Saturday, February 26, 2011




Tort Reform in America –too little, too late

The shopping cart example: A young mother is in a supermarket when her 2 year old child accidently falls from the shopping cart. The child strikes his head, momentarily looses consciousness, but quickly awakens & cries inconsolably for about 5 minutes. The child soon calms and is acting normal. The Mother appropriately takes him to be examined by a physician.

The European Physician: Carefully examines the child. Sees the bump on the forehead. He notes that the child looks & acts fine in all other aspects. The Physician knows that even in a well appearing child there is still a 1 in 1000 chance the child may have a skull fracture or brain hematoma. The physician is also aware of the evidence that radiation in a CT scan (Standard of care) can be dangerous to children The Physician realizes that he would have to irradiate 999 children to find that one fracture he may miss. He turns to the mother, explains the risks, and reassures her. He gives her a list of signs to watch for. In his country the legal system and the lay population know that the standard of care has been followed. His countryman also realize that because annually several thousand kids fall out of shopping carts and….statistically a fracture/hemorrhage will be missed.

The American Physician: Carefully examines the child. Sees the bump on the forehead. He notes that the child looks & acts fine in all other aspects. The Physician knows that even in a well appearing child there is still a 1 in 1000 chance the child may have a skull fracture or brain hematoma. The physician is also aware of the evidence that radiation in a CT scan (Standard of care) can be dangerous to children; he realizes that he would have to irradiate 999 children to find that one fracture he may miss. He knows however, that American’s demand 100% certainly in all aspects of medical care. If he doesn’t order a costly CT of the child, the mother will be angry or feel that “the doctor didn’t care enough.” She may even write an angry letter to hospital administration. The physician knows that 100% accuracy is expected of him and ANY missed fracture will result in a costly lawsuit. The physician sighs & goes ahead & orders the CT scan of the well child.

It is not just greedy attorneys that are the problem, it is a matter of national perspective & psyche:

The European: see’s fat people and blames it on Junk food & Lack of exercise. The American: blames McDonalds

The European: sees the space shuttle disaster as a tragic accident due to the very technical & inherently dangerous exploration of space.
The American: wants to close NASA down until a completely safe shuttle is available
.

Lightning strikes a man golfing. “Bad luck!” says the European. The American says ”Let’s sue the weatherman & find a way to hold god himself accountable”.

Until Americans “get real” & stop getting their medical knowledge from unrealistic television programs, tort reform won’t change the very broken medical system we now “enjoy

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