To all my wonderful subscribers, my apologies for the messed up version of this post. I thought I was editing it very, very early this morning but on exiting, I forgot to hit the "update" button so parts of the revision and all of the old error prone stuff was repeated. I've revised all, corrected previous errors and added a paragraph to include comments about a Jimmy Kimmel Excerpt. Thank you Jeff. The revised post should be error free (I hope) and more readable. I promise never again to post an article in the wee small hours of morning.
My biggest issue is the lack of understanding of unintended consequences - look at Alabama and IVF as an excellent example. Furthering this, any competent doctor (M.D.) would tell you how they would have to see each case to determine what is medically necessary (hence ‘case-by-case’ basis). Note, this is NOT moving the goalposts or changing one’s beliefs - this is a careful analysis (by a trained MEDICAL professional) of each particular situation to decide what is necessary and proper.
Even if MDs tried to write the laws, I think they would quickly recognize that treatment can’t be as easily proscribed as your ‘loyal’ public servants insist.
Another reason why we shouldn’t let a felon run the federation (why we shouldn’t let a narcissist run the nation? Asking for a friend)
Thank you James. We are in agreement here. To me there are many reasons not to interfere in Medical procedures of any kind. But common sense should tell them, they have no right under any circumstance to interfere in something of which they have no knowledge. An obstetriion/gynecologist has spent at least 16 years learning his/her position, they are the only ones with sufficient competency to make decisions with their patient on what is best for the patient and fetus. No lawyer or business man puts in that much training.
And as a turn on your comment, the lawyer would consider an approach based on the circumstances of their client, not a one-size-fits all approach to every prosecution (as with a businessman and their clients/customers/etc). Neither the lawyer or the businessman should be bound by the musings of the physician outside the bounds of their expertise.
Thanks for the post - I think too many (even who would agree with you) over simplify the meaning of ‘choice’
Also, I’m disappointed your visuals didn’t make it into the post - as a reformed Anatomy and Physiology Instructor I can appreciate how much a picture can help your explanation
Me too. My masters degree is in physiology. I even tried scanning in my own drawing but that wouldn't work either. Hopefully if other reader's are interested there are lots of online drawing models and pictures. That's also how my original post got so messed up. I had to rewrite the entire paragraph and then Substack double poster the original beneath the edited. UGH
As a geneticist, I take issue with your comments on genes on the X and Y chromosomes.
No gene is regressive, the only options are dominant and recessive. Genes on the X chromosome can be either dominant or recessive and that will be determined by the expression or not in the female (XX) individual. In the male(XY), all genes will be expressed if they are on the X and the Y chromosomes because there is only one X and one Y chromosome present in normal males.
You are very welcome. The level of ignorance among men, and prior to medical school that includes me, about women’s reproductive anatomy and physiology is breathtaking!
Thank you Dr. Loveluck, in good conscience, I believe the same is true of both men and women, and a good part of that is because as we were growing up our parents and teachers were so uncomfortable with any discussion of coitus, (and for girls menstruation). My girls, learned everything, we had a farm with dairy goats and they were involved in the breeding of their personal goats and in the birth of kids. Why earlier generations refused to acknowledge normal biological 'activities', is beyond my comprehension.
Something else that concerns me more than the lack of knowledge of our own anatomy, is the interference by the government AT ANY LEVEL, in medical procedures, including abortion. I wish the AMA would take a stance against this ignorant intrusion. If the AMA interfered with the ABA or Chamer of Commerce the way the government has intruded on medical procedures there'd be hell to pay
I'm going to post a complete response to this post...it is very powerful. One comment though on your statement about malpractice. It touched a nerve having to do with a very vindictive governor.
Dr. Martin Makary who was part of the Johns Hopkins team that conducted the study, said that the prevalence of medical errors is not known by the general public because there is no requirement that doctors report medical error as a cause of death.
"Incidence rates for deaths directly attributable to medical care gone awry haven't been recognized in any standardized method for collecting national statistics," Makary says. "The medical coding system was designed to maximize billing for physician services, not to collect national health statistics, as it is currently being used."
Makary said would like to see medical error listed as a cause of death on death certificates. He would also like to see the CDC include medical errors in its annual reporting on the leading causes of death in this country.
In fact, doctors and hospitals rarely own up to medical errors. According to a study published in the November 2013 Journal of Patient Safety, a mere 9 percent of patients surveyed said the hospital voluntarily disclosed medical errors in their case.[4]
In Texas, the Texas Medical Board receives over 7,000 complaints a year from patients and their families regarding health care providers in the state. The board investigates about a quarter of these complaints, issuing professional discipline to the worst offenders but no compensation to victims.
However, the board is not keeping up with the rising level of complaints. According to statistics recently published by the board, the number of patient complaints rose 44 percent from 5,211 in 2006 to 7,510 in 2015. During the same time period, the number of investigations of Texas doctors declined 9 percent from 2,032 to 1,853.
Are There Medical Malpractice Recovery Caps in Texas?
In 2003, Texas Governor Rick Perry overhauled the medical malpractice law in Texas, the main consequence of which was a new $250,000 recovery cap for non-economic damages in malpractice suits. (Non-economic damages are defined as non-monetary losses suffered by the claimant, such as pain, suffering, inconvenience, emotional distress, loss of society and companionship, loss of consortium, and loss of enjoyment of life. Economic damages are monetary losses incurred by the claimant, such as past and future medical expenses, loss of wages, or loss of employment or business opportunities. Texas likewise caps economic damages, limiting them “to the amount actually paid or incurred by or on behalf of the claimant” and nothing more. A handful of states allow for economic damages to be doubled or tripled in exceptional cases. A defendant [the healthcare professional] may incur punitive damages as well if convicted. Punitive damages are exclusively for the purpose of punishment, usually in cases of reckless or malicious behavior. In applicable cases, the defendant must pay the punitive penalty but this will not be awarded as compensation to the claimant.) California and Montana share the same recovery cap.
Perry called his legislation the “most sweeping tort reform in the nation.” The result was an influx of medical professionals relocating to Texas. Low risk of liability is a potent incentive for doctors to practice in a given state. Prior to this reform, the New York Times described Texas’ physicians per capita ranking as “abysmally low.” Texas may have gained a wealth of human capital because of Perry’s legislation, the consequence was a relative hit to the justice system for injured claimants. No matter how severe the damage exacted by a negligent medical professional, they will be liable for no more than the patient’s economic losses (i.e. medical expenses), and at maximum $250,000 more in non-economic damages, and an additional $250,000 each if there is more than one defendant institution. [11]
To put this in perspective, 12 states impose no limit on how much money an injured party can recover in a medical malpractice case – in Arizona, Pennsylvania, and Wyoming imposing recovery limits in medical malpractice cases in constitutionally prohibited. Eight states impose a non-economic limit of $1 million dollars or slightly more. The remaining 30 states have limits in the neighborhood of $350,000 – $750,000. By comparison, Texas’ $250,000 limit sits on the lower end of the spectrum.
Medical malpractice only works when the patient or their next of kin if the patient dies as a result of faulty or inept medical procedures sues. The major problem is more with greedy lawyers (and no I am certainly NOT accusing all lawyers of being greedy - just the so-called ambulance chasers) There are some unscrupulous lawyers who will convince patients to sue for no good reason, because they know they can collect 40% of the settlement because most doctors are too busy to defend themselves in court. Health agencies at all levels carry malpractice insurance - they have to.
There are a few, very few, inept physicians who should not be practicing. But the vast majority of physicians do great work. Not all people can be cured of whatever they have. Also some people have a stronger feeling of pain than others. And since pain is perceived only by the individual, there is no way of measuring it at this time.
The lady living across the hall from me has a very low pain threshold, so much so that she became addicted to norcal (I think that's the name of the drug, it's a commonly prescribed opiate) so, now the doctor refuses to give her anymore. and she dwells on how much she suffers.
I on the other hand have neuropathy and am unable to feel pain. I frequently injure myself and am unaware until I see the blood and have to clean it up. So you can see some of the problems.
Thank you, for this URL. I was unaware the death rate was that high, but also not terribly surprised. I underwent parturition 4 times. The first time I was anesthetized and cut to allow faster delivery. The next time I was again anesthetized but not cut. The last two I refused anesthesia or any medication and had quick deliveries.
We are understaffed with doctors for several reasons. First, there are too few medical schools. Second, what schools there are strictly limit the number of students accepted.
My middle daughter had genius level mentality. From Junior high school through University pre-med she received all A's. In Medical School at UC San Francisco, rated fifth best in the Nation, she was top of her class. But it was hard as hell to get in there. She was accepted at Cornell, Georgetown, Dartmouth, and Stamford but turned down at Harvard (ranked first in the Nation) She decided on UCSF because of its ranking and it was closer to home - I live in Sacramento 90 miles away.
Third, the high cost of medical school, $180,000 in the 1990's. Fourth, the tensity and stress of medical school and especially internship.
Laura, my daughter, did her internship at Mount Cedar Sinai in Los Angeles. She worked 30 hour shifts, was on call 24/7, and so stressed she came close to suicide.
Fifth, and final is the length of education required. Following a 4 to 5 year baccalaureate in pre-med, the potential physician, then has Medical School an additional 3 to 4 years, Intensive study to pass the National Boards followed by one year of excessively stressful internship. This is followed by an additional 3 to 7 years of residency, depending on the field of practice.
Laura had decided on Dermatology. She became interested in Dermatology while she was in her Senior year at UC San Diego. She took a job at Scripps Institute in nearby La Jolla (pronounced la hoya) and worked with the AIDS virus, Human Immunodeficeincy virus (HIV) studying the rate of mutation. She had a paper published on her work on which her name was included as an author along with the professor who led the investigation because of the quality of her work and the paper which she wrote.
The point is getting to the position of being a doctor is gruelling. Then when they are given too long hours it is no wonder they sometimes take short cuts.
This is particularly true among obstetricians who may be delivering babies at any hour of day or night. And few women are prepared for birth. I remember listening to women screaming their fool heads off cursing their doctors, nurses, the babies father, and anyone else they could think of. If they'd just shut up and breathe they'd get it over faster and with less pain.
So, it really isn't surprising that some doctors take short cuts. They read about the efficacy of something like Digoxin, and decide to try it.
What we need is an incorruptible board to oversee the use of all new drugs before they reach the market. And release must be tied to the specific use on which the drug was tested.
We used to have this with he CDC and FDA. That thalidomide I referred to in the post was not available in the US because it had not been adequately tested to suit the FDA standards. I don't know what's happening now - I've read rumors that bribes have been given by 'Big Pharma' but rumors are not facts. I do know that both education and medicine have been short-changed since Ronnie took the scene in 1981. The Republican Party in particular and the sudden worship of WEALTH in the past fifty plus years have resulted in more concern with 'appearances' and less concern with the common good.
How Gov. Greg Abbott won millions and helped stop Texans from doing the same
Forty years ago this week, a tree fell on Greg Abbott, paralyzing the future governor from the waist down. He sued for damages and won millions—and then helped stop Texans from doing the same.
By Brooke Kushwaha,News Reporter
July 15, 2024
Texas Attorney General Greg Abbott (r), talks to the press at the Texas Capitol after Governor Rick Perry (l) signed a bill stiffening the penalties on human trafficking at the Texas Mexico border. (Photo by Robert Daemmrich Photography Inc/Corbis via Getty Images)
Robert Daemmrich Photography Inc/Corbis via Getty Images
Forty years ago this week, a 26-year-old law school graduate named Greg Abbott was out jogging on the streets of River Oaks when a tree snapped and fell, paralyzing him from the waist down. Abbott, in the midst of studying for the bar, sued the tree owner and later the tree-trimming company that had neglected the 75-year-old tree. He won a multimillion-dollar settlement, the details of which remained private for years.
Decades later, Abbott campaigned in support of tort reform curtailing "frivolous" lawsuits and won. Abbott's critics claimed that he helped usher in a Texas significantly less friendly to plaintiffs seeking damages like the ones Abbott won. Looking back on the case 40 years later, Don Riddle, Abbott's personal injury lawyer at the time, agrees that Texas has changed.
"It would be next to impossible to get the kind of settlement we got," Riddle told Chron Monday. Tort reform, or as Riddle calls it, "tort deform," has severely capped the kind of damages individuals can seek out, and Riddle doesn't see that changing in Texas anytime soon. So how did we get here, and how did Abbott come to turn against the legal mechanism that made him millions?
The Accident
Abbott's accident was more than just a wayward tree branch. The falling tree totaled two cars and broke Abbott's back and some of his ribs, resulting in months of surgery and recovery and lifelong paralysis in his legs. Yet to embark on his future, lucrative law career, Abbott had no health insurance or even a paycheck to cover the medical expenses.
The injuries left Abbott with two steel rods in his spine. Although debilitating, Abbott has since turned the accident into a lesson of perseverance on the campaign trail. As his campaign website says, "While some politicians talk about having a spine of steel, Governor Abbott actually has one."
The Lawsuit
Abbott's soon-to-be colleagues connected him with Riddle, who agreed to sue the tree's owner and the tree-trimming company on Abbott's behalf. Poring through documents, Riddle was able to prove that the homeowner had known the tree suffered from root rot and that the tree company had mistakenly treated the tree with a chemical that worsened its condition.
"We made an extremely nice settlement for him," Riddle said of the outcome.
The question of who is responsible for managing Houston's aging urban forest remains up for debate to this day, particularly as residents point fingers at electricity provider CenterPoint Energy for failing to regularly trim vegetation around the company's power lines. In the end, residents do have a responsibility to manage trees on their property, covering the costs of trimming and removal.
The Settlement
Dick Ellis, one of the experts brought in on the suit, told The Texas Tribune in 2002 that Abbott was a particularly sympathetic plaintiff who, barely beginning his career, also happened to be broke. He could have never afforded a trial, Ellis said, and so they agreed to settle.
The details of Abbott's settlement were never released on public record, and Abbott himself remained cagey on the matter until 2013, when he disclosed the payments while making a gubernatorial bid. Based on Abbott's life expectancy, the payments totaled to about $11 million when adjusted for inflation, although the full number won't be known until Abbott's death. Much of those payments cover Abbott's ongoing medical expenses, he said, many of which are not covered by insurance.
WEST, TX - APRIL 18: Texas Attorney General Greg Abbott briefs the media after touring the West Fertilizer Company April 18, 2013 in West, Texas. A fiery explosion that damaged or destroyed buildings within a half-mile radius ripped through the facility last night, injuring more than 160 people and killing an unknown number of others. (Photo by Kevork Djansezian/Getty Images)
Kevork Djansezian/Getty Images
“There are thousands of dollars a year out of my own pocket,” Abbott told the Tribune in 2013. “But there’s all kinds of other things that normal people wouldn’t think of, such as additional costs for modifications, ranging from cars to ramps to other kinds of expenditures to be able to move around in life.”
Tort reform, widely adopted in the mid-90s, shut down the possibility that individuals could get similar results, Riddle said. "In those days, any negligence no matter how large or small could be held responsible for the entire loss," Riddle said, and plaintiffs could sue multiple defendants at once. "That doesn't exist in the same form today."
The Campaign
Sixteen years after he won millions, Abbott, now a candidate for attorney general, campaigned to usher in tort reforms that would further limit plaintiffs' abilities to pursue accident damages. Democrats called hypocrisy, but Abbott maintained that the reforms only applied to so-called "frivolous" lawsuits clogging up the court systems, and that an individual faced with the same circumstances as Abbott could still win a similar settlement today.
Texas attorney general candidate, Republican Greg Abbott, makes a point during a candidate's debate Thursday, Oct. 24, 2002, in Dallas. (AP Photo/Tony Gutierrez)
TONY GUTIERREZ/AP
Still, beyond Abbott, tort laws have changed significantly in the past few decades. Most people might recall an infamous 1994 suit in which a woman sued McDonald's after getting burned by their coffee. The woman, popularly conceived as the poster child of frivolous lawsuits, sustained third-degree burns to her crotch and groin area after placing the cup between her legs to add cream and sugar. Her lawyers were able to prove that McDonald's served its coffee near-boiling between 180 and 190 degrees—30 to 40 degrees hotter than competing companies.
The McDonald's case is just one example of "indoctrination" insurance companies pushed decades ago to sway juries against big-buck settlements, Riddle said. Most settlements were paid out through insurance money, Riddle explained, and so companies had an interest in keeping payments low. Few people realize that the McDonald's woman's settlement had later been reversed, Riddle added. "That poor lady never really got anything," he said.
Back in Texas, however, Abbott ran his attorney general campaign attacking Democratic nominee Kirk Watson for his background as a personal injury lawyer. He was heavily financed by the PAC Texans for Lawsuit Reform, a political supergroup still backing Abbott and other Texas power players today. Despite the ideological headstand, Abbott won the race handily with 56.7 percent of the vote, going on to become the state's longest-serving Attorney General.
The Fallout
Although Democratic gubernatorial candidate Wendy Davis tried to rekindle accusations of Abbott's hypocrisy in a series of controversial campaign ads in 2014, her calls ultimately fell on deaf ears. Abbott beat Davis 59 percent to 39 percent, continuing Republicans' decades-long streak of statewide domination.
Today, Texans for Lawsuit Reform PAC continues to dole out millions to Texas Republicans including Lt. Gov. Dan Patrick, House speaker Dade Phelan, and yes, Abbott. The governor meanwhile is in the midst of setting up a new business court in Texas, complete with governor-appointed judges charged with taking businesses' unique interests into account.
"Texas is so bogged down by corporate influence," Riddle said, citing Texas' lawmakers hefty corporate campaign contributions. "Look at what people like Governor Abbott get today from ERCOT...you can see it happening, but normal people don't have the mechanism to change that...and lawmakers are not inclined to make changes."
Even everyday Texans rarely sympathize with personal injury plaintiffs, Riddle said, pointing to a 2003 constitutional amendment in which Texans directly voted to cap medical malpractice payments by doctors and hospitals to just $250,000. "It just defies all reason, but it happened," Riddle said. "We did it to ourselves."
Riddle is now estranged from his one-time plaintiff turned governor, although he said he and Abbott did keep in touch for a time following the suit. "He's gotten so big and powerful and famous, and I was misquoted a couple times by the newspapers, that I think he developed a dislike for me," Riddle said.
... And then there are the "devout Christians" who believe Deuteronomy where it says a woman should become the property of her rapist upon payment to her father.
Thank you for a well-explained article on gestation and prenatal development! I have one small correction to offer : in your paragraph about thalidomide in the 50's and 60's, you say that ultrasound detected the limb anomalies in the affected fetuses, allowing the mother the option of abortion. Ultrasound was evidently first developed for medical use in the 1950's but very limited. It wasn't available widely until the 1970's in medicine. Likely the limb anomalies would have been detected on X-rays, which were used to assess fetal size and position even into the later 1980's. I'm a board-certified radiologist, and taught body imaging including ultrasound. Now retired!
Thank you, Rebecca. I also should have mentioned that abortions were very difficult to obtain prior to 1973 and Roe v Wade. So those women able to abort did so in other countries (if possible) or very expensively in the US. What happened were a too large number of malformed children born who were intelligent but doomed top live their lives as handicapped.
3/ Greg Abbott was AG who proposed and promoted the Texas medical and tort reforms. His heart began pumping vile ever after his injury. Okay, sad. He should have been compensated. But he hated and hated and hated and became a politician to punish every citizen of Texas. The compensation wasn't enough, the vile in his veins spewed into a hideous desire to punish everyone.
Abbott's life has been dedicated since that day of his injury to injure everyone to the fullest extent. There may have been psychological damaged men who have become leaders, but I've never seen one who couldn't refrain from crookedly smiling when children were killed, when women died from suffering from the consequences of his abortion ban, an boy did anyone see how his eyes gleamed when the legislature banned mandatory water breaks.
Can anyone claim Hamas are terrorists and Greg Abbott is not?
I don't believe in Hell but I do believe Greg Abbott is attempting to smile his way into its apex role. I don't believe in dragons but there is fire breathing man named Greg Abbott.
Okay there are bad men from the best and plenty of terrorists living and breathing in America today, Trump, Vance, Thiel, Clarence Thomas, Elon Musk---but I don't think they know they are terrorists.
But Abbott knows exactly the evil he is projecting...He wants to do harm. Look at that smile, then look at the frown on those other faces.
It is unfortunate he survived his accident, and that is mean, but no man should live who delights in torture. Many have tried to rationalize their minds to believe they are righting wrongs by doing bad actions. But not Abbott. He delights in every injury he causes.
He is the worst. He is Mephistopheles in the flesh promising riches while he gleefully burns people in the flames of his fury. He thought he was the angel of heaven and a falling tree cast him into a determined desire to punish, torture and maim.
I'm sorry. I can't say enough bad about him because there is too much evil in him. He touches an unfathomable nerve into my being that I can't expunge.
Agree with much of what is written here except the comments that a woman with injuries or disability that would necessitate a wheelchair are incapable of bearing children or parenting. That is incorrect for many and creates a bias against women in the disability community.
To all my wonderful subscribers, my apologies for the messed up version of this post. I thought I was editing it very, very early this morning but on exiting, I forgot to hit the "update" button so parts of the revision and all of the old error prone stuff was repeated. I've revised all, corrected previous errors and added a paragraph to include comments about a Jimmy Kimmel Excerpt. Thank you Jeff. The revised post should be error free (I hope) and more readable. I promise never again to post an article in the wee small hours of morning.
My biggest issue is the lack of understanding of unintended consequences - look at Alabama and IVF as an excellent example. Furthering this, any competent doctor (M.D.) would tell you how they would have to see each case to determine what is medically necessary (hence ‘case-by-case’ basis). Note, this is NOT moving the goalposts or changing one’s beliefs - this is a careful analysis (by a trained MEDICAL professional) of each particular situation to decide what is necessary and proper.
Even if MDs tried to write the laws, I think they would quickly recognize that treatment can’t be as easily proscribed as your ‘loyal’ public servants insist.
Another reason why we shouldn’t let a felon run the federation (why we shouldn’t let a narcissist run the nation? Asking for a friend)
Thank you James. We are in agreement here. To me there are many reasons not to interfere in Medical procedures of any kind. But common sense should tell them, they have no right under any circumstance to interfere in something of which they have no knowledge. An obstetriion/gynecologist has spent at least 16 years learning his/her position, they are the only ones with sufficient competency to make decisions with their patient on what is best for the patient and fetus. No lawyer or business man puts in that much training.
And as a turn on your comment, the lawyer would consider an approach based on the circumstances of their client, not a one-size-fits all approach to every prosecution (as with a businessman and their clients/customers/etc). Neither the lawyer or the businessman should be bound by the musings of the physician outside the bounds of their expertise.
Thanks for the post - I think too many (even who would agree with you) over simplify the meaning of ‘choice’
Agreed. It's not a simple choice. It's frequently a life or death choice for the female (of any age).
Also, I’m disappointed your visuals didn’t make it into the post - as a reformed Anatomy and Physiology Instructor I can appreciate how much a picture can help your explanation
Me too. My masters degree is in physiology. I even tried scanning in my own drawing but that wouldn't work either. Hopefully if other reader's are interested there are lots of online drawing models and pictures. That's also how my original post got so messed up. I had to rewrite the entire paragraph and then Substack double poster the original beneath the edited. UGH
As a geneticist, I take issue with your comments on genes on the X and Y chromosomes.
No gene is regressive, the only options are dominant and recessive. Genes on the X chromosome can be either dominant or recessive and that will be determined by the expression or not in the female (XX) individual. In the male(XY), all genes will be expressed if they are on the X and the Y chromosomes because there is only one X and one Y chromosome present in normal males.
Thank you for the correction Richard, even as I typed regressive, I knew it was wrong.. I will correct that word
You are very welcome. The level of ignorance among men, and prior to medical school that includes me, about women’s reproductive anatomy and physiology is breathtaking!
Thank you Dr. Loveluck, in good conscience, I believe the same is true of both men and women, and a good part of that is because as we were growing up our parents and teachers were so uncomfortable with any discussion of coitus, (and for girls menstruation). My girls, learned everything, we had a farm with dairy goats and they were involved in the breeding of their personal goats and in the birth of kids. Why earlier generations refused to acknowledge normal biological 'activities', is beyond my comprehension.
Something else that concerns me more than the lack of knowledge of our own anatomy, is the interference by the government AT ANY LEVEL, in medical procedures, including abortion. I wish the AMA would take a stance against this ignorant intrusion. If the AMA interfered with the ABA or Chamer of Commerce the way the government has intruded on medical procedures there'd be hell to pay
I'm going to post a complete response to this post...it is very powerful. One comment though on your statement about malpractice. It touched a nerve having to do with a very vindictive governor.
Dr. Martin Makary who was part of the Johns Hopkins team that conducted the study, said that the prevalence of medical errors is not known by the general public because there is no requirement that doctors report medical error as a cause of death.
"Incidence rates for deaths directly attributable to medical care gone awry haven't been recognized in any standardized method for collecting national statistics," Makary says. "The medical coding system was designed to maximize billing for physician services, not to collect national health statistics, as it is currently being used."
Makary said would like to see medical error listed as a cause of death on death certificates. He would also like to see the CDC include medical errors in its annual reporting on the leading causes of death in this country.
In fact, doctors and hospitals rarely own up to medical errors. According to a study published in the November 2013 Journal of Patient Safety, a mere 9 percent of patients surveyed said the hospital voluntarily disclosed medical errors in their case.[4]
In Texas, the Texas Medical Board receives over 7,000 complaints a year from patients and their families regarding health care providers in the state. The board investigates about a quarter of these complaints, issuing professional discipline to the worst offenders but no compensation to victims.
However, the board is not keeping up with the rising level of complaints. According to statistics recently published by the board, the number of patient complaints rose 44 percent from 5,211 in 2006 to 7,510 in 2015. During the same time period, the number of investigations of Texas doctors declined 9 percent from 2,032 to 1,853.
Are There Medical Malpractice Recovery Caps in Texas?
In 2003, Texas Governor Rick Perry overhauled the medical malpractice law in Texas, the main consequence of which was a new $250,000 recovery cap for non-economic damages in malpractice suits. (Non-economic damages are defined as non-monetary losses suffered by the claimant, such as pain, suffering, inconvenience, emotional distress, loss of society and companionship, loss of consortium, and loss of enjoyment of life. Economic damages are monetary losses incurred by the claimant, such as past and future medical expenses, loss of wages, or loss of employment or business opportunities. Texas likewise caps economic damages, limiting them “to the amount actually paid or incurred by or on behalf of the claimant” and nothing more. A handful of states allow for economic damages to be doubled or tripled in exceptional cases. A defendant [the healthcare professional] may incur punitive damages as well if convicted. Punitive damages are exclusively for the purpose of punishment, usually in cases of reckless or malicious behavior. In applicable cases, the defendant must pay the punitive penalty but this will not be awarded as compensation to the claimant.) California and Montana share the same recovery cap.
Perry called his legislation the “most sweeping tort reform in the nation.” The result was an influx of medical professionals relocating to Texas. Low risk of liability is a potent incentive for doctors to practice in a given state. Prior to this reform, the New York Times described Texas’ physicians per capita ranking as “abysmally low.” Texas may have gained a wealth of human capital because of Perry’s legislation, the consequence was a relative hit to the justice system for injured claimants. No matter how severe the damage exacted by a negligent medical professional, they will be liable for no more than the patient’s economic losses (i.e. medical expenses), and at maximum $250,000 more in non-economic damages, and an additional $250,000 each if there is more than one defendant institution. [11]
To put this in perspective, 12 states impose no limit on how much money an injured party can recover in a medical malpractice case – in Arizona, Pennsylvania, and Wyoming imposing recovery limits in medical malpractice cases in constitutionally prohibited. Eight states impose a non-economic limit of $1 million dollars or slightly more. The remaining 30 states have limits in the neighborhood of $350,000 – $750,000. By comparison, Texas’ $250,000 limit sits on the lower end of the spectrum.
Medical malpractice only works when the patient or their next of kin if the patient dies as a result of faulty or inept medical procedures sues. The major problem is more with greedy lawyers (and no I am certainly NOT accusing all lawyers of being greedy - just the so-called ambulance chasers) There are some unscrupulous lawyers who will convince patients to sue for no good reason, because they know they can collect 40% of the settlement because most doctors are too busy to defend themselves in court. Health agencies at all levels carry malpractice insurance - they have to.
There are a few, very few, inept physicians who should not be practicing. But the vast majority of physicians do great work. Not all people can be cured of whatever they have. Also some people have a stronger feeling of pain than others. And since pain is perceived only by the individual, there is no way of measuring it at this time.
The lady living across the hall from me has a very low pain threshold, so much so that she became addicted to norcal (I think that's the name of the drug, it's a commonly prescribed opiate) so, now the doctor refuses to give her anymore. and she dwells on how much she suffers.
I on the other hand have neuropathy and am unable to feel pain. I frequently injure myself and am unaware until I see the blood and have to clean it up. So you can see some of the problems.
Let's collaborate?
ok
"medical errors ...251,000 deaths annually in the United States"
https://pubmed.ncbi.nlm.nih.gov/28186008/
Thank you, for this URL. I was unaware the death rate was that high, but also not terribly surprised. I underwent parturition 4 times. The first time I was anesthetized and cut to allow faster delivery. The next time I was again anesthetized but not cut. The last two I refused anesthesia or any medication and had quick deliveries.
We are understaffed with doctors for several reasons. First, there are too few medical schools. Second, what schools there are strictly limit the number of students accepted.
My middle daughter had genius level mentality. From Junior high school through University pre-med she received all A's. In Medical School at UC San Francisco, rated fifth best in the Nation, she was top of her class. But it was hard as hell to get in there. She was accepted at Cornell, Georgetown, Dartmouth, and Stamford but turned down at Harvard (ranked first in the Nation) She decided on UCSF because of its ranking and it was closer to home - I live in Sacramento 90 miles away.
Third, the high cost of medical school, $180,000 in the 1990's. Fourth, the tensity and stress of medical school and especially internship.
Laura, my daughter, did her internship at Mount Cedar Sinai in Los Angeles. She worked 30 hour shifts, was on call 24/7, and so stressed she came close to suicide.
Fifth, and final is the length of education required. Following a 4 to 5 year baccalaureate in pre-med, the potential physician, then has Medical School an additional 3 to 4 years, Intensive study to pass the National Boards followed by one year of excessively stressful internship. This is followed by an additional 3 to 7 years of residency, depending on the field of practice.
Laura had decided on Dermatology. She became interested in Dermatology while she was in her Senior year at UC San Diego. She took a job at Scripps Institute in nearby La Jolla (pronounced la hoya) and worked with the AIDS virus, Human Immunodeficeincy virus (HIV) studying the rate of mutation. She had a paper published on her work on which her name was included as an author along with the professor who led the investigation because of the quality of her work and the paper which she wrote.
The point is getting to the position of being a doctor is gruelling. Then when they are given too long hours it is no wonder they sometimes take short cuts.
This is particularly true among obstetricians who may be delivering babies at any hour of day or night. And few women are prepared for birth. I remember listening to women screaming their fool heads off cursing their doctors, nurses, the babies father, and anyone else they could think of. If they'd just shut up and breathe they'd get it over faster and with less pain.
So, it really isn't surprising that some doctors take short cuts. They read about the efficacy of something like Digoxin, and decide to try it.
What we need is an incorruptible board to oversee the use of all new drugs before they reach the market. And release must be tied to the specific use on which the drug was tested.
We used to have this with he CDC and FDA. That thalidomide I referred to in the post was not available in the US because it had not been adequately tested to suit the FDA standards. I don't know what's happening now - I've read rumors that bribes have been given by 'Big Pharma' but rumors are not facts. I do know that both education and medicine have been short-changed since Ronnie took the scene in 1981. The Republican Party in particular and the sudden worship of WEALTH in the past fifty plus years have resulted in more concern with 'appearances' and less concern with the common good.
Texan anti abortionists quizzed on female anatomy(funnier than fiction?):
https://youtu.be/Ez6phBoRvpc?t=829
Another person sent this to me, my reply: men of this caliber probably couldn't identify their own repoductive organs beyhond penis and testis'
Fay Reid: Apologies for coming across as crude but “penis and testis”? I think you’re overestimating their level of vocabulary. Try “dick and balls…”
LOL
2/ Greg Abbott Story
How Gov. Greg Abbott won millions and helped stop Texans from doing the same
Forty years ago this week, a tree fell on Greg Abbott, paralyzing the future governor from the waist down. He sued for damages and won millions—and then helped stop Texans from doing the same.
By Brooke Kushwaha,News Reporter
July 15, 2024
Texas Attorney General Greg Abbott (r), talks to the press at the Texas Capitol after Governor Rick Perry (l) signed a bill stiffening the penalties on human trafficking at the Texas Mexico border. (Photo by Robert Daemmrich Photography Inc/Corbis via Getty Images)
Robert Daemmrich Photography Inc/Corbis via Getty Images
Forty years ago this week, a 26-year-old law school graduate named Greg Abbott was out jogging on the streets of River Oaks when a tree snapped and fell, paralyzing him from the waist down. Abbott, in the midst of studying for the bar, sued the tree owner and later the tree-trimming company that had neglected the 75-year-old tree. He won a multimillion-dollar settlement, the details of which remained private for years.
Decades later, Abbott campaigned in support of tort reform curtailing "frivolous" lawsuits and won. Abbott's critics claimed that he helped usher in a Texas significantly less friendly to plaintiffs seeking damages like the ones Abbott won. Looking back on the case 40 years later, Don Riddle, Abbott's personal injury lawyer at the time, agrees that Texas has changed.
"It would be next to impossible to get the kind of settlement we got," Riddle told Chron Monday. Tort reform, or as Riddle calls it, "tort deform," has severely capped the kind of damages individuals can seek out, and Riddle doesn't see that changing in Texas anytime soon. So how did we get here, and how did Abbott come to turn against the legal mechanism that made him millions?
The Accident
Abbott's accident was more than just a wayward tree branch. The falling tree totaled two cars and broke Abbott's back and some of his ribs, resulting in months of surgery and recovery and lifelong paralysis in his legs. Yet to embark on his future, lucrative law career, Abbott had no health insurance or even a paycheck to cover the medical expenses.
The injuries left Abbott with two steel rods in his spine. Although debilitating, Abbott has since turned the accident into a lesson of perseverance on the campaign trail. As his campaign website says, "While some politicians talk about having a spine of steel, Governor Abbott actually has one."
The Lawsuit
Abbott's soon-to-be colleagues connected him with Riddle, who agreed to sue the tree's owner and the tree-trimming company on Abbott's behalf. Poring through documents, Riddle was able to prove that the homeowner had known the tree suffered from root rot and that the tree company had mistakenly treated the tree with a chemical that worsened its condition.
"We made an extremely nice settlement for him," Riddle said of the outcome.
The question of who is responsible for managing Houston's aging urban forest remains up for debate to this day, particularly as residents point fingers at electricity provider CenterPoint Energy for failing to regularly trim vegetation around the company's power lines. In the end, residents do have a responsibility to manage trees on their property, covering the costs of trimming and removal.
The Settlement
Dick Ellis, one of the experts brought in on the suit, told The Texas Tribune in 2002 that Abbott was a particularly sympathetic plaintiff who, barely beginning his career, also happened to be broke. He could have never afforded a trial, Ellis said, and so they agreed to settle.
The details of Abbott's settlement were never released on public record, and Abbott himself remained cagey on the matter until 2013, when he disclosed the payments while making a gubernatorial bid. Based on Abbott's life expectancy, the payments totaled to about $11 million when adjusted for inflation, although the full number won't be known until Abbott's death. Much of those payments cover Abbott's ongoing medical expenses, he said, many of which are not covered by insurance.
WEST, TX - APRIL 18: Texas Attorney General Greg Abbott briefs the media after touring the West Fertilizer Company April 18, 2013 in West, Texas. A fiery explosion that damaged or destroyed buildings within a half-mile radius ripped through the facility last night, injuring more than 160 people and killing an unknown number of others. (Photo by Kevork Djansezian/Getty Images)
Kevork Djansezian/Getty Images
“There are thousands of dollars a year out of my own pocket,” Abbott told the Tribune in 2013. “But there’s all kinds of other things that normal people wouldn’t think of, such as additional costs for modifications, ranging from cars to ramps to other kinds of expenditures to be able to move around in life.”
Tort reform, widely adopted in the mid-90s, shut down the possibility that individuals could get similar results, Riddle said. "In those days, any negligence no matter how large or small could be held responsible for the entire loss," Riddle said, and plaintiffs could sue multiple defendants at once. "That doesn't exist in the same form today."
The Campaign
Sixteen years after he won millions, Abbott, now a candidate for attorney general, campaigned to usher in tort reforms that would further limit plaintiffs' abilities to pursue accident damages. Democrats called hypocrisy, but Abbott maintained that the reforms only applied to so-called "frivolous" lawsuits clogging up the court systems, and that an individual faced with the same circumstances as Abbott could still win a similar settlement today.
Texas attorney general candidate, Republican Greg Abbott, makes a point during a candidate's debate Thursday, Oct. 24, 2002, in Dallas. (AP Photo/Tony Gutierrez)
TONY GUTIERREZ/AP
Still, beyond Abbott, tort laws have changed significantly in the past few decades. Most people might recall an infamous 1994 suit in which a woman sued McDonald's after getting burned by their coffee. The woman, popularly conceived as the poster child of frivolous lawsuits, sustained third-degree burns to her crotch and groin area after placing the cup between her legs to add cream and sugar. Her lawyers were able to prove that McDonald's served its coffee near-boiling between 180 and 190 degrees—30 to 40 degrees hotter than competing companies.
The McDonald's case is just one example of "indoctrination" insurance companies pushed decades ago to sway juries against big-buck settlements, Riddle said. Most settlements were paid out through insurance money, Riddle explained, and so companies had an interest in keeping payments low. Few people realize that the McDonald's woman's settlement had later been reversed, Riddle added. "That poor lady never really got anything," he said.
Back in Texas, however, Abbott ran his attorney general campaign attacking Democratic nominee Kirk Watson for his background as a personal injury lawyer. He was heavily financed by the PAC Texans for Lawsuit Reform, a political supergroup still backing Abbott and other Texas power players today. Despite the ideological headstand, Abbott won the race handily with 56.7 percent of the vote, going on to become the state's longest-serving Attorney General.
The Fallout
Although Democratic gubernatorial candidate Wendy Davis tried to rekindle accusations of Abbott's hypocrisy in a series of controversial campaign ads in 2014, her calls ultimately fell on deaf ears. Abbott beat Davis 59 percent to 39 percent, continuing Republicans' decades-long streak of statewide domination.
Today, Texans for Lawsuit Reform PAC continues to dole out millions to Texas Republicans including Lt. Gov. Dan Patrick, House speaker Dade Phelan, and yes, Abbott. The governor meanwhile is in the midst of setting up a new business court in Texas, complete with governor-appointed judges charged with taking businesses' unique interests into account.
"Texas is so bogged down by corporate influence," Riddle said, citing Texas' lawmakers hefty corporate campaign contributions. "Look at what people like Governor Abbott get today from ERCOT...you can see it happening, but normal people don't have the mechanism to change that...and lawmakers are not inclined to make changes."
Even everyday Texans rarely sympathize with personal injury plaintiffs, Riddle said, pointing to a 2003 constitutional amendment in which Texans directly voted to cap medical malpractice payments by doctors and hospitals to just $250,000. "It just defies all reason, but it happened," Riddle said. "We did it to ourselves."
Riddle is now estranged from his one-time plaintiff turned governor, although he said he and Abbott did keep in touch for a time following the suit. "He's gotten so big and powerful and famous, and I was misquoted a couple times by the newspapers, that I think he developed a dislike for me," Riddle said.
... And then there are the "devout Christians" who believe Deuteronomy where it says a woman should become the property of her rapist upon payment to her father.
Yeah, that's a great idea - NOT.
Thank you for a well-explained article on gestation and prenatal development! I have one small correction to offer : in your paragraph about thalidomide in the 50's and 60's, you say that ultrasound detected the limb anomalies in the affected fetuses, allowing the mother the option of abortion. Ultrasound was evidently first developed for medical use in the 1950's but very limited. It wasn't available widely until the 1970's in medicine. Likely the limb anomalies would have been detected on X-rays, which were used to assess fetal size and position even into the later 1980's. I'm a board-certified radiologist, and taught body imaging including ultrasound. Now retired!
Thank you, Rebecca. I also should have mentioned that abortions were very difficult to obtain prior to 1973 and Roe v Wade. So those women able to abort did so in other countries (if possible) or very expensively in the US. What happened were a too large number of malformed children born who were intelligent but doomed top live their lives as handicapped.
I wish men were held accountable for pregnancies too
3/ Greg Abbott was AG who proposed and promoted the Texas medical and tort reforms. His heart began pumping vile ever after his injury. Okay, sad. He should have been compensated. But he hated and hated and hated and became a politician to punish every citizen of Texas. The compensation wasn't enough, the vile in his veins spewed into a hideous desire to punish everyone.
Abbott's life has been dedicated since that day of his injury to injure everyone to the fullest extent. There may have been psychological damaged men who have become leaders, but I've never seen one who couldn't refrain from crookedly smiling when children were killed, when women died from suffering from the consequences of his abortion ban, an boy did anyone see how his eyes gleamed when the legislature banned mandatory water breaks.
Can anyone claim Hamas are terrorists and Greg Abbott is not?
I don't believe in Hell but I do believe Greg Abbott is attempting to smile his way into its apex role. I don't believe in dragons but there is fire breathing man named Greg Abbott.
Okay there are bad men from the best and plenty of terrorists living and breathing in America today, Trump, Vance, Thiel, Clarence Thomas, Elon Musk---but I don't think they know they are terrorists.
But Abbott knows exactly the evil he is projecting...He wants to do harm. Look at that smile, then look at the frown on those other faces.
It is unfortunate he survived his accident, and that is mean, but no man should live who delights in torture. Many have tried to rationalize their minds to believe they are righting wrongs by doing bad actions. But not Abbott. He delights in every injury he causes.
He is the worst. He is Mephistopheles in the flesh promising riches while he gleefully burns people in the flames of his fury. He thought he was the angel of heaven and a falling tree cast him into a determined desire to punish, torture and maim.
I'm sorry. I can't say enough bad about him because there is too much evil in him. He touches an unfathomable nerve into my being that I can't expunge.
Agree with much of what is written here except the comments that a woman with injuries or disability that would necessitate a wheelchair are incapable of bearing children or parenting. That is incorrect for many and creates a bias against women in the disability community.