OB-GYN quits practice over insurance cost

[JJC]

Fed-up doc: I've had it

By CARL CAMPANILE
Last Updated: 10:30 AM, October 19, 2009
Posted: 4:25 AM, October 19, 2009
Dr. Jacquelline Perlman, who's helped deliver hundreds of Brooklyn babies in her 12-year OB-GYN career, is calling it quits -- and citing sky-high malpractice insurance and plunging income.
"I've decided to retire from obstetrics," said Perlman, 42. "It breaks my heart. Malpractice costs are a big part of it. It's a very sad story.
The last straw, she said, came last spring when her insurer, the Combined Coordinating Council, noting the high risk of covering obstetricians, canceled her policy and those of doctors she practiced with at Brooklyn Women's Health Care, a New York Methodist Hospital affiliate.

She found a new insurer, but the damage was done. Her annual malpractice premium now runs about $160,000 -- for a doctor against whom no malpractice case or even so much as a settlement has ever been upheld.
And, she said, in the last five years, as her malpractice-insurance costs have risen, her income has dropped by 20 percent. http://www.nypost.com/p/news/local/brooklyn/fed_up_doc_ve_had_it_ZYukuH5vh0PFszTvpPwiyH (http://www.nypost.com/p/news/local/brooklyn/fed_up_doc_ve_had_it_ZYukuH5vh0PFszTvpPwiyH)
This is ridiculous. Doctors are forced to end careers while lawyers are lobbying to keep their source of income going (malpractice.) I know an internist who retrained in laser cosmetics and opened up a shop on Park Avenue. He says pushing Botox and collagen is more profitable and less stressful.

[Parx400]

http://www.nypost.com/p/news/local/brooklyn/fed_up_doc_ve_had_it_ZYukuH5vh0PFszTvpPwiyH (http://www.nypost.com/p/news/local/brooklyn/fed_up_doc_ve_had_it_ZYukuH5vh0PFszTvpPwiyH)
This is ridiculous. Doctors are forced to end careers while lawyers are lobbying to keep their source of income going (malpractice.) I know an internist who retrained in laser cosmetics and opened up a shop on Park Avenue. He says pushing Botox and collagen is more profitable and less stressful.


You can thank that **** sucking John Edwards for this one. He sued all sorts of OBGYN's over some birth defect that turned out was complete bs.

It would be nice to have some tort reform in our health bill but since Trial lawyers are big donors for the Dems it will never happen.

[Chulo]

Tort Reform would take care of the major of the issue and drop health care cost

[Yeti2424]

That's one of the problems. Even if a case gets thown out her insurance company still had to hire a defense lawyer to get it dismissed. When something goes wrong and the standard is to simply sue everyone and have the court sort it out, costs go up.

[hank]

You can thank that **** sucking John Edwards for this one. He sued all sorts of OBGYN's over some birth defect that turned out was complete bs.

How so? I'm no Edwards fan but none of the lawsuits he filed "turned out was complete bs."

How were they bs?

hank

[hank]

That's one of the problems. Even if a case gets thown out her insurance company still had to hire a defense lawyer to get it dismissed. When something goes wrong and the standard is to simply sue everyone and have the court sort it out, costs go up.

How does that work? Suing everyone and have the court sort it out? I'm interested in hearing about that.

hank

[GregHJ]

Although I think tort reform should be implemented, it's not the holy grail of cost cutting that its been made out to be. In every instance tort reform has been adopted, it has never sufficiently brought down costs for those with health insurance. Of course it has helped the doctors, so it should be part of any health care reform plan.

[Albatross]

We need tort reform, badly.

Also, don't buy into to much of this an ob-gym can make over 400k at a facility in nyc. She is probably ready to retire, or has had enough of looking at distorted ******s, and used it to draw attention to a bad situation.

[EatenByRats]

That poor doctor had no idea that the premiums were hideous when she got into Obstetrics because the lawyers from the worldwide communist conspiracy black helicopters won't let anyone talk about it in medical school. I feel for the poor little gal.

The US needs to go back to trial by combat, or just shooting each other like they do in civilized countries like Venezula. No one (or their dependents) should have legal, non-violent recourse if they're maimed or killed through malpractice. This rule of law crap has gotten out of hand.

[LineDoggie]

Tort Reform would take care of the major of the issue and drop health care costTort Reform?

Better Chance of discovering Amelia Earhart alive and well in New Guinea leading a tribe of Headhunters.

[LineDoggie]

That poor doctor had no idea that the premiums were hideous when she got into Obstetrics because the lawyers from the worldwide communist conspiracy black helicopters won't let anyone talk about it in medical school. I feel for the poor little gal.

The US needs to go back to trial by combat, or just shooting each other like they do in civilized countries like Venezula. No one (or their dependents) should have legal, non-violent recourse if they're maimed or killed through malpractice. This rule of law crap has gotten out of hand. No, no, your supposed to vent the exhaust outside of your car while driving.

[Zarak]

Almost everyone for a hundred years who held an elected position in the Federal Government has been a lawyer. Lawyers make money via stupidass lawsuits. Things are the way they are for a reason.

[dacanadianbomb]

No, no, your supposed to vent the exhaust outside of your car while driving.
Seriously eh.Freak.

[Yeti2424]

How does that work? Suing everyone and have the court sort it out? I'm interested in hearing about that.

hank

A good friend of mine is a products liability defense attorney here in California. When someone who worked in an industry that uses chemicals dies of lung cancer their spouse will sue the employer, and the manufactures of every chemical that they came across in the course of their employment. Every company that has gotten sued has product liability insurance and the insurance company will send a lawyer to deposition. During discovery it may come to light that the product 1 was only used in building A and the deceased only worked in buildings B and C and never stepped foot in building A the judge dismisses that product from the suit. However an attorney still had to show up to get the product they represent dismissed which costs the insurance company money. He had story of a new case that had been assigned to a judge so he and 33 other lawyers representing different insurance companies showed up only to have the judge walk in and tell them that he owned stock in one of the companies being sued so he would have to pass the case on to another judge. So 34 lawyers showed up to court (My friend sat in an hour’s worth of traffic each way), charged their clients accordingly only to have the judge pass it off and re-adjourn the next day. IMO it’s just a waste of money.

[hank]

A good friend of mine is a products liability defense attorney here in California. When someone who worked in an industry that uses chemicals dies of lung cancer their spouse will sue the employer, and the manufactures of every chemical that they came across in the course of their employment. Every company that has gotten sued has product liability insurance and the insurance company will send a lawyer to deposition. During discovery it may come to light that the product 1 was only used in building A and the deceased only worked in buildings B and C and never stepped foot in building A the judge dismisses that product from the suit. However an attorney still had to show up to get the product they represent dismissed which costs the insurance company money. He had story of a new case that had been assigned to a judge so he and 33 other lawyers representing different insurance companies showed up only to have the judge walk in and tell them that he owned stock in one of the companies being sued so he would have to pass the case on to another judge. So 34 lawyers showed up to court (My friend sat in an hour’s worth of traffic each way), charged their clients accordingly only to have the judge pass it off and re-adjourn the next day. IMO it’s just a waste of money.


Yeah well that is very common in PRODUCTS LIABILITY cases because the chemical you are talking about (like asbestos) doesn't have anybody's name on it. So you have to sue everybody to get the right defendant.

By the way, I spent a year defending an asbestos manufacturer before I started my own firm. Litigation like that you describe is set up by the Court that way. The Complaints in those huge products liability cases are basically just forms that get filled out for a particular plaintiff and all the manufacturers have a designated firm that defends them. About 1 in every 10000 case goes to trial and the rest settle. Why? Because those manufacturers all KNOW that they manufactured something that injured folk and the only question becomes one of which particular defendant will pay a particular plaintiff. The reality is all the defendants agree to the system you describe because it SAVES MONEY on the defense to do it that way. If individual lawsuits were filed and pursued as they are in non-products cases it would cost many thousands of dollars more per case. In effect, the system you describe is an "assembly line" designed by the COURT and the defendants to drive down the unit (in this case the individual lawsuit) cost.

Also just FYI the lawsuits I defended were all in Madison County, Ill. That was one of the 10 "judicial hellholes" Bush got up and talked about at the news conference for CAFTA (I think that's the right acronym for that class action law that passed a while back). I probably worked on between 50 and 100 cases during the time I did that work. Not one single plaintiff I saw was not seriously injured as a result of asbestos. Some had died from Mesothelioma. We had form motions we'd file to get out when the injuries weren't caused by our product. And we got out of most of the cases. I bet we paid on maybe 8 cases while I was doing that. But every single plaintiff recovered something. And during that whole time there was 1 trial and the Plaintiff got a fair amount of money (I don't think it was 7 figures but I know it was significant 6 figures).

So, none were frivolous. All were real lawsuits where companies paid. And all involved serious injuries including death which I pretty darn serious.

How is that applicable in medmal where you have a doctor and a hospital. Who is the "everybody" in that situation.

Do you think you'd feel the same if the chemical you buddy's client manufactured injured you or maybe your grandfather? Most of my clients think lawsuits are a waste of time as well until they get hurt or killed. Then it becomes pretty important to them or their family. As it would to you I imagine. But I doubt you'll admit that.

hank

[seraosha]

Lawyers are the priests in the current theocracy.
Shakespeare had it right.

[Yeti2424]

Yeah well that is very common in PRODUCTS LIABILITY cases because the chemical you are talking about (like asbestos) doesn't have anybody's name on it. So you have to sue everybody to get the right defendant.

By the way, I spent a year defending an asbestos manufacturer before I started my own firm. Litigation like that you describe is set up by the Court that way. The Complaints in those huge products liability cases are basically just forms that get filled out for a particular plaintiff and all the manufacturers have a designated firm that defends them. About 1 in every 10000 case goes to trial and the rest settle. Why? Because those manufacturers all KNOW that they manufactured something that injured folk and the only question becomes one of which particular defendant will pay a particular plaintiff. The reality is all the defendants agree to the system you describe because it SAVES MONEY on the defense to do it that way. If individual lawsuits were filed and pursued as they are in non-products cases it would cost many thousands of dollars more per case. In effect, the system you describe is an "assembly line" designed by the COURT and the defendants to drive down the unit (in this case the individual lawsuit) cost.

Also just FYI the lawsuits I defended were all in Madison County, Ill. That was one of the 10 "judicial hellholes" Bush got up and talked about at the news conference for CAFTA (I think that's the right acronym for that class action law that passed a while back). I probably worked on between 50 and 100 cases during the time I did that work. Not one single plaintiff I saw was not seriously injured as a result of asbestos. Some had died from Mesothelioma. We had form motions we'd file to get out when the injuries weren't caused by our product. And we got out of most of the cases. I bet we paid on maybe 8 cases while I was doing that. But every single plaintiff recovered something. And during that whole time there was 1 trial and the Plaintiff got a fair amount of money (I don't think it was 7 figures but I know it was significant 6 figures).

So, none were frivolous. All were real lawsuits where companies paid. And all involved serious injuries including death which I pretty darn serious.

How is that applicable in medmal where you have a doctor and a hospital. Who is the "everybody" in that situation.

Do you think you'd feel the same if the chemical you buddy's client manufactured injured you or maybe your grandfather? Most of my clients think lawsuits are a waste of time as well until they get hurt or killed. Then it becomes pretty important to them or their family. As it would to you I imagine. But I doubt you'll admit that.

hank

I have no problem at all for those who are actually liable for a person’s health problems or death being held accountable. With that said I have heard stories that while in the discovery process it was found that the deceased was a smoker, used a product not in accordance with the directions, or in one case they had painted their own car themselves in a non-ventilated garage without any repertory equipment. How does this relate to health insurance? Correct me if I am wrong but if there were complications during some kind of medical procedure would the patient then file suit against the anesthesiologist, the surgeons, the nurses, the hospital, and the manufacturer of any equipment used during the procedure? If that is the case then a similar situation would occur with each party’s insurance company having to send a legal defense to weather they were actually liable or not to at least get their portion dismissed. If that is the least expensive way to work through the process then I have no argument. But I would think that there would be some way to do a little more front end research to narrow down the parties involved insurance companies resulting in lower premiums.

[Fat Lazy American]

Lawyers are the priests in the current theocracy.
Shakespeare had it right.

You mean he was right when he said eliminating lawyers was the best route to chaos and civil war?

[seraosha]

You mean he was right when he said eliminating lawyers was the best route to chaos and civil war?

Considering who will be first up against the wall?
Tempting.
How many actually act as stewards of the law, instead of it's pimp?

[California Joe]

Hank does. He's like Atticus Finch and all the cool guys in John Grisham novels.

[wotsnext]

"To kill a mocking bird"............I remember we did that at school, Great book.

[hank]

Considering who will be first up against the wall?
Tempting.
How many actually act as stewards of the law, instead of it's pimp?

This is what I'm talking about. No lawyer is a steward for the law. We are only advocates for our clients. I'm not allowed to ask whether what I'm doing in a lawsuit is good for society, the law, or anything else. I am charged with being a zealous advocate for my client - that and nothing else. Its unethical to consider whether zealously advocating for my client is good for "the law."

I'm not busting on you specifically but its comments like yours and Yetis that show y'all have no idea what you are talking about. No lawyer is a steward. You can't just sue everybody and let the Court sort it out in medmal cases. But y'all cling to those wrong facts (probably because somebody with an agenda - like Beck, or Rush, or Dobbs, or some other quasi-journalist who wants to sell ads) says it and you don't know any better. So you cling to it as true. And its flat wrong.

hank

[California Joe]

Hank, check out off topic, some dude in VA was making coffee naked at 5:30AM and some broad and her 7 year old trespassed on his lawn and saw his junk and he got arrested. WTF?

[seraosha]

Ok Hank, here is a copy of the Texas State Bar Oath (http://www.texasbar.com/Template.cfm?Section=Home&CONTENTID=9721&TEMPLATE=/ContentManagement/ContentDisplay.cfm)-




I, __________________________________________________ do solemnly swear that I will
support the constitution of the United States, and of this State; that I will honestly demean
myself in the practice of the law, and will discharge my duties to my clients to the best of my
ability. So help me God.


Virginia (http://docs.google.com/gview?a=v&q=cache:S9khkm5pkjgJ:www.vsb.org/docs/valawyermagazine/apr05brown.pdf+oath&hl=en&gl=us&sig=AFQjCNEUFazP7rJ7a5hGa2taPBtcJPDN0Q)


“Raise your right hand, please. Do you
solemnly swear or affirm that you will
support the Constitution of the United
States and the Constitution of the
Commonwealth of Virginia, and that you
will faithfully, honestly, professionally, and
courteously demean yourself in the prac-
tice of law and execute your office of
attorney at law to the best of your ability,
so help you God?”



California (http://calbar.xap.com/applications/CalBar/PDFs/code_section_6068.pdf)



It is the duty of an attorney to do all of the following:
(a) To support the Constitution and laws of the United States and
of this state.
(b) To maintain the respect due to the courts of justice and judicial
officers.
(c) To counsel or maintain those actions, proceedings, or
defenses only as appear to him or her legal or just, except the
defense of a person charged with a public offense.
(d) To employ, for the purpose of maintaining the causes confided
to him or her those means only as are consistent with truth, and
never to seek to mislead the judge or any judicial officer by an
artifice or false statement of fact or law.
(e) (1) To maintain inviolate the confidence, and at every peril
to himself or herself to preserve the secrets, of his or her
client.
(2) Notwithstanding paragraph (1), an attorney may, but is
not required to, reveal confidential information relating to the
representation of a client to the extent that the attorney
reasonably believes the disclosure is necessary to prevent
a criminal act that the attorney reasonably believes is likely
to result in death of, or substantial bodily harm to, an
individual.



So how long ago did you take the "Oath", Hank?
What state?
What does it say?



EDIT - Yeah, this is way offtopic, my bad.
just pm me if you would be so kind Hank

[hank]

I have no problem at all for those who are actually liable for a person’s health problems or death being held accountable. With that said I have heard stories that while in the discovery process it was found that the deceased was a smoker, used a product not in accordance with the directions, or in one case they had painted their own car themselves in a non-ventilated garage without any repertory equipment. How does this relate to health insurance? Correct me if I am wrong but if there were complications during some kind of medical procedure would the patient then file suit against the anesthesiologist, the surgeons, the nurses, the hospital, and the manufacturer of any equipment used during the procedure? If that is the case then a similar situation would occur with each party’s insurance company having to send a legal defense to weather they were actually liable or not to at least get their portion dismissed. If that is the least expensive way to work through the process then I have no argument. But I would think that there would be some way to do a little more front end research to narrow down the parties involved insurance companies resulting in lower premiums.

There is a lot contained in this. I'll try to take each point you make in turn.

First, with respect to your claims about products liability none of the things you mention make it impossible for a plaintiff to recover. The law recognizes the "egg shell skull" rule which says defendants take their victims as they find them. If your lungs are weak from smoking but the asbestos causes mesothelomia you still recover under the law from the asbestos manufacturer AND the person who made the product that has mesothelomia. Under the law in every state they'd both still be liable. A jury COULD find that the smoking was a factor and reduce the award or find no liability. But its a question of fact for the jury and not something that makes the claims impossible or frivolous or anything like that.

Also note that the types of cancers caused by asbestos can only be caused by asbestos. I don't know about the particular chemical your friend deals with but you cannot get mesothelomia from anything but asbestos.

You also mention how the plaintiff uses the product. Those cases are warning cases. Meaning if the manufacturer knows that using an unventilated garage is happening and increases the risk then they have an obligation to warn not to do that. If they do warn then that is a defense to the lawsuit. But again its a fact question meaning its for a jury to decide. So its not a legal bar to the claims and the existence of those facts don't make the lawsuit frivolous.

I'm not following you about health insurance. This thread was originally about malpractice insurance.

In a medmal case sometimes you do have claims against all the doctors involved as you mention. Sometimes you don't. I've sued doctors individually and I've sued everybody as you mention. Note though that before you can even sue a doctor in almost every state you have to get a sworn statement from another doctor that say the doctor you are suing was negligent and it has to say why. That's one of the facts about tort reform that never gets mentioned. In every medmal case there is a doctor willing to testify that the doctor being sued was negligent. The jury may not agree but that testimony is always present in medmal cases.

Every defendant gets a lawyer and the medmal insurance pays. Very very few medmal cases (like none) ever get "dismissed" because of the affidavit I just explained and because the question of negligence is a fact question so its decided by the jury. Sometimes medmal cases do but its rare and almost always after discovery. What happens in way more than 99% of medmal cases (something close to 990 out of 1000) is that the defense lawyers deny everything and then at the end the case settles. Trials are very rare and medmal trials are even more rare. So the idea that there are lots of "frivolous" medmal cases is garbage. If they are so frivolous why are the medmal insurance companies willing to pay to settle the case? Because they know there is a real chance the plaintiff will win and get a judgment. And they want to avoid that - its public information. But a settlement is private so at the end - right before trial - almost all medmal cases settle.

Yeti you are really showing your ignorance (not a bad thing just a lack of info) if you think any lawyer (especially a medmal lawyer) can do more "research" before he files suit. As I've explained above there is a lot of "research" that takes place in medmal cases because there are lots of medical records that other doctors can review and use to form their opinion about who did what wrong. But other than that you can't do "research" before lawsuits. Why?

Think about it. Do I seem like a nice guy? If you are a doctor and a patient you treated lost their baby and I call and say, "Yeti why don't you tell me what happened?" what are you going to do? Talk to me? No way. You'd do what all prospective defendants do. You'd get a lawyer and tell me to "f*ck off." Hell, that's what I'd do too. So I sue you to get to do the "research" you are talking about. Its called "discovery" in the legal world.

Now, is every lawsuit that gets filed one that has a 100% chance of success? No. Nobody who does what I do wants to waste his time and energy working on a case that won't win. So we do as much as we can before we file a lawsuit. But you never ever "know" what happened until you file the lawsuit and take the depositions under oath. That's just how it works.

The last thing you say is about limiting the involvement of insurance companies. Understand that in all civil litigation insurance companies are only involved because their customer-the doctor or whoever your defendant is-has a contract with the insurance company for the insurance company to provide a lawyer. And I've already addressed the up front "research" thing.

And I do wear seersucker in the summer just like Atticus.

hank

[hank]

Ok Hank, here is a copy of the Texas State Bar Oath (http://www.texasbar.com/Template.cfm?Section=Home&CONTENTID=9721&TEMPLATE=/ContentManagement/ContentDisplay.cfm)-



Virginia (http://docs.google.com/gview?a=v&q=cache:S9khkm5pkjgJ:www.vsb.org/docs/valawyermagazine/apr05brown.pdf+oath&hl=en&gl=us&sig=AFQjCNEUFazP7rJ7a5hGa2taPBtcJPDN0Q)




California (http://calbar.xap.com/applications/CalBar/PDFs/code_section_6068.pdf)


So how long ago did you take the "Oath", Hank?
What state?
What does it say?



EDIT - Yeah, this is way offtopic, my bad.
just pm me if you would be so kind Hank

I'm in Georgia. And I took it in 04. And it did reference God. As I said in that other thread sometimes you do reference God in oaths and sometimes you don't.

I think you are missing the point of those oaths. Read them carefully. I can't break the law. So long as I'm not breaking a law my duty is to my client and to push his interests within the law and to the full extent of the law. I know you guys like to play lawyer and stuff but believe me when I tell you that I (and every other lawyer) cannot worry about whether what we are doing is driving up insurance rates or anything like. Our job is to protect our client's interest. That's it.

And you should know also that there is a huge group of rules in every state that every lawyer has to follow. They are mostly based on the Uniform Rules of Professional Responsibility. Here's a link to those in Georgia. If you want to read them all knock yourself out.

http://www.gabar.org/handbook/part_iv_after_january_1_2001_-_georgia_rules_of_professional_conduct/

I see what you are trying to say but you are missing the mark.

hank

[Yeti2424]

Thank you Hank! Your posts have been most enlightening. The only insurance companies that I was talking about were the medical malpractice for the doctors. The original post spoke about the rising costs of such insurance. Like I said I am not a lawyer so I am very unaware of the process that goes on behind the scenes from the perspective of the attorney filing suit. The only perspective that I have is my buddy who does the products liability defense and what I have seen here as a personal lines insurance agent. All too often I see a person who gets in a car accident and immediately thinks that it’s their “payday” gets an attorney. Now something that was as simple as paying for a person’s vehicle damage and car rental becomes complicated because everything has to go through their attorney. Once again thank you for your point of view!