Personal Injury Law

Substandard Medical Care: More is not always better

By Hurley, McKenna & Mertz

Hurley, McKenna & Mertz of Chicago represents many clients that have been harmed by substandard medical care, focusing primarily in nursing home, obstetrics and gynecology, and wrongful death cases. As medical malpractice lawyers, we find the issue of substandard medical care to be a critically important societal issue.

Medical studies from prior decades are now resurfacing in the important health care debate. Jack Wennberg began an ambitious study in the 1970?s collecting and comparing data on medical procedures all over the state of Main (NPR, 10/8). Initially, he was taken aback by the striking differences in medical care across the state. After the populations had been compared for health statistics and controlled for age, the differences were staggering. For example, in two neighboring communities, 75% of children in one community had their tonsils removed, while just 20% in the other community had their tonsils removed.

Eventually, they convinced many doctors in all practice areas to convene and discuss the differences on regular intervals. Their findings indicated many contributing factors. First, doctors were affected by the fear of being sued. Second, local medical culture had a profound influence. People in small town Vermont assumed that a child with a 102 fever would go to the hospital, as had been the practice for years. Doctors continued to act consistently with the local medical culture even though they knew that children were put at higher risk of illness by being sent to the hospital and being in the proximity of other sick patients. Third, the fee for service payment system inevitably induced doctors to perform more procedures. If you structure payment on quantity, then quality of service may suffer as the expense of trying to see as many possible patients. Further complications of insurance system hassles also induce doctors to perform more procedures in hopes of collecting more from insurance companies. Furthermore, in counties with extremely high incidence of procedures, the outcomes were undeniably poorer, which is likely a reflection of the fact that the patients were not optimum surgery candidates.

Many important factors affecting doctor behavior addressed in previous studies should be revisited and addressed in policy initiatives.

Full post as published by Chicago Medical Malpractice Lawyer Blog on November 02, 2009 (boomark / email).