Vitals Spotlight - We Give the Doctor an Exam

Obama Care (stolaf.edu)

President Obama is preparing to address the nation on Wednesday, clarifying healthcare reform yet again. An issue that looms large for physicians is the exorbitant cost of malpractice, which has lead to the expensive practice of ordering unnecessary tests for their patients.

The Wall Street Journal has estimated that malpractice litigation costs have crept up to 30 billion dollars a year. The Massachusetts Medical Society and UConn Health Center did a study of over 900 physicians in Massachusetts and found that 83 percent reported practicing defensive medicine and that 18-28 percent of tests was ordered to protect them from malpractice. The cost incurred in the state of Massachusetts was estimated at 1.4 billion dollars a year.

The response from litigators is that if doctors would make fewer errors then fewer cases would end up in court.

This type of rhetoric from the legal profession has gotten under the skin of physicians everywhere. Dr. Richard Rafal has come up with his own solution and feels it’s time to give lawyers a taste of their own medicine. According to Vitals.com, Dr. Rafal received his medical degree at Drexel University and completed his residencies in radiology at Lenox Hill Hospital and Cornell.

Here is an abbreviated version of his suggestions, printed in the Wall Street Journal, for a proposed bill that would dismantle the existing framework of law practice and institute socialized legal care:

• Contingency fees will be discouraged, and eventually outlawed, over a five-year period. This will put legal rewards back into the pockets of the deserving—the public and the aggrieved parties.
• Legal “DRGs.” Each potential legal situation will be assigned a relative value, and charges limited to this amount. Government schedules of flat fees for each service, analogous to medicine’s Diagnosis Related Groups (DRGs), will be issued. For example, any divorce will have a set fee of, say, $1,000, regardless of its simplicity or complexity. This will eliminate shady hourly billing.
• Legal “death panels.” Over 75? You will not be entitled to legal care for any matter. Why waste money on those who are only going to die soon? We can decrease utilization, save money and unclog the courts simultaneously. Grandma, you’re on your own.
• Ration legal care. One may need to wait months to consult an attorney. Possibly one may not get representation before court dates or deadlines. But that’ s tough: What do you want for “free?”
• Physician controlled legal review. This is potentially the most exciting reform, with doctors leading committees for determining the necessity of all legal procedures and the fairness of attorney fees. What a wonderful way for doctors to get even with the sharks attempting to eviscerate the practice of medicine.
• Discourage/eliminate specialization. Legal specialists with extra training and experience charge more money, contributing to increased costs of legal care, making it unaffordable for many.
• Electronic legal records. We should enter the digital age and computerize and centralize legal records nationwide. Anyone with Internet access will be able to search the database.
• Ban legal advertisements. Catchy phone numbers such as 1-800-LAWYERS would be seized by the government and re-purposed for reporting unscrupulous attorneys.
• Collect data about the supply of and demand for attorneys. Create a commission to study the diversity and geographic distribution of attorneys, with power to stipulate and enforce corrective actions to right imbalances. The more bureaucracy the better. One can never have too many eyes watching these sleazy sneaks.
• Lawyer Reduction Act (H.R. -3200). A self-explanatory bill that not only decreases the number of law students, but also arbitrarily removes 3,200 attorneys from practice each year. Textbook addition by subtraction.

READ MORE ABOUT DR. RICHARD RAFAL