September 10, 2008

Maryland Board of Physicians Findings: Do They Matter in Civil Trials?

Sometimes medical malpractice clients assume that they have a “slam dunk case” when they learn that there have been displinary action by the Maryland Board of Physicians.

But under Maryland law, specifically § 14-410(a) of the Maryland Health Occupations Article, minutes or notes taken in the course of determining the denial, limitation, reduction, or termination of the employment contract of any physician in an alternative health system are not subject to review or discovery by any person nor are any finding made by the Board subject to subpoena or discovery.

In other words, these documents or findings from the medical board are not only inadmissible but are not even discoverable. This may seem unfair from the patient’s perspective. For good reason, the findings of the medical board and the doctor’s statements or ommisions might be relevant to the patient’s medical malpractice lawyer’s effort to support the claim against a negligent doctor.

Then why are the findings inadmissible? The purpose behind the Maryland medical peer review privilege is not to foster justice in individual medical malpractice cases but for effective review of medical care so that it can be improved. Confidentiality is considered essential to the peer review process because doctors hate criticizing other doctors as it is. If we expose those doctors to fears of exposure to involvement in medical malpractice case they may wish to avoid, loss of referrals from other doctors, or even from becoming a litigation target themselves (far less likely but feared by doctors involved in the peer review process).

Accordingly, this process may harm individual patients who have been harmed by medical negligence but it is believed for the health care system as a whole. Medical malpractice lawyers do not like the rule but it probably is a good rule for overall medical care in Maryland.

September 8, 2008

Medical Malpractice Lawyers and Their Families: Can Doctors Ethically Withhold Care?

USA Today has a good article about a nurse who was fired because her husband is a medical malpractice lawyer in Texas. Wait, strike that, the hospital she worked for assumed he was a medical malpractice lawyer. He is not.

Many are surprised to hear such a species still exists in Texas anyway, given its draconian medical malpractice damage caps. But this story highlights a new trend of many doctors refusing care to medical malpractice lawyers, their families, and employees.
Some medical malpractice lawyers – and many doctors - see the refusal of doctors to provide medical treatment to patients seeking care as contrary to the Hippocratic oath, in which new doctors vow to appreciate "special obligations to all my fellow human beings."
I can’t imagine a decent doctor withholding care because you married to, work for, or are a medical malpractice lawyer. But if you encounter a doctor who refuses to give you treatment, I think you are probably better off.

It is also worth noting that our law firm occasionally does legal malpractice work in Maryland. This is not at all frowned upon by other personal injury lawyers or any other lawyers. I’m not putting lawyers on a pedestal above doctors. I have three kids and I want them all to be doctors, not lawyers. Believe me. But I don’t think lawyers feel targeted by legal malpractice lawyers because we figure if we do our job within the standard of care, we will be fine. This is why I get so confused by doctors who have never so much as seen a medical malpractice lawsuit – 96% according to a recent study in North Carolina - who get so involved in this issue.

August 7, 2008

Legislation to Shelter from Medical Malpractice Claims Doctors Volunteering to Treat Low-Income, Uninsured Patients

Wyoming Senator Mike Enzi introduced a bill designed to encourage doctors and other medical professionals to volunteer their services to patients who cannot afford or access care. The law would provide grants that states would use in part to assume medical malpractice risk for doctors and ensure patients can recover damages from medical malpractice.

I have not thought through all of the ramifications of such a bill but it sure seems to make a lot of sense. What we also need to look at more creatively as a society is trying to get more doctors into rural areas. There have always been reports of doctor shortages in the more rural parts of Maryland.