Good and Bad News about Liability Rates and Standards of Practice

James D. Butterick, M.D.

To the Editor:

I read with interest the editorial in the September APSF Newsletter by Dr. Pierce regarding the good and bad news about liability rates and standards of practice. I am President-elect of the New Hampshire Medical Society and sit in on the meeting of our own JUA here in New Hampshire I have become convinced that anesthesia can be made a safer experience for our patients and liability rates should reflect this.

Unfortunately, those of us who still take administering anesthesia so casually that they do not employ even the most basic monitors such as an EKG machine will forever drag us down unless we penalize them so severely that they no longer can afford to practice this way.

As sad as it makes me to realize it, there are those among us that seem to understand only finances and if that is the case, we must demonstrate to them that state-wide organizations such as JUA:s can and will enforce a higher standard of care than these practitioners apparently are willing to currently provide

I presume that this would take the form of surcharges and deductibles on liability insurance. While these are being tried in some areas, perhaps our own national and state organizations should Set on the bandwagon and push the individual states to do this. If individual practitioners understand that if they do not employ reasonable amounts of monitoring, then not only can they be held liable for negligence in the event of an untoward outcome, but the first five or ten thousand dollars of any award would come directly out of their pocket.

Similarly, if they have a pattern of such behavior that results in patient injury and awards, then they will be charged a higher liability premium than those of us who employ appropriate monitors. Obviously, settlements and awards for situations that are not the direct result of misuse or nonuse of monitoring devices would be excluded.

Working with legislators and listening to the reports at our JUA meetings makes me realize how very tired I am of taking the rap for those among us who don’t seem to care enough about what they are doing. I am also convinced that if we do not continue to clean up our act while we still have a chance, the state and federal governments will force it upon us. When they do that, no one would be so foolish as to believe that they will do it better than we could do it ourselves. The central question, of course, is, will we?

James D. Butterick, M.D. Manchester, NH