something wrong. Unfortunately, sympathetic juries many times do not understand how complicated the cases they are asked to decide may be. Even medical experts can differ in their analysis of many such cases so how can a jury of men and women, without any medical background, be expected to decide such complicated cases? Too often cases are decided by the show put on by the attorneys rather than the facts involved. Too often physicians have been forced into not defending a case by their own insurance company trying to limit their possible loss. The possibility of a handicapped child being paraded in front of a sympathetic jury is a powerful tool used by plaintiff lawyers. I think that some lawyers have acted despicably by specializing in prosecuting those types of cases. I know of one prominent plaintiff attorney who would not take a case if the child involved did not survive because it was much more lucrative to have a live handicapped child brought before a jury. They have learned how to play the game with juries very well. “Ladies and gentlemen, this poor child is the result of this doctor’s actions and, naturally, it must have been his fault.” How many of them would do it pro bono and have the patient receive the entire settlement in a legitimate case? Simple answer: probably very few. Let’s set it straight: they are in the business of making money and I have seen how cruel and callous some of them can be. And yet our legal system allows it to continue. The system often reminds me of a lottery. If lawyers pursue enough cases, sooner or later they will get a winner. Fortunately the vast majority of medical malpractice cases brought to trial are decided in favor of the physician. But what I want everyone to understand is what it does to a physician to have to endure this process. In my opinion there are far too many frivolous cases which are brought to trial. On the lawyer’s side of the issue, they are not paid unless they win a case so the profitability factor cannot be denied.
Believe me, I respect the judicial system and lawyers in general, many of whom are good friends. But some of them will admit in private that there are bad actors in their profession that they are not proud of as well as in my profession. And it is this small group of greedy people and bad docs who are destroying the medical profession. So what’s the answer and how must things change? First, all physicians ask is that the system be reformed so that it is fair for all. Are there physicians who have harmed their patients? Sadly, there are and they should be punished. Secondly, jury awards must be capped to reasonable numbers for a particular grievance. If a doctor takes off the wrong leg or removes a normal organ, he or she should be punished. That doesn’t mean a jury should be allowed to put as many zeros as they want into the settlement. Thirdly, a lawyer who brings a frivolous case to court should be punished also. Most true cases of medical malpractice are obvious and do not even need to go to court. There is no provision in the law currently to prevent those frivolous cases from making it to the courtroom or of hoping for a settlement to prevent an even worse outcome before a sympathetic jury. If you bring a poor case to trial and lose you should pay for the expense of the court and the expenses of the defendant. Either that or the lawyers will need to police their own, which by the way physicians do. So now that we’ve laid out the issues, let’s try to analyze them a little more closely.
As I’ve said, I do not want to make this into a lawyer bashing testimonial. But we must make changes in our judicial system that allows frivolous lawsuits to waste the court's time and have the potential to destroy a physician’s reputation. Jury verdicts against physicians are now a matter of public record. This can easily lead to misconceptions about a physician’s ability or character. How did the situation we are faced with now evolve? When I entered private practice in the mid 1970s, insurance premiums for an Obstetrician/Gynecologist were in the area of $10,000 a year. Malpractice lawsuits were just beginning to become a problem at that time. When I was a chief resident in New York City, I was interviewed by NBC on the subject and how it would influence where I would practice medicine. At that time the high risk states for doctors were New York, Florida and California. Prior to the mid ‘70s there were so few cases that it was not even a subject to discuss. Today it is around $125,000 a year per Obstetrician depending on the particular state you are in and the doctors’ previous claims history. Are physicians currently making more mistakes or has our society just become more litigious? I submit it is the latter and I will try to explain why. As mentioned in the ‘70s, malpractice lawsuits were few and far between. Physicians historically were placed on a pedestal by society and few dared knock them off. I do not believe that we should be placed on a pedestal, but I do believe we have lost a considerable amount of respect. I also think there were a fair amount of malpractice cases at that time that were not pursued because of the high opinion physicians were held in. Unfortunately I think we have lost some respect sadly of our own doing, but I just don’t know when we became the bad guys and gals. That is part of the reason I have undertaken this endeavor. I think you can appreciate by now that Medicine is not the profession to go into if you are purely interested in making money and do not have the dedication and drive to help others. This is true now more than ever with the way our salaries have decreased over the years. We were told on day one of medical school if you are only here for the money you should leave now. It’s possible to make more money in many other careers with a lot less time, effort and cost involved. I asked one of my children when he was in high school have you thought about possibly becoming a physician? His answer was simply “are you crazy dad”. I know how hard you studied to become a doctor and how hard you work now and I am not interested. I was really very sad with his answer. Slowly over the years, however, physicians began to be sued more frequently. Initially both physicians and their insurance carriers tried to settle most cases before going through the long ordeal and expense of a court trial. From the time a lawsuit is filed until it is settled takes many years especially if it is decided by a trial. It is a long process that is physically and, I hope you understand by now, emotionally draining. To have a malpractice case hanging over your head for years takes a toll on the physician. I personally can attest to that fact and I hated every minute of it. Lawyers quickly recognized that and more and more cases were filed with the hope that a quick monetary settlement would be relatively easy to obtain. And indeed that was the case. I know many physicians who would never go to court and would always try to settle a case without a trial. This was the beginning of a long journey downhill in Medicine. Besides valuable time lost from their practice, who would elect to be accused of being a negligent or bad doctor and listening to a lawyer assault your knowledge, reputation and integrity in public? So the vast majority of those cases were settled for small amounts and a trial avoided. It seemed like a legitimate decision, but it eventually led to more and more cases being filed. This became the philosophy of trial attorneys and the numbers of cases escalated. Lawyers and plaintiffs began to feed upon the deep pockets of the malpractice insurance companies and, as a consequence, insurance rates began to slowly rise. As our society became saturated with lawsuits in general, medical malpractice cases increased tremendously. Have you not heard a family member or friend suggest that you should sue the doctor over an unhappy or unexpected outcome?
By the late ‘80s and early ‘90s insurance companies began to defend more and more doctors over what appeared to be an increase in frivolous cases. I personally believe that because doctors have become more cautious about lawsuits and, therefore, practice defensive medicine, that there, in reality, are fewer and not more errors occurring now. On the other side is the legal profession that holds the belief that many errors have been hidden by the medical profession. As a physician practicing for 45 years, at least in my observance, that is not the case. There are so many people looking over our shoulders that hiding medical errors is not a significant problem and I honestly have never seen it. That is not to say that medical errors do not occur, but they usually occur unintentionally and not by negligence. Yes, believe it or not, physicians are human and occasionally we make mistakes. I have seen unintentional errors occur where the patient was made aware immediately and the error was corrected and lawsuits avoided. But no one takes errors more seriously than we do.
So the stage was finally set where large law firms began to specialize in medical malpractice cases and, on the opposite side, defense attorneys grew in response to that increase in demand for the defense of physicians. How often do we see ads on television for law firms trying to drum up business. Every time I see one of those ads, I am tempted to throw something at the television. The implied tone of them is destroying my profession and it is time to put a stop to it. Experts for plaintiffs and defendants emerged as more and more cases went to courts for jury trials. So now we have a rather elaborate system of trial lawyers, defense attorneys, plaintiff experts, defense experts all prepared to do battle in the courts. Attempts were made along the way to have cases reviewed by a peer review system to try and weed out frivolous cases, but that was never successful to any degree. So this rather complicated system has emerged to handle the tremendous increase in the volume of malpractice cases. Do I sound bitter? You bet I am, as I have had to endure two lengthy court trials which I eventually won but were exhausting physically, emotionally and monetarily to defend myself. To be sued by a patient I have tried to help is something I just don’t understand. And in the end, although I was acquitted of any wrongdoing, the plaintiffs’ attorneys had no repercussions for their actions. They just walked out the door and moved on, I’m sure, to other cases oblivious to the harm they caused or the costs in time and money. In the meantime my malpractice insurance premiums increased because of the high costs of defending myself. This is not right. One case was so ridiculous that the expert witness for the plaintiff never even showed up in court. In another case, the judge involved actually told my attorney halfway through the trial that if the jury returned a guilty verdict against me he would overturn the decision because the case was so weak. And yet he allowed the case to continue on for several more days in order that the process would be allowed to play itself out. I asked my attorney why? Well there would be less of a chance of an appeal if a jury verdict was given in my favor. Does this make sense to anyone? I have trained too long and worked too hard to have my reputation destroyed by someone trying to make a buck and then tell me “sorry doc it’s just business”.
Several states have established caps for jury awards in an attempt to bring about more reasonable compensation for legitimate cases. Multi-million dollar awards are the norm and sympathetic juries have been allowed a free hand to award outlandish amounts of money to injured parties. In many states, the caps have been shown to bring the cost of medical malpractice down to reasonable amounts as well as the actual costs of medicine. Unfortunately every time that has come up on a national level, trial attorneys, with their lobbying of politicians, have been able to stop it. The opposing position is that the most severely injured people are the ones who suffer because of an arbitrary cap on the awards they are given. It would allow someone, at least in theory, with a minor degree of an injury to receive the same amount as someone with a larger or more devastating degree of a similar injury. Many physicians have given up practicing Obstetrics because of high premiums which resulted from excessive jury awards often not for malpractice by a doctor but for a poor result, which can happen to the best of physicians. It is difficult for a lay person to understand the difference between negligence and a legitimate complication resulting in damages to a patient. Why is it that there are few, if any, physicians who have never been sued? Are we not teaching our young doctors properly? Far from it, our new doctors have the finest training in the world as evidenced by the fact that physicians come from all over the world to train in our teaching hospitals. Insurance companies actually have statistics on how often a physician in a particular specialty will be sued over a certain time period and that is how premiums are now determined. So the chance of being sued is merely a calculated risk over a certain time period in every specialty of medicine. The really high-risk specialties of Obstetrics, Neurosurgery and Anesthesiology have the highest number of cases and the largest jury awards. What that is all leading to, I’m afraid, is ultimately a shortage of physicians in these specialties, especially in Obstetrics. Part of the reason I stopped delivering babies was because of the high malpractice premiums. And sadly to say, I am not alone. High-risk Obstetricians in my area have actually given up doing deliveries all together in order to decrease their malpractice premiums. Many more physicians are limiting their practices because of the excessive costs of insurance. Is that really what America wants? The answer is no but that is where things are going. It also is beginning to generate the long waits we now see in physicians’ offices and, believe me, it is going to get worse. By the way, the premiums are due in full at the beginning of every year before one patient is seen. Most physicians take out loans in order to pay premiums up front and then pay them off over the year. This is definitely leading to an increase in the cost of medical care. I know of several physicians who have actually had to borrow money from their pension plans because they could not get bank loans because of the excessive amounts involved. Do we wonder why many of our brightest men and women are no longer thinking of becoming physicians? That is the saddest result of all. Bright students are now realizing that the cost of a medical school education, the lengthy time involved and the high costs of malpractice insurance are too expensive a price to pay to become a doctor. After coming out of medical school with hundreds of thousands of dollars in loans added on top of the cost of setting up a private practice plus malpractice insurance premiums, I understand why none of my children and many others were not interested in becoming physicians. Sadly, I must admit for these reasons I also discouraged it. Those who really see first-hand what is happening to the medical profession really want nothing to do with it. That is truly the saddest part of it all. The medical profession is slowly being destroyed and we need to stop it before health care, as we know it, will disappear forever. We are ultimately going to pay the price for that sometime down the road. Our best and brightest students do not want to subject themselves to the time commitment and monetary burdens that are being placed upon them for a difficult lifestyle with diminishing rewards. That is the sad-but-true commentary on what is happening in Medicine today and no one outside of the profession really knows or cares. Yet!
I do understand that, unfortunately, there have been patients who have been injured by medical mistakes ultimately caused by physicians or by the teams they lead. What I am vehement about is the numbers of those cases in relation to the vast majority of cases are extremely small. If someone harms another person, I am in favor of both punishment for the offender and fair compensation for the injured party. I and my colleagues in no way condone a physician who harms a patient. Remember the oath we take upon graduation from medical school? In my 40 plus year career, I have occasionally seen doctors of whom I am less than proud. They need to be weeded out in order to protect the public and preserve the profession. I have been on disciplinary committees at the hospitals where I have practiced and, believe me, those bad apples can be, and are, identified by the system. But sadly to say it is the same legal system that protects many of them. Physicians who are identified as practicing sub-par medicine can, and are, put under sanctions or made to retrain themselves in areas where they show weaknesses. Many times privileges are withdrawn or restricted as a result. So policing of the profession does take place, but it could improve and I believe it is. Retraining standards have improved over the years as well, to the point where I believe the physician who cares for you today is better trained and more knowledgeable than ever before. But because we are human beings we will never be perfect. The phrase “standard of care” is what we are held up to in our daily work. It means that whatever we do or don’t do must not deviate from what most physicians under similar circumstances and with similar training would do. That is such a broad standard to be held up to and too often is used as a catch phrase to condemn a physician. A patient who suffers an injury during a surgical procedure that is recognized as a possible complication by the best of surgeons has not deviated from the standard of care but, certainly, can and more often than not, will wind up in a court defending his or her actions. These are the biggest portions of malpractice claims and the biggest dilemmas we and juries face. How should a person who suffers an unintentional injury be compensated? And the bigger question is should all such bad outcomes be compensated at all? Those are the difficult decisions juries must face and without any medical background to help them understand the circumstances. A well-trained surgeon who does a lot of surgery is going to have occasional complications just because of the difficulty of the procedures that they do. Does that make him or her a bad physician or have violated the standard of care? No! Hospitals and surgical departments keep track of complication rates to make sure they are not excessive. But my point is complications do occur. However, lawyers will bring these patients before a jury and sympathetic decisions are made without an understanding of the circumstances. I firmly believe that some juries are incapable of making medical decisions because of their naturally sympathetic bias and lack of medical background. Some of the malpractice cases, however, I believe have been brought on by ourselves. Sometimes our behavior is looked upon, and in reality, as arrogant. How a physician deals with his or her patients often can lead to anger in a patient which then if problems occur results in lawsuits. I have heard it myself from some of my patients about a previous physician. “I’m going to fix that arrogant so and so.” I often think to myself when I encounter that type of patient, do I really want to care for that person? Or am I more inclined to make sure I document very well what I do for that patient and maybe order a few more tests to, excuse me, cover my butt. More often I will try to use kindness and a sense of understanding to alleviate the hostility this type of patient now has for physicians because of a bad experience in the past. That, I believe, cannot be taught in medical school but is just something that we all hopefully have in our personalities as part of the reasons that drove us into the profession in the first place. But unfortunately we all don’t have those personality traits and an uncaring or non-sympathetic physician can often be taken for a bad doc, which leads to anger in a patient and a potential lawsuit as a result.
The government must finally realize that malpractice reform is needed. It will be difficult because so many of our politicians are lawyers who are reluctant to rock the boat. Trial lawyers also make huge contributions to political campaigns. More and more physicians are now seeking public office to try and get the message out of what is happening and create more understanding of the issues. Unfortunately, to date our numbers and voice are far too small. But I believe, if we are going to preserve medical care as we know it, more must be done. Why is it that many physicians in Florida do not even carry malpractice insurance any longer? They prefer to “go bare” and place all their assets in family members names. I have served on the underwriting committee of my malpractice carrier for several years. It is a physician-owned and run company designed to hold down the costs of insurance for doctors that practice good medicine. We evaluate all applicants and try to eliminate those doctors who are bad risks for one reason or another. Unfortunately some good doctors with multiple lawsuits also have to be excluded. Rarely did we see a doctor who has never been sued. I often saw applications from physicians who had been dropped by their current insurance carrier because of the sheer number of lawsuits filed against them. It was not because of why they had lost cases, it was just that they had too many. That is the sad but true situation that is happening too often to basically good doctors. The American College of Obstetrics and Gynecology recently released a statistic that showed over 90% of its members had been sued one or more times in their career. This is flat-out absurd. My carrier has a strong policy of defending its physicians in frivolous cases. This is starting to make some lawyers think twice about bringing weak cases against our physicians. I believe that is one way we can police the profession and help to supply good doctors with reasonable coverage. But we must have malpractice reform or we will just be treading water. The system is badly broken and it must be fixed to be fair to all. The answers are quite simple, but are we ready to implement them now or are we going to let things deteriorate to the point where we are all going to suffer, patients and doctors alike? First off, lawyers must begin to take some responsibility for bringing questionable cases before our courts. If they accuse a physician of wrongdoing and they, in reality, are the ones who are proven wrong, there must be a way they are held accountable. If they were required to pay for the defense of the accused when they are acquitted, then maybe they would not be so quick to try weak cases. The lottery mentality of bringing multiple cases to trial with the hope of hitting the big one is wrong. I know lawyers who have told me that there are law firms known for these kinds of tactics. If we are held to a higher standard, then so should they. That in no way should deter a harmed individual from seeking redress. But as I have said before, most of the real malpractice cases do not even need to go to court and maybe that will put a stop to the majority of those poor cases. But even in those cases a lawyer seeking a huge monetary reward for his client would rather have a sympathetic jury decide how much his client is going to be compensated. That is where the system is out of control and not fair. Right now they have nothing to lose while the physician has everything to lose. Name, reputation and hard-earned financial security are put on the line every time a case is brought to trial. Jury awards in excess of insurance limits are being given out which can wipe out a career and future. So I appeal to our government officials to do the right thing and change the laws that govern malpractice cases and awards before it is too late. If we fail to act we will only further weaken a system that we need so badly in our society. If we cannot treat our physicians fairly, how will they be able to preserve our health in the future. Many of the fixes have been identified and we must now act to address the problem and enact reform.
I would also like to discuss what has happened to the medical profession because of the threat of malpractice lawsuits. The answer is what is referred to as defensive medicine. Because Medicine in the past involved subjective judgement decisions, when a case was brought against a physician, we rapidly found out that documentation was the key to a good defense. Oh yes, we are learning how the system works also. Therefore, more and more tests are now ordered in order to substantiate the doctors’ decisions. Each and every decision must be carefully documented with objective tests that verify why a course of action was followed. And because technology has improved over the years, the costs involved in documentation are becoming staggering. CT scans and MRIs are now being performed at alarming rates just because they are available to concur or not with the diagnosis a physician has made. Those tests are extremely expensive but are available and better be used if doctors want to stay out of or win in court. Isn’t that a terrible way to practice medicine? It is, but, we are no doubt being forced into making those decisions to protect ourselves. This is a double-edged sword in that those tests are very precise in diagnosis and yet they are so expensive. And how often are they absolutely necessary in making the correct diagnosis? I can tell you from personal experience the more tests that have been done which confirm the physician’s impressions, the easier it is to defend him or her in a court of law. This has led to insurance companies having patients get prior approval before these tests are performed. Consequently as a result care is delayed or denied. I think most patients would rather have their physician rather than an insurance company decide which tests need to be done. Lawyers love to second guess diagnoses with the question “well, why didn’t you order this test doctor?” Difficult decisions doctor may have to make are made in a short period of time as opposed to the lawyer who has years to question what was done. I have seen and heard it over and over again. In the meantime, the costs of caring for a patient are being driven up by the fear of lawsuits and the availability of expensive pieces of technology. Why wouldn’t a physician want to back up his or her diagnosis with a test that shows they were right? The result is that health insurance companies are now screaming at the rising costs and eventually they pass it on to the consumer. It is quite common now to have to pre-approve many of these tests with insurance companies before they will authorize them. And here again the physician is in the middle. You can’t have it both ways folks, it’s one or the other. Many patients actually encourage that process. I have had many patients come into my office telling me what tests they would like to have done. It is a fact of life that belligerent patients will ultimately have more tests done on them because the physician feels threatened and will do everything possible to protect themselves. So, ultimately we have created a system that just feeds upon itself and drives up the cost of delivering health care. Why some patients come into a doctor’s office with a chip on their shoulder I will never understand. If you are going to someone for help why do you want to make it more difficult by coming in with an attitude? I have even had to dismiss some patients from my office because they have become so argumentative and difficult to deal with. They look shocked when I tell them they are unhappy and you are making me unhappy so I suggest they see someone else. Many times you can predict a patient who might potentially sue you. There are even some patients who come in bragging about suing their former physicians. Why do I need or want to subject myself to this kind of behavior? Patients need to realize they only hurt themselves when they act like that but, nonetheless it happens. They are the kind of patients that we know lead to lawsuits frequently and more and more physicians are now just turning them away. The problems we face are quite obvious, but we must all sit down and try to fix them. And that is where our government must step in to control the costs. But instead, we see only partisan politics as usual and, in their effort to control costs, all they want to do is lower the compensation to health care providers because we have been and are easy targets. “Let’s get the doctors, they make too much money anyway.” I recently met with a local congressman who seemed sympathetic to our problems but pretty much said nothing can be done because the Democrats are so resistant to malpractice reform. That kind of mentality, I assure you, will only lead to a decrease in the number of physicians and consequently decreased availability of care. They need to reform the legal system or the costs will continue to rise out of control. We all know what is happening, but we must have the guts to speak out and fix it before it is too late. Physicians are now realizing that they must become more active politically the way lawyers have been. This is slowly happening but not fast enough.
I would like to give you a malpractice case summary to illustrate my points. A 31-year-old mother of three underwent a hysteroscopic tubal sterilization procedure because she wanted to avoid future pregnancies. The procedure involves the placement of a small plug into the opening of the fallopian tubes. This results in a blockage, preventing the union of egg and sperm. Before the surgery she signed a consent form stating she must return in 3 months for a hystero-sonogram to confirm that the procedure was effective in creating a blockage. It also stated she must use alternate means of contraception in the meantime. The patient neglected to return for the test and because she failed to use contraception a few months later she discovered she was pregnant. She sued the doctor and the case went to court.
PATIENT’S CLAIM: The physician was negligent in failing to inform her that postoperative testing was necessary and, more importantly, to confirm her inability to become pregnant. He also failed to advise her to use alternative contraception methods until that test had been performed.
PHYSICIAN”S DEFENSE: The patient was told the postoperative test was needed to confirm her inability to become pregnant and was also told to use alternative contraception until it was done. She also signed a consent stating this. The physician also documented that 5 postoperative appointments were scheduled for her to have the test done, but each time she either canceled or failed to come in.
VERDICT: For the defense.
COMMENT: This is the kind of frivolous lawsuit that should never have made it to court but it did. The case resulted in a waste of time for the court and expensive legal fees to defend the physician involved which will, in turn, lead to higher insurance rates in the future for the physician. The physician clearly did nothing wrong. Why did the judge, when presented with such a clear-cut case, allow it to progress to an expensive court case? Is our legal system so slanted towards a plaintiff that their right to a day in court can occur with evidence that is clearly false? The patient did not follow instructions and failed to return for the test to confirm her inability to get pregnant. She signed a written consent stating the test was necessary following the surgery and to use contraception in the meantime. What more could the doctor have done? If our legal system is not changed, these types of cases will continue to be brought to our courts needlessly.
So now I hope you understand the physicians’ plight a little better when it comes to the issue of malpractice and why it makes the hair on the back of my neck stand up when I even discuss it. When I was in medical school I don’t think I even heard the term medical malpractice. That just shows how quickly this has become such a big problem for the profession. I, like most physicians, value my reputation very much and I think society in general does not fully understand what it means to accuse a doctor of malpractice. No one wants to hear someone accusing them of harming someone in public. It violates the basic reason why we became physicians in the first place. You cannot make a more serious accusation against a physician. Again, remember the oath we take on the day we graduate from medical school. The fact of the matter is the issue has forced us into making decisions too often based on the fear of a lawsuit and, I assure you, that is a real and worsening problem in the medical profession. Any physician will tell you that it is often a consideration in how they take care of their patients now. The costs of this brand of medicine are staggering and it is obvious that the country can no longer afford to have it continue. But don’t take my word for it, just ask your physician if he or she worries about being sued and what they have to do to prevent it and you will see first-hand what a tremendous problem it really is. And the sad part is that it is getting worse all the time. To my lawyer friends I say there must be a reasonable way we can sit down and hear each other out. We have the best system of medicine in the world. Let’s not destroy it, let’s try to make it even better!
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