Saturday, November 12, 2005

Thank You John Edwards And Ilk

My wife's Ob-Gyn, Dr. Linda M. Brownlee, notified us today that she's shuttering her practice in Roswell, Georgia, and taking a job with Kaiser Permanente. Despite having never been sued for malpractice her insurance premiums increased 50 percent this year to $105,000. She'll earn a stable salary from Kaiser without worrying about huge premium increases cutting into her income every year.

Kaiser apparently self-insures its doctors to keep their costs down. I'm sure they also have a full stable of lawyers ready to fight malpractice suits to the bitter end. Ironically, many of the same liberals who hate Wal-Mart also oppose tort reform. Their efforts will likely speed the walmartization of health care as the industry consolidates into fewer and fewer large corporations for just these reasons. (Not that I'm anti-Wal-Mart by any means.)

Georgia finally limited pain and suffering awards in medical malpractice suits to $250,000 in February of this year. But premiums had already risen rapidly for years (though Georgia's increases are far from the worst in the country). It seems unlikely that the just-passed law would apply to existing malpractice cases so we may not see much effect for a few years.

The trial-lawyers' stock answer to rising insurance rates is that they're caused by underperforming insurance company investments (low interest rates + stagnant stock market). Sure, maybe that accounts for a portion of the rise (along with catch-ups from supposedly lower than normal rates in past years). But please! The insurance companies didn't base their old rates on Dow 100,000 -type performance! And despite its losses since 2000, the S&P 500 has still gained an average of 10 percent per annum since 1980 (from 115 to 1225), not including dividends.

No, I think the trial lawyers knew they were losing the battle for public opinion. Too many people have felt the personal pinch, in one way or another, of rising health and malpractice insurance premiums. Their association flacks cast around for a story with which to deflect blame and astutely latched on to the flat stock market and low interest rate line which, true or not, everyone can understand.

Really, the argument over responsibility for insurance premium increases is a distraction. We know there are lots of frivolous or unscientifically based lawsuits and ridiculously large damage awards (though these are often reduced on appeal). They range from big class action jobs like the silicone breast implant cases that sent Dow Chemical into bankrupty; to asbestos cases that continue to multiply and bankrupt dozens of companies only remotely associated with the stuff; to the building stream of Vioxx suits against Pfizer; to hundreds of suits blaming individual Ob-Gyns for cerebral palsy and the like. Off the top of my head I can name several friends and relatives that have been directly harmed or undeservedly helped by frivolous suits:

  • My aunt who's a family practioner in Houston works part-time at a free health care clinic. She doesn't want to work full-time and high malpractice premiums make it very difficult for her to join a normal private practice part-time (I believe the premiums for her work at the clinic are paid out of government or charitable funds). CLARIFICATION: My aunt does pay her malpractice premiums but out of pre-tax income. She has stopped delivering babies so her costs aren't nearly as high as those of an obstetrician, but they have still increased by over 600 percent over the past eight years.

  • My uncle (her husband) is an anesthesiologist who's been sued at least once or twice. In the case I'm familiar with a woman with some type of chronic condition (perhaps diabetes) failed to take her medicine and was rushed to the hospital on the verge of death. She needed a rapid IV infusion to live so he used much larger needles than normal, which resulted in some nerve damage in her arms. His thanks for saving her life was a malpractice lawsuit over the nerve damage.

  • A friend of my wife received $60,000 from the silicone breast implant lawsuit against Dow. Not that she had any health problems or that there was ever any evidence that the implants in general caused problems. She was just automatically signed up as a member of the plaintiff class by virtue of being a Dow customer.

  • A coworker who once worked as a contractor for Microsoft will soon receive nearly $100,000 in damages from the temp worker lawsuit filed against Microsoft several years ago. Again, he was simply added to the class action suit, though he was wronged in no way by Microsoft (nor were any other of the plaintiffs--they simply didn't like an employment arrangement that kept their hands out of the stock option pie). Indeed, as a result of the case, current contractors at Microsoft receive fewer benefits than in the old days to ensure they have no grounds for claiming de facto permanent employment.

  • A college acquaintaince won $150,000 by smashing his hand while in high school. Essentially, he hit the lottery by screwing around with his buddies in shop class.

Right now there's a class-action suit ramping up over scratched iPod Nano screens. How much longer will we let these legal leeches and their thieving symbiant plaintiffs bleed us?


gregward said...

Having worked for a large law firm that represents corporations, I can assure you that while your rant has some relevant points, there are also flaws in your reasoning that John Edwards and other attorneys are to blame.

There are more than a few instances in which companies are most certainly to blame for their actions; for the courts and a jury to decide is a far better alternative than massive government oversight or protection from suit for the companies, two alternatives available were the issue not settled in courts. For this reason, protection of the public, there should be recourse for a harmed individual to receive some sort of comensation for their loss/injury.

However, I most certainly agree that the automatic appendage of a person to a class action suit is frivilous and done to increase the overall award and therefore the income for the prosecuting firm. This practice bothers me greatly.

Moving to your specific impetus for the blog entry, lawsuits against physicians, I tend to agree more strongly. [Disclaimer: I am planning on attending medical school; however, this has little bearing on my stance, because I'm going into international medicine.] Physicians should be driven by one m.o.: doing the best for their patient (yes, I know this is idealistic). However, in my experience as a volunteer in clinics and hospitals, this is often not the case, given the fear of lawsuit. Thus, physicians will often call for superfluous tests, scans, etc. in order to cover their tails. THIS is far more critical in the current rapid increase in health care costs. I'm sure there is also likely a link between this escalation and the fact that premiums are increasing for physicians such as your wife's.

I do think that a reasonable cap in the case of physician error is due; however, I also think that better physician oversight is needed, given the experience of mine and physician friends of mine in hospitals. Too much of a code of silence leads to escalation of errors.

I enjoyed the blog (I cam here from Easterbrook's page) and figure to come back.

Greg Ward

gregward said...

oh, and I know my post was rambling; it's hard to type something coherent when people keep coming in your office with more work. Back to it!

Ashley said...

Thanks for the comments, Greg.

I definitely agree that there's a place for lawyers and lawsuits. That may not have come through due to my being in rant mode, as you rightly called it.

Anonymous said...

I was just online looking for Linda Brownlee's contact information as someone I know had recommended her highly in the past and my girlfriend is in need of a good female OB-GYN as she has so far had no luck. I can be like rainman when it comes to remembering names as this person who recommended dr brownlee recommended her back in early 2005. I came across your post as one of the items that came up on the first search page from a google search for dr linda brownlee. I'm still looking as her current male doctor doesn't seem to be of any use, nor does he seem to think the very real pain she is experiencing should be taken seriously. Has your wife had any luck in finding another doctor? I know this is extremely random and probably a weird question to ask a random internet stranger that you've found only by chance, but if she has found another decent practitioner, would you be averse to providing that information to me or directly to her? Please drop me a line at Thanks so much.


LeeAnne said...

I did not like Dr. Brownlee at all. She does not have a good bedside manner. She had me on a pitosin drip the whole 29 hours I was in labor. I pushed for four hours after 25 hours. She should have done a c-section, because my son was in fetal distress and we were both on oxygen, but she insisted that if I would try harder then I could have him naturally. The umbilical cord was wrapped around his neck and when my son came out he was blue and we thought he was dead. They did CPR on him for 5 minutes and he finallly took his first breath. Today he has a pervasive developmental disorder and I have to wonder if the oxygen deprivation is the reason for it. My point is I believe she made a poor medical decision when she did not do a c-section after 24 hours. Not to mention when I was in labor, she told me to, and I quote, "Suck it up! Crying is not going to get this baby out!" Feel free to email me if you have any questions. My email address is lacarruthers@