Some of my: Inventions | Magazine interviews | Sheds | Favorite ER memories

Information for people contemplating
a career in emergency medicine and
other medical specialties

By Kevin Pezzi, MD


A proposal to help shield doctors from unjust malpractice lawsuits

Q: I am working on an Intel project for the Quality of Life Competition. My proposal is to help shield doctors from unjust lawsuits. I would like to achieve this by proposing to have a pre-hearing before the actual court case. This involves having 6 doctors acting as judges, who will decide if the accused doctor is at fault. If it was the doctor's fault, the case will go to regular court. The 6 judges will be paid about half of what they make on average in a regular workday. The City's budget can support this financially. However, I need approval from a doctor to see if it is a good idea.

Thank you so much,

Want to save money on gas?
Read this free e-book by Dr. Pezzi

Answer by , MD: I like your idea, Natalie. Some states have enacted a superficially similar concept to prescreen lawsuits for medical merit (or lack thereof), but the ones I know of only require that a single physician certify that the allegations are medically meritorious. However, when that doctor is paid by the plaintiff's attorney, his objectivity goes out the window. No one needs a crystal ball to predict what his proclamation will be: Yup, it's malpractice, so let's sue!

I have another idea for prescreening lawsuits. In a nutshell, here it is: Medical charts are reviewed by a physician panel, of the same specialty as the practitioner in a case in which malpractice is being alleged. So far, this is no different from your proposal. In my panel, however, the doctors review many cases, the majority of which have normal, uneventful outcomes—just as in real life. For a case to proceed, the panel must identify the care rendered as being below the accepted standard of practice. If the panel could not differentiate the ones with alleged malpractice from the others, it is a good indication that those cases lack merit (as most malpractice cases do, according to the Harvard study).

At first glance, it may seem that the inclusion of many normal (i.e., ones without pending malpractice litigation) would burden the panel by increasing its workload. However, this is not necessarily true. Currently, selected (random) charts are reviewed by Quality Assurance Committees (QAC) that screen them for medical errors. Thus, the overall number of charts reviewed would not increase appreciably. Instead, the responsibility for their review might be transferred to a QAC, which already reviews countless charts. Sprinkle in a few with alleged malpractice and see if they are flagged by the QAC as being below the standard of practice.

My proposal would eliminate the injustice of having charts nitpicked by Monday-morning quarterbacks with 20/20 hindsight, especially when those reviewers have a financial stake in finding something the doctor did wrong. Some of those reviewers are so desperate to suggest something the doctor should have done that they find dirt where there is none and propose things that could kill patients. This occurred in a case that I was involved with (read about it here) in which the reviewing doc—and the lawyer employing him—either had the IQ of a turnip or the morals of Adolf Hitler.

Back to the main Question & Answer page