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A well-intentioned journalist, who is not a physician, recently wrote an article in The New York Times asking why medical mistakes occur. See Leonhardt, Why Doctors So Often Get It Wrong. The New York Times, 2/22/06; www.nytimes.com/2006/02/22/business/22leonhardt.html?ex=1141534800&en=c05e7e8e96d865d3&ei=5070&emc=eta1 (2/22/06) ('A BIG part of the answer is that all of the other medical progress we have made has distracted us from the misdiagnosis crisis'). There, the author advanced a theory that if doctors were better paid, there would be higher quality of care, and fewer misdiagnoses. This theory assumes that doctors are mainly motivated by money, which, in this author's opinion, is not the primary impetus for a doctor, or any other medical practitioner, to do the job right.
By way of background, I practiced family practice and emergency room medicine for 18 years ' 'blood 'n' guts' work, so to speak. I then went to law school and pursued an LLM. in Health Law. My day-to-day work now is the medical legal analysis of medically related cases, much of this associated with medical negligence litigation throughout the United States. My clients are lawyers and I guide them through the medical and legal alleys and mazes. I see cases in all states, from all sorts of institutions and from every type of medical setting, but primarily I work in the medical negligence field. While doing so, I have taken note of the fact that the preparation of the defense of a medical malpractice case is 'after-the-fact' damage control ' not unlike our Vice-President trying to clean up after accidentally shooting his hunting partner. But, how do we prevent the 'shooting'? That is the more important question.
Although, admittedly, what I have to say is empirical in nature, I have through my experiences in both the medical and legal environments come up with some observations about medical practice that are germane to the fostering of safer medical care. This exercise requires a medical analysis, not a legal analysis. Still, the legal implications of getting to the bottom of why medical errors occur are obvious ' if knowing those reasons can lead to a reduction in errors, legal problems can be avoided.
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