Hey everyone!

I was a proponent of the "Ask A" sub-forum, but I never did one myself, largely because I was going through a career transition and a whole lot of things were going on in my life during the second half of 2016.  Now that I've got a long-term job and such, I figured I'd go ahead and do this just in case anyone's interested or has any questions about what TRJF's got going down.

I am a lawyer who represents hospitals and their staff when patients sue them for medical malpractice.  I really like my job and find it really interesting, because it sort of sits at the intersection of multiple fields.

So, ask me about anything, including:

- becoming a lawyer (especially given that my true love/talent, as well as my undergrad degree, is/was mathematics);
- working as a lawyer
- representing doctors/nurses/hospitals when they get sued
- my cat, Space Ghost
- anything else

Come on, it will be fun!  It's not like lawyers are the devil or anything

EXPLANATORY NOTE:  I was browsing threads this morning when I came upon an interesting discussion of empathy and how it can affect one's professional life.   Essentially, the contention was that empathy greatly burns you out, and that the best doctors are not *empathetic* so much as they are *caring*.  I started to post in that thread, hoping to be able to offer an interesting perspective from a different angle (because I too see a lot of people in my work who are sick/injured), but my response kept getting longer and touching on more professional and personal considerations that I thought it might just be better to try to tackle some of it in the "Ask A" subby.  So, go to town!

Note 2: Grrr I've gotta post this no I can't give you legal advice mofos

Do you shave/trim your pubic hairs?

What would you say the ratio is between bullshit malpractice suits and legitimate malpractice? Do you usually know when you're defending someone/a hospital that's guilty as hell?

(January 10, 2017 at 4:12 pm)Catholic_Lady Wrote: Do you shave/trim your pubic hairs?

No.  Also that is a different thread.

So what do you think of this?

http://www.npr.org/sections/health-shots...cal-errors

Quote:Medical Errors Are No. 3 Cause Of U.S Deaths, Researchers Say

(January 10, 2017 at 4:16 pm)Shell B Wrote: What would you say the ratio is between bullshit malpractice suits and legitimate malpractice? Do you usually know when you're defending someone/a hospital that's guilty as hell?

Medmal cases are usually very expensive to bring and defend.  A benefit of this is that there are fewer silly or frivolous cases filed in the medical malpractice field that in other areas of law.  Maybe only 1 in 10 cases is the sort where you look at it and think "they shouldn't have filed that, they've got no chance."  That's not to say that every other case is ultimately meritorious - of the ones that go to trial, between 60% and 80% end in defense verdicts - but those are the sort where there could be room to disagree over whether the care was reasonable, and in those cases a lot depends on what the doctors/nurses knew at what time, what was communicated to whom, and the other very technical facts of dealing with the human body.  Everyone on both sides of every case knows that, sometimes, in a hospital, you can do everything right and the patient still has a negative outcome.  The doctor/nurse explains to the jury what they did and why, experts provide the jury with info to help them decide if what the doctor/nurse did was reasonable, and the jury tries to look at the situation and say "did the doctor's actions meet the professional standards we expect of doctors?" or whatnot.

Part of the reason there's such a high rate of defense verdicts is because the cases where someone clearly goofed up are settled pretty quickly, so they never get to trial.  It's pretty easy to tell when someone's obviously messed up, because it's right there in the medical record: "nurse so and so informed the doctor that the wrong drug was administered" or something.  In those cases, the only hang-up would be what the damages are.  I don't view my job in such cases as "trying to get the doctor/nurse/hospital off the hook," rather, it's trying to facilitate a resolution of the claim that gets money into the hands of an injured person who deserves it quickly and easily while protecting the health provider's interests and letting them get back to helping people.  That is, trying to be fair to both sides.

---

(January 10, 2017 at 4:30 pm)Minimalist Wrote: So what do you think of this?

http://www.npr.org/sections/health-shots...cal-errors

Quote:Medical Errors Are No. 3 Cause Of U.S Deaths, Researchers Say

I think the health system could be wayyy better. 

I think that doctors and nurses and medical professionals have a very difficult task, because in a world where "everyone makes mistakes," they (along with airline pilots and a handful of other people) are in a position where "mistake = someone dies (or is badly hurt)."  The vast number of people who need serious medical care, combined with the fact that the people administering that care are people, means that there will always be a significant number of deaths and injuries caused by medical errors.

That's why we need to 1) try to make the medical system better in any way possible (because the stakes are so high) and 2) ensure that there's always a system, whatever that may be, for determining which deaths and injuries are caused by medical errors and compensating people and their families for those errors.

That's a good answer.  Realistic, at least.

Do you have any control or influence over hospital policy, i.e. can you make suggestions for improvements to help staff avoid lawsuits in the first place? The only reason I ask is I read a study a few years ago where surgeons had to follow a checklist before and during the surgery (much like pilots do) and death rates were cut in half: http://content.time.com/time/health/arti...59,00.html

It strikes me that such a simple policy could not only save lives but also reduce the number of lawsuits from families.

(January 10, 2017 at 4:49 pm)Tiberius Wrote: Do you have any control or influence over hospital policy, i.e. can you make suggestions for improvements to help staff avoid lawsuits in the first place? The only reason I ask is I read a study a few years ago where surgeons had to follow a checklist before and during the surgery (much like pilots do) and death rates were cut in half: http://content.time.com/time/health/arti...59,00.html

It strikes me that such a simple policy could not only save lives but also reduce the number of lawsuits from families.

Personally, I am not in such a position.  This is a good point to be aware of, though, and I will always look for opportunities to help reduce problems in any way I can.

Organizationally, I believe a large amount of hospital policy is dictated by the legal department.  Generally, a hospital will have an in-house legal department that deals with things like this and also works with the hospital's trial counsel (that's me).  I do know that policies/procedures are generally updated for virtually all departments at least yearly, and often more so.  It's also the nature of the profession - both on the medical side and the legal side - that if someone does something that reduces errors and improves care, most other hospitals also do so quickly.  On the medical side, this is both good doctor sense and good business sense.  On the legal side, this is because whether you're negligent depends on the standard of care, that is, the standard to which we hold doctors and hospitals.  If that standard increases, so too must your care in order to be adequate.

For what it's worth, the article and the work cited on pre-and-post-surgery checklists was written in 2009.  I, having seen surgeries primarily from the last 3 or 4 years, have never seen a surgery in which there wasn't a pre-surgery checklist, which had entries for things like patient ID, right area of body, number of sponges/scalpels/tools used, medications, and all sorts of other things trying to prevent errors, and a post-surgery checklist to make sure that those things are consistent.  These (in slightly different forms) are filled out by the surgeon, the anesthetist, and at least one nurse/assistant. 

I can't say if that's because of the research done above or not, but those sorts of check-list-type things are ubiquitous in the records I've seen.  And, I do think that goes hand-in-hand with what I said in a previous post: doctors and nurses are people, so there will always be instances of bad judgment, and these should be minimized; however, that means there should always be a focus on absolutely eliminating errors based not on bad judgment but on miscommunication or inattentiveness or the like.

Do you drive a beemer or Audi?

Good stuff man ...you done good.