The bill for my Golfer's Elbow consult and shot!!

Discussion in 'Health & Fitness' started by chess9, Nov 26, 2009.

  1. chess9

    chess9 Hall of Fame

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    $456! Incredible. I cannot believe it....

    -Robert
     
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  2. Puddy

    Puddy Rookie

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    What did the MD shoot you with?

    What kind of bandaid? A cool Superman version? I hear those can be a bit costly. :-?
     
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  3. BreakPoint

    BreakPoint Bionic Poster

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    That's why I never go to the doctor. :)
     
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  4. yemenmocha

    yemenmocha Professional

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    Are you kidding me?

    Do you know how much it costs for a plumber or an electrician? This is a visit to doctor and that seems like too much?

    I've spent nearly $5000 on my GE and it's still not better, including multiple doctor visits (including a 2nd opinion), an MRI, two cortisone shots, and many PT sessions.
     
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  5. Moz

    Moz Hall of Fame

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    I'm not clear here - your $5000 bill has not improved your condition but you don't think the doctor costs too much? Or are you just warning Robert of what is to come? :)

    At least when you employ a plumber you can flush your toilet afterwards.

    Hope it gets better for you mate - mine didn't. I started running again instead!
     
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  6. yemenmocha

    yemenmocha Professional

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    Heck yeah I hope it gets better. It started 18 months ago. A few doctor visits with cortisone shots on different times, followed by no 3rd cortisone and instead referred me to doing ASTYM. Did that and PT for awhile with various treatments (around $80/visit, several times per week). MRI after that. After 6 months I tried to come back to tennis slowly and the GE returned. Went to an orthopedic guy who specializes in arms. No surgery recommended, instead take 1 full year off.

    It all adds up. It was a sum, not one visit for $5000.

    I was making a general point though that I'm surprised that people are so surprised at doctor's bills.
     
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  7. EcoRick

    EcoRick New User

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    I'm assuming you were also prescribed physical therapy. If it works, it will be well worth it. I had it a few years ago and can't imagine my life without the cortisone and therapy. After a few months, it was all cleared up.
     
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  8. chess9

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    That is the bill for one visit with the doctor's P.A. and a shot. The whole thing took about 15 minutes.

    The cost seems excessive.

    -Robert
     
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  9. mikeler

    mikeler G.O.A.T.

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    My visit to an orthopedic surgeon for GE was $25 but I have health insurance. I don't think the cortisone pills were very expensive either. I'm currently paying $40 a pop to visit a chiropractor that does not take my insurance. The electrostimulation and ultrasound therapy is really working for me.
     
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  10. equinox

    equinox Hall of Fame

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    democratic way for the government to send a message.
    If you can't afford to live, then don't do so. die painfully instead.
     
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  11. chess9

    chess9 Hall of Fame

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    Oh, yes, I have insurance. That's what they billed my insurance company. No wonder insurance bills are so high! I only paid my co-pay of $25, but I paid for the Medicare Advantage plan through my medicare payments. I just think no one should be ripped off in this system, but I think the doctors need to show some restraint, and particularly the specialists.

    This guy's getting over $1500 an hour.

    -Robert
     
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  12. mikeler

    mikeler G.O.A.T.

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    How well did the shot work for you? My pain also included triceps tendinitis so I had to take the pills. Within 2 days I had no pain. Then it gradually came back when I started playing again.
     
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  13. scotus

    scotus Legend

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    The cortisone shots are that expensive.

    And most doctors don't make that much money. It's pittance compared to blood-sucking lawyers (Okay, there are some lawyers who are sort of at "pro bono" work level).

    But take this. My chiropractor bills my insurance company $250 for what amounts to 15 minutes of his time, 5 minutes of his assistant's time, and 30 minutes on his massage chair (a machine). Now this guy grosses $1000 an hour.
     
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  14. yemenmocha

    yemenmocha Professional

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    Your doctor is not "getting over $1500 an hour". Most of the costs are not the doctor's takehome salary - the facility, the equipment (including R&D that goes into equipment, meds, etc.), the nursing staff, the administrative staff, etc. and oh... let's not forget that you also pay for the people who try to sue for frivolous reasons. Sorry, but it strikes me as either naive or downright belligerent to think/say that the doctor is getting $1500 an hour.
     
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  15. yemenmocha

    yemenmocha Professional

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    Finally, some sense in this thread. I'm not going to run with the lawyer rant but you're right, most of the costs of the bill are NOT going to the doctor's salary.
     
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  16. chess9

    chess9 Hall of Fame

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    I didn't say it was going to his salary, but I ran my own law office, and we tried to keep expenses around 55% of income. I don't know anything about medical office economics, but even if his overhead is 60%, he's taking home a bundle. Maybe I'm wrong. I admit I don't know enough about medical office costs.

    How expensive can cortisone be? $20 for the doctor?

    -Robert
     
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  17. I broke my leg 4 years ago, stayed 2 nights at the hospital- The bill was 25 USD :)
     
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  18. chess9

    chess9 Hall of Fame

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    But, aren't you a 3.5? ;)

    -Robert
     
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  19. mike53

    mike53 Professional

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    Just because they bill that amount doesn't mean they get it. Your doc would be lucky to get $100 from the insurance company, but he gets to keep your entire copay. If he runs enough people through at $25/shot, he can make a decent living.
     
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  20. chess9

    chess9 Hall of Fame

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    No, that's what my insurance company says they paid him. My carrier is United Healthcare and they send me monthly statements. Since the insurance carriers have been taking so much heat, I think they want the patients to know what the doctors are charging. United won't be my carrier January 1, however.

    -Robert
     
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  21. mike53

    mike53 Professional

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    So United paid the doctor what he billed them or did he bill them something like $1200?
     
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  22. charliefedererer

    charliefedererer Legend

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    It sounds like you haven't figured out the way medical billing works .

    It's a lot like the old Soviet system: They pretended to pay the workers and the workers pretended to work.

    That doc is not going to see more than $150.
    It doesn't matter what he charges, it's what he collects.
    But if sets his rates lower, the insurance company will pay him even less.
    No it does not make sense.
    But it is the insurance company that sets the rules. And the billing company for the doctor submits rates it has established for working with many other specialists. The doctor rarely has has more than a vague idea about what his actual charges are. He just knows he's only going to see a fraction from the insurance company.
     
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  23. larry10s

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    i have not read all the posts but my question is what did your insurance pay?? i assume your doctor accepted your insurance so that is what he was paid and you did noy pay the difference??? yes???
     
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  24. mlktennis

    mlktennis Semi-Pro

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    The doc has gone through 4yrs college, 4 yrs med school, prob 5 yrs orthopedic residency and didn't prob make any real money till 35+ yrs old.

    Med school education prob 200K not including undergraduate college.

    pays prob 100K in malpractice,

    is at the mercy of whatever insurance wants to pay him.

    Works prob 80-100hrs a week

    every tom,dick or jane wants to sue him whenever anything doesn't turn out like it should, or just b/c he wasn't nice.

    What do you think his services to diagnose and treat your body are worth?
     
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  25. charliefedererer

    charliefedererer Legend

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    In most areas the doctor only collects what the insurance company pays. As part of the standard agreements he signs with the insurers, Medicaire and Medicaid, there is a clause that the physician will accept the payment from the insurer and not bill the patient the remainder of the bill.
    Independent physicians, and small to medium size hospitals don't really have bargaining power to change the rates. They can take it or leave it with each insurer. But it's usually take it as the big insurers cover the majority of people, and hence their potential patients.
    It's all an example of the "golden rule". He who owns the gold rules. The insurance companies, Medicaire and Medicaid hold the gold. They set the rules.
     
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  26. mlktennis

    mlktennis Semi-Pro

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    Most rates in most professions go up as inflation goes and as the markets will bear. This is fair, but did you know that most doctors are getting making the same or less money for the last 8-10 years and having to work harder and harder for the same coin year after year? This while malpractice rates go through the roof.

    Put all this together and what you are and will be seeing is that the best and brightest minds will not be stupid enough to go into medicine...and when they do, the financial pressures will be so great that they will lose sight of what brought them into the profession in the first place.
     
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  27. charliefedererer

    charliefedererer Legend

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    A long time ago medicine was a "mom and pop" enterprise. Doctor's set their rates, and patient's paid for service out of pocket, if they were able.
    Now of course everything is on a data base, and the same crushing push for increased productivity is applied to medicine as it is to any business. No doctor is happy with this. I don't think insurance companies are happy either. It's just the way it is. And with taxpayers facing an ever bigger portion of medical bills, the push for greater productivity is of course only going to intensify. Of course greater productivity has to mean less personal care. But that is definitely going to be the trend.
     
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  28. chess9

    chess9 Hall of Fame

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    Good grief! I have no clue if he billed more. LOL! The copy I got just showed what they paid him.

    -Robert
     
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  29. chess9

    chess9 Hall of Fame

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    I didn't even see the ortho doctor. I saw his PA. I think $250 an hour seems reasonable for a doctor. That's $10,000 a week on 40 hours. :)

    -Robert
     
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  30. charliefedererer

    charliefedererer Legend

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    Bob,

    I, and three other surgeons tried to form a group about twenty years ago.

    We paid an attorney $25,000 to draw up the agreement.

    But we never finished, because it was clear this was just an initial payment, and the final agreement was going to cost a lot more.

    I just wanted to let people know what attorneys charge.
     
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  31. charliefedererer

    charliefedererer Legend

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    It seem like the cost of injections varyhttp://www.steadyhealth.com/How_much_do_cortisone_injections_cost__t135946.html based on the responses on this web site:

    I just had an elbow injection in kansas city by my md...the cost with office visit was $249 less 20% because I paid in full at time of treatment

    I went to the ortho dr and he told me off the cuff the shot is cheap about 40 bucks and when I got the desk to pay it was 300.00 I freaked I dont have Dr office visits covered or shots pretty much cheap coverage, but I told her hey wait, the dr told me 40.00 so she looked again and said, Oh Ok 260.00, I told her look thats still too much, mind you I have never had to do this before I have had great coverage for 53 years but with my job loss I didnt have but cheap 200.00 a month coverage, she checked with the Dr he says is what it is and said to her give her the cash price less 25% so thankful.. I am getting some other shot that lubed your knee joint it costs 600-800 but the cash price would be 505.00 she told me costing me heaps.. gotta do it.. I have bone on bone on my right knee. I used to be a meat cutter for 24 years this heavy lifting was not good for my knees.. hope this helps.

    Just had a cortisone injection in my elbow that was performed by my family doctor and it cost $250. A friend just had the uterus cut out of his cat and with anesthesia and pain meds, he paid $90. Doesn't that seem fair?
     
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  32. yemenmocha

    yemenmocha Professional

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    Wow, just amazing what attorneys charge. And law school is only 3 years, with no internship & residency, and it's incredibly easy to get into law schools outside the 1st tier. Simple robbery for them to charge you that much.

    An agreement from an attorney should cost.... ah.... uhhh... no more than $750. You overpaid. :shock:
     
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  33. chess9

    chess9 Hall of Fame

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    Do you have any idea how hard it can be to get 4 doctors to agree on the color of carpet, let alone all the legal nuts and bolts? I hesitate to offer an opinion because the amount of time and expertise involved could be anywhere from 2 hours to 50 hours, with tax lawyers, corporate lawyers, an insurance guy for malpractice/building/premises, leasing agent, realtor, etc. If the agreement can be drawn up for $750 then you can get a form off the internet and edit it for your needs. You don't need someone with a brain. ;)

    I can honestly say I never netted over $200K in my years in practice. I was probably in the middle in terms of income as I spent some time being politically active and some being a jock. ;) A lot of young lawyers were making $50K a year, and in today's climate, I'll bet a lot are unemployed. No doctors are unemployed unless they were bad or have retired. It's a recession proof industry! They almost have to kill people in groups of 100 or more to lose their licenses. ;) j/k

    -Robert
     
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  34. mikeler

    mikeler G.O.A.T.

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    My Dad is a general MD. He makes about 5 times less now than he made 20 years ago.
     
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  35. yemenmocha

    yemenmocha Professional

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    Chess9 - I was being sarcastic. :)

    Mikeler - that's the sad reality. A procedure that the market would bear at $2500 in 1983 is lucky to be reimbursed at $1000 now because of non-negotiable Medicare and other factors. Nobody realizes that while most professional careers kept up with inflation over longer periods (I mean 15-20 years), medicine has not, at least for physicians.
     
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  36. chess9

    chess9 Hall of Fame

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    Well, all you doctors should be begging for NHS style care then because in England, for instance, most doctors are earning at least $200K a year, and they have no malpractice premiums, no insurance company forms, and only the NHS bureaucracy to deal with. Of course, they are employees, and not the boss. They must answer to non-doctor managers, which totally sucks from my perspective. (I think this is one of the reasons why the NHS does such a poor job.)

    -Robert
     
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  37. Steady Eddy

    Steady Eddy Hall of Fame

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    About 2 years ago I got pneumonia and had to spend a week in the hospital. They didn't operate on me, just gave me IV's, and then billed by insurance company $100,000! I don't get that bill. After that, nothing surprises me.
     
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  38. scotus

    scotus Legend

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    For a fairly simple LLC document that can be downloaded off the internet, one lawyer that I hired charged $6000.

    My accountant used to do fill out this form himself at no extra cost, but he must have made a business acquaintance, so he told me that I needed to get this done "correctly" and suggested that I hire this lawyer.

    After I told him what the lawyer charged me, he apologized profusely and swore that was the last time he ever referred this lawyer to anyone.
     
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  39. chess9

    chess9 Hall of Fame

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    No harm in asking? ;)

    -Robert
     
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  40. BreakPoint

    BreakPoint Bionic Poster

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    Which is why I think we need tort reform, as well as or before, heath care reform.
     
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  41. yemenmocha

    yemenmocha Professional

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    Amen to that, Breakpoint. :neutral:
     
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  42. snoopy

    snoopy Professional

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    I sort of agree, but then I think there shouldn't be a limit on the price a dr should pay for chopping off the wrong leg.
     
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  43. mikeler

    mikeler G.O.A.T.

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    I'd prefer tort reform to take place first and then react to the results of that change before pursuing healthcare reform.
     
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  44. yemenmocha

    yemenmocha Professional

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    You can have a lot of tort reform without caps.

    Docs are far more worried about the frivolous cases that shouldn't be considered at all. In Europe, I think, there's an early stage where people with medical credentials pre-screen the cases before they go to a further stage. That needs to take place here. Average citizen in a jury is an idiot, and that's partly why some of the joke cases are won and/or settled for $ when they should have never received serious consideration at all. People are incapable of deciding based on the merits of the case vs. sympathy for the plaintiff.

    There's also the well-known issue of practicing excessively defensive medicine because of fear of lawsuits. That drives up costs unnecessarily.

    The minor tangential stuff needs changed too, such as being "named" in a case that really isn't about you. You still have to get an attorney and still endure the damn process, even though you're not directly being sued.

    The process is incredibly flawed, and the cases without merit are far more common than "chopping off the wrong leg".
     
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  45. jazzyfunkybluesy

    jazzyfunkybluesy Banned

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    That makes the OP really happy.:shock:
     
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  46. borg number one

    borg number one Legend

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    Don't fall for the Tort reform will really help health care reform mantra. It won't work in terms of lowering insurance premiums.

    See articles on this oft-debated topic:
    http://www.redding.com/news/2009/aug/31/bob-williams-the-holy-grail-of-tort-reform/?partner=RSS

    http://www.kellogg.northwestern.edu...al/Documents/Working Papers/ADS_9_09w_ack.pdf

    http://prescriptions.blogs.nytimes.com/2009/08/31/would-tort-reform-lower-health-care-costs/

    You know who has pushed Tort Reform? The Republican Party, Conservatives, Big Business, Insurance Companies, and many Physicians. I wonder why?

    Meanwhile, Tort Reform in the U.S. has not hugely impacted Attorneys who handle a lot of med mal cases. Attorneys can handle a wide variety of cases by and large, so most of them feel little if any real "financial impact" from Tort Reform. Heavy Hitters in that arena have plenty of other work to pursue. Most all of them that I have met and worked with truly do care deeply about patients that have been severely injured due to medical malpractice.

    They seek justice and HATE the idea of trying to pursue frivolous lawsuits. There are simply too many good cases to pursue and they surely do not want to sink hundreds of thousands of dollars into a "dog" case. Why would they want to do that, even from business perspective?

    When Tort Reforn occurs in one state. Guess what tends to occur. Bad Doctors from a State that has not enacted Tort Reform, whose malpractice insurance premiums are skyrocketing due to court losses, move to the State with Tort Reform, so they can somehow obtain malpractice insurance and continue to practice.

    So, such Tort Reform states tend to basically attract more bad doctors, who are in the minority overall. The AMA needs to do a much better job of policing its own doctors to make sure "repeat offenders" can't continue practicing and hurting patients.

    You know who gets hurt most by Tort Reform? Injured Patients due to Medical Malpractice, which 99% of the time goes ABSOLUTELY UNDETECTED.

    There is even falsification of medical records when it is even suspected at hospitals/clinics. That's one of the first things I saw in a Law School Course I took, that was taught by a Law Professor, whose father was a Doctor, and who often lectured at the Texas Medical Center to assist Physicians learn more about the interplay between the Law and Medicine. Be careful when those medical records come back a little too neat and tidy! I've seen this up close and personal with many cases I have personally handled. The "cover ups" can be outrageous and shocking to witness.

    What would doctors do/What do doctors do when malpractice hits their own families (say a wife during pregnancy or her delivery)? Oh yeah, they hire a lawyer often to pursue a malpractice case against a fellow physician.

    Here is some information to consider:

    Health Care Costs are out of control:
    http://www.kaiseredu.org/topics_im.asp?imID=1&parentID=61&id=358

    Insurance Premiums have DOUBLED since just 2000:
    http://www.commonwealthfund.org/Con...-Insurance-Premiums-Increase-119-Percent.aspx

    If Health Care Costs and Insurance Premiums are not tamed, it will further bankrupt the Country and working families.
     
    Last edited: Nov 28, 2009
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  47. chess9

    chess9 Hall of Fame

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    Yup. Very good post.

    Most states already have engaged in MAJOR malpractice reform. Like 40 years ago. Tort reform won't help doctors much at all unless caps are established at $250K or less, and that ain't happening. Very few medical malpractice cases actually get to the trial stage. Most are dismissed by either the plaintiff's lawyer or the courts. Appeals are rare, and granting the appeals is even rarer. Doctors are being ripped off more by their insurance carriers than by the courts. Take a closer look at the expenses of the major doctor owned/run malpractice carriers, as in Cali. The doctors/managers are making a bundle and the amount paid out for claims is less than 50% of revenues in many cases. And, the market is very limited. Insurance carriers can pretty much charge what they want to charge. The degree of collusion and monopoly power is high. Doctors ripping off doctors. This is one reason why every good doctor needs a damned fine lawyer. ;)

    -Robert
     
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  48. yemenmocha

    yemenmocha Professional

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    Only one of those in the first set was a real "article". OP-eds are entertaining but certainly not articles, even if it's an academic who is giving his opinion. There's plenty of room for debate on this, and some of the same researchers' data is used for opposing views (Kessler & McClellan, for example: http://www.aaos.org/news/aaosnow/sep09/reimbursement4.asp)

    I don't think $100+ billion is chump change, or should be diminutively referred to as a "rounding error", even if it is only 1-2% of healthcare costs. Many other well-regarded studies place the dollar amounts higher and the % higher, especially with the defensive medicine estimates factored in. At a minimum, this is large debate, and not some slam dunk in favor of "we don't need tort reform".

    And even if the 1-2% estimate is correct, and that's the major complaint from the medical community, then FFS why not just fix it. If the major complaint is such a minor one, and then they'll STFU, then fix it. It's like Dr.Evil demanding just ONE MILLION dollars to not destroy the earth, and yet the negotiators won't give in. If it's only a small percentage, then just fix it. But I suspect that either the data isn't right, or the people who will lose out if that $100+billion is no longer there for the taking. Who would that be?

    As I said earlier, it doesn't necessarily just have to be about caps. Maybe that's the most effective way of having the quasi-trickle down effect where the smaller cases never get seen, but something has to be done about cases with little merit having the influence that they do. Every physician I know has had one like this or knows physicians who have had them. This isn't some urban myth or hasty generalization from a few small instances. Some of the most absurd cases get settled with decent payouts, and ironically I've seen that with appendicitis cases somewhat similar to the one mentioned in the above "article".

    If a medically credentialed committee existed that would serve as an early filter for sifting out the cases lacking appropriate merit in terms of the medical fault (such as there is in Europe), then you the attorneys would have nothing to fear and nothing to lose - because according to those in the articles posted above, very very few cases are frivolous. If so, then pretty much everything would still get through, so you should have no worry about a loss of business for yourselves. But if the critics are right that a lot of cases are frivolous, then such a committee would be a good idea. It would probably give peace of mind to physicians to not practice excessively defensive medicine because the proper criteria would be in place -whether in fact a medical mistake was made, and not whether a jury of laypeople would possibly side with the plaintiff over some "rich doctor".

    The general public doesn't seem to understand that doctors can do everything they're supposed to do and more, and still get sued. That, as a system, is broken. There's no confidence that doing what one is supposed to do will guarantee no lawsuits. It's sad that this isn't so.
     
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  49. chess9

    chess9 Hall of Fame

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    Yemenmocha:

    Most states already have a medical malpractice review panel, with doctors on board, who review claims.

    The largest single issue with doctors and the malpractice problem is they rarely lose their licenses. Get rid of bad doctors and you can cut a lot of the costs. You have a small number of bad apples who are not only giving good doctors a bad name but are raising the costs for good doctors.

    Should Michael Jackson's doctor still be practicing medicine? ;) And he's probably one of the weaker examples. I had a triathlete buddy of mine who was a defense lawyer for a large malpractice carrier tell me that the mistakes he's seen doctors make should be crimes, yet the burden on plaintiff's counsel is so difficult, many of the doctors (meaning their carriers) don't pay a red cent. I wasn't a negligence lawyer, but I'm sure the defense and plaintiff's negligence bar could regale us with scary stories. I'd like to see doctors work as hard to improve their licensing standards as they are to lower malpractice costs.

    Btw, ANYONE can get sued at any time. Some states have instituted 'frivolous case' rules to charge the costs of filing such suits to the lawyer and his client. But, that's a difficult issue because one man's frivolity, is another man's bread and butter.

    -Robert
     
    Last edited: Nov 29, 2009
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  50. chess9

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