Too Risky to Help? How Lawsuit Culture Changed Health Care
Myself and my patients whom I have been serving for the past 14 years have grown together and been through many changes in the healthcare system, but recently, the government stipulated that as of May 1st, only certified healthcare professionals would be able to certify professional drivers as healthy to operate motor vehicles on the road in a work-related capacity. I take care of a number of patients who require this certification and had made this part of their care routinely, so my natural inclination was to get this certification. I was discouraged by a colleague, however, reasoning that now the finger could be more easily pointed at me if there were some tragic event that occurred while a patient I had approved was behind the wheel. It got me thinking about the culture we have created in the medical community, where any risk seems unacceptable.
Over the years, society has shifted to a place where risk is just not tolerated. Sometimes I think people have come to expect existence in a bubble where everything comes out as planned. And if this does not occur just so? Well, they must be entitled to restitution of some sort! Score for the legal and insurance industry!
It's fair to say that in healthcare, litigious behavior is firmly rooted. A glance at daytime television reveals class action lawsuits for a number of pharmaceutical products on the market. Doctors in higher risk professions like obstetrics, surgery and emergency medicine are restricted in their abilities to practice simply because their malpractice insurance premiums are too high. Obstetrician-gynecologists are at the highest risk given the high stakes and high expectations of their field. In New York, for instance, it is not uncommon for doctors in this field to pay more than $225,000 per year just for malpractice insurance! The unfortunate fact, however, in healthcare is that bad things can happen no matter what we do or do not do. High expectations, guilt and poor communication can easily lead to blame.
Where We are Heading
While negligence deserves justice and restitution, bad outcomes and bad luck do not. It's a scary thought to consider our medical system following the same trend as our public beaches. The cost of risk has replaced lifesaving personnel at most beaches with a sign, "No lifeguard on duty-- swim at your own risk." Healthcare professionals and companies have definitely seen trends in response to the pressure of responsibility. Some states have enacted reforms to make lawsuits more difficult and this seems to be having an impact, however, decline in job satisfaction has still led to new shortages in high-risk fields.
I don't want to paint too bleak a picture. There are some encouraging signs! Though I sometimes feel that attitudes follow a bit more slowly, I also feel that we have peaked as far as an intolerance to risk in our country. The reforms I've seen progressing are making it possible to grow again in healthcare.
To me, it comes down to a relationship and communication. There's risk in everything we do - swimming, driving, flying in an airplane, maintaining health and figuring out health problems. I want my patients to know that I am human and bound by the imperfections of any human being. Still, I am called to this position, charged with caring their health and committed to doing the best job I can. In these sometimes treacherous waters, I will man my post like so many others in the healthcare field.