PPACA and Tort Reform

On April 4th, 2012, the Associated Press reported that doctors need to quit ordering additional medical tests for each of their patients. The overall point of the brief sound byte was that physicians order extra diagnostic studies, to protect themselves from being sued. Surveys and polls of health care workers for the past two decades in America have concluded that doctors overwhelmingly admit to practicing "defensive medicine." A study conducted by the American Medical Association, in 2010, revealed of the 1231 physicians surveyed, 91% responded that they order more tests and procedures than needed in order to protect themselves from malpractice suits.

Many members of Congress have strongly claimed that they will never consider medico-legal tort reform and have encouraged their colleagues to follow suit, because it is their responsibility to protect the patients and the American citizens from medical negligence. They say that doctors want tort reform so that they can practice cavalier, careless medicine, and not be held accountable. They lead their constituents to believe that they are champions of compassion and compunction, but that doctors collectively are irresponsible and perfunctory. They deny the medical providers claim that they believe they must practice defensive medicine, as the statement to physicians just out of training today is: "it isn't if you get sued any more, it's when and how many times."

The politician's ignore the facts, or misrepresent the truth whenever it is expedient to their cause. The facts show consistently that doctors practice defensive medicine, and the reason for this practice pattern is the fear of liability. The media is willing to suggest that doctors must curtail their excessive ordering habits to control costs. Health care costs are growing at exponential rates, and all doctors are certainly cognizant of this problem. Congress and the media accusingly reprimand doctors that we must quit ordering all of these diagnostic tests, reminding us that American medicine is too costly. Yet, when the medical providers push back with a plausible explanation, like, we would happily trust our clinical skills, and decrease the number of studies and procedures that we require of our patients, if Congress would simply enact some reasonable reform of our medical legal system, they refuse to listen.

As long as tort reform remains a sacred cow with our Congress, we will never see legitimate control of our health care expenditures, nor will we truly reform our health system. On the American Association of Justice, AAJ, (formerly known as the Association of Trial Lawyers of America-ATLA) website, under the newsroom section, they have an article titled "The Truth about 'Defensive Medicine', Debunking the Myths." The AAJ, in spite of the overwhelming proof that doctors practice defensive medicine, spend their time, effort, and resources trying to persuade anyone willing to listen that doctors don't actually practice defensive medicine. And they're the some of the same people claiming that doctors need to quit ordering all of the extra, expensive, diagnostic studies. Let me ask the AAJ, why do doctors order these additional studies and procedures?

The 112th Congress (435 US House, and 100 US Senate, total of 535) has 202 attorneys (down from 203 attorneys in the 111th Congress). 37% of our Congress are attorneys. Any decision about medico-legal tort reform will never be legitimately discussed and considered, as long as two-fifths of Congress are lawyers. This group will never seriously consider honestly examining the current medical liability system in our country. Yet, when they are up for re-election, they'll tell you vehemently that they're simply spokes persons for their constituents. If this were really true, then why wouldn't they live by the same standards they require of the American citizens; their constituents? Instead, they exempt themselves from the Patient Protection and Affordable Care Act (PPACA), they designed automatic cost of living adjustment (COLA) salary increases applied to their salaries every year, and their retirement and pension plans are superior than most.

Will we really see legitimate health care reform anytime soon? As long as 37% of Congress are attorneys, and as long as this powerful body of politicians refuse to honestly discuss tort reform, we will never see real and lasting health care reform. But one thing is certain, we'll continue to chastise and reprimand the doctors for liberally ordering expensive and unnecessary studies, until doctors are finally fed up to the point of standing together, or until they simply throw their hands in the air, and find a new way to make a living.

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