1. Fewer than one-half of 1% of the nation’s doctors
face any serious state sanctions each year. 2,696 total serious disciplinary
actions a year, the number state medical boards took in 1999, is a pittance
compared to the volume of injury and death of patients caused by negligence
of doctors. A recent study by the Institute of Medicine of the National Academy
of Sciences estimated that as many as 98,000 patients may be killed each year
in hospitals alone as a result of medical errors.Earlier studies also found
that this was a serious national problem.
2. Harvard researchers found that 1% of a representative sample
of patients treated in New York state hospitals in 1984 were injured, and one-quarter
of those died, because of medical negligence.Nationwide, that would have translated
into 234,000 injuries and 80,000 deaths in 1988 from negligence in American
hospitals. Most of this involves physicians. There is no clear evidence that
there has been significant improvement since then.
3. A similar study conducted in California in 1974 found that
0.8% of hospital patients had either been injured by negligence in the hospital
or had been hospitalized because of negligent care. Extrapolation of those findings
would have yielded an estimate of 249,000 injuries and deaths from negligent
medical practice in 1988.
4. In 1976 the HEW Malpractice Commission estimated similarly
that one-half of 1% of all patients entering hospitals are injured there due
to negligence. That estimate would have indicated 156,000 injuries and deaths
resulting from doctor negligence in 1988.
5. Expanding these estimates to include general medical practice
outside of a hospital, the potential abuse by physicians is even greater. An
in-depth interview with 53 family physicians revealed that 47% of the doctors
recalled a case in which the patient died due to physician error. Only four
of the total reported errors led to malpractice suits, and none of these errors
resulted in an action by a peer review organization.
6. Medical students at SUNY-Buffalo were asked to recall incidents
during their clinical training that raised ethical concerns. More than 200 students
responded (40% of total sample); the majority of instances they reported (60%)
did not in the researchers’ opinions threaten the patient’s life,
health or welfare. This, however, implies that potentially 40% did.
7. It is not unreasonable to estimate that at least 1 percent
of doctors in this country deserve some serious disciplinary action each year.
This would amount to 7,703 physicians being disciplined each year, a number
that, unfortunately far exceeds the actual number of physicians disciplined.
8. Sexual abuse of or sexual misconduct with a patient is
also a serious issue. Six to ten percent of psychiatrists surveyed confessed
to having engaged in sexual contact with a patient and in a longitudinal study.
9. Two studies surveyed residents to determine the incidence
of substance use. Recent alcohol use was extremely high in both groups (87%
within the last year for emergency medicine residents; 74% within the past 30
days for surgery residents).Additional findings proved extremely disturbing;
although the emergency medicine program directors accurately determined the
incidence of alcohol use amongst residents, they dramatically underestimated
the percent who were actually impaired by the substance as indicated by diagnostic
tests (1% estimate impaired vs. 13% diagnosed.)
10. This does not bode well for creating a medical system
that prevents mishaps before they occur. And although the surgery residents
reported negligible recent cocaine use, when employed, the drug was typically
obtained from the hospital supply, indicating a greater ease of access than
for the general population.
11. residents excessive work hours Their longest period without
sleep during their first year of residency was an average of 37.6 hours (standard
deviation (SD) 9.9).
· During a typical work week, they worked an average of 56.9 total hours
(SD 30.19) in on-call shifts (as distinguished from the total average number
of hours they worked per week). An on-call shift is a continuous shift at the
hospital allowing for little to no sleep; two on-call shifts are typically scheduled
per week.
· 25% reported being on-call in the hospital a total of over 80 hours
per week. Surgeons reported the highest average hours of on-call time per week
(72.5).
· On a scale of 0 (never) to 4 (almost daily), residents most frequently
gave a response of 3 for the amount of sleep deprivation experienced during
the first year. Over 10% of residents indicated sleep deprivation was an “almost
daily” occurrence.
12. Just 5.1 percent of doctors account for 54.2 percent of
the malpractice payouts, according to data from the National Practitioner Data
Bank. Of the 35,000 doctors who have had two or more malpractice payouts since
1990, only 7.6 percent of them have been disciplined. And only 13 percent of
doctors with five medical malpractice payouts have been disciplined.
13. Between 44,000 and 98,000 people die in hospitals annually
each year due to preventable medical errors, the Institute of Medicine found.
A survey of doctors and other adults released in December in the New England
Journal of Medicine found that more than a third of the doctors said they or
their family members had experienced medical errors, most leading to serious
health consequences. The cost to society in terms of disability and health care
costs, lost income, lost household production and the personal costs of care
are estimated to be between $17 billion and $29 billion. In contrast, the medical
liability system costs $6.7 billion annually, about what is spent on dog food
each year.
14. There is no growth in the number of new medical malpractice
claims. According to the National Association of Insurance Commissioners, the
number of new medical malpractice claims declined by about four percent between
1995 and 2000. There were 90,212 claims filed in 1995; 84,741 in 1996; 85,613
in 1997; 86,211 in 1998; 89,311 in 1999; and 86,480 in 2000.
While medical costs have increased by 113 percent since 1987, the amount spent
on medical malpractice insurance has increased by just 52 percent over that
time.
Insurance companies are raising rates because of poor returns on their investments,
not because of increased litigation or jury awards, according to J. Robert Hunter,
director of insurance for the Consumer Federation of America. Recent premiums
were artificially low.
Malpractice insurance costs amount to only 3.2 percent of the average physician’s
revenues.
Few medical errors ever result in legal claims. Only one malpractice claim is
made for every 7.6 hospital injuries, according to a Harvard study. Further,
plaintiffs drop 10 times more claims than they pursue, according to Physician
Insurer Association of America data.
The experienced attorneys at Weinstein, Chase, Messinger and Peters represent clients throughout New York, and the five Boroughs of New York City, including the communities in the counties of Suffolk, Nassau and Westchester. Contact an attorney at Weinstein, Chase, Messinger and Peters for a free consultation.
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