I can defend our malpractice system only because it is the consequence of our Constitutional right to use the courts to resolve disputes. I agree it’s problematic, but not so much that it should be answered by the loss of our rights. If you have suggestions as to how to fix malpractice without making patients still more vulnerable, I am entirely open to those ideas.

I’m not sure what you’re referring to by “anecdote”; I understood your line on MQSA as mostly anecdotal. I do think I’m pretty good about showing data and evidence where appropriate – maybe more so than most med-bloggers. But I also think it useful to the discussion to show where my experience connects to the evidence, and how what has happened to me relates to what is happening to a lot of people. Nonetheless, I appreciate your feedback, and my best wishes to your child.

Insofar as the current malpractice system, it cannot be defended. The attorneys triage their work based on the potential for profit. They will not accept cases that do not offer them adequate financial rewards. This is in no way, and only randomly, associated with the patient’s best interests or improvement in health care quality. By definition this is grossy inefficiant, and in actuality it is harmful to the system. I can think of ten better ways to address patient grievences and physician errors off the top of my head that are better directred at the issues.

Finally, anecdote never advances anyone’s cause or adds to the weight of a conclusion, so what has happened to you or me (I have a child with a significant severe and chronic disorder similar to yours) cannot be adduced for the purpose of advancing the argument.

Thank you for answering, and I like this blog.

@Dr. T: I am relying on the authority of Pat. S, a physician, and Health Beat, who wrote and published the post I quoted (link now fixed). My argument is no different from Pat. S’s, and there has been a vigorous discussion in his comments section that you might want to join.

It’s not quite clear how your MQSA tangent pertains, since the quoted passage is about standards written by doctors. I will say that if written standards “don’t work”, then the courts are still the best tool we have to resolve malpractice claims on a case-by-case basis, and we patients must rely on lawyers to that end.

I assume you know this. Otherwise, why would you be writing so authoritatively?

If you want an egregious example of how setting down written standards and requirements don’t work — and can actually do great irreversible harm — why don’t you address thew much greater example of MQSA (Mammography Quality Standards Act) in which the federal government wrote to rules and standards and backed them with a law.

Do you think medical liability became less of an issue in mammography?

Do you think that mammograms find mor cancers after MQSA than before the law?

Do you think mammography is more available to women now than before MQSA?

http://tedstumor.blogspot.com/2009/03/mqsa-mussolini-and-mammography.html