In-store clinics, 'telemedicine' and the death of windfall malpractice judgments

May 22, 2014

Diminishing windfall medical malpractice judgments for inadvertent bumps and bruises might make some lawyers sick.

What's worse, the Affordable Care Act is expected make malpractice litigation even more challenging.

"There will still be errors and there will be compensation, but it won't be anything like what we've seen where patients win millions of dollars," says Jim O'Reilly, a volunteer professor in the University of Cincinnati's College of Law. "For lawyers to better serve their clients, they have to understand the system has changed. If they don't know about it, their client loses."

But O'Reilly offers a remedy in his groundbreaking new textbook.

This week the American Bar Association Press will publish "The New Medical Malpractice" by O'Reilly, an author of dozens of books and articles, and a longtime student of Ohio damages lawsuits. The book shares O'Reilly's insight on the rapidly shifting world of medical malpractice law.

"There was no book – I looked for one – that explained what's happening in health care," O'Reilly says. "That's why most of what's in my book is pioneering, because I talked to the people in Washington, D.C., and asked what they're really doing."

As provisions of the Affordable Care Act are rolled out nationwide, it's estimated that millions of previously uninsured Americans will gain access to coverage. The massive influx of clients is expected to bring a new level of competition among providers, potentially driving them to cut costs.

As a result, O'Reilly expects to see fewer local doctor's offices; growing numbers of grocery and convenience stores with on-site clinics staffed by nurses, not doctors; a proliferation of "telemedicine," where patients and doctors interact via video conference technology; and a rise in federally subsidized neighborhood health centers, such as the 46 such clinics operating in Greater Cincinnati and the thousands nationwide.

The changing medical landscape brings exciting ways to deliver medical services, O'Reilly says, but a fair amount of concerns too.

"Telemedicine has great potential but also the possibility for great mischief," O'Reilly says. "We're finding more cases where a nurse is giving the advice and if it's a really significant case, the doctor comes on video and offers an evaluation from a remote location. In that circumstance, we have questions about whether he or she can actually do an appropriate evaluation."

Further complicating things, O'Reilly says many of the newly insured will have "deferred maintenance" issues, or medical problems they have long ignored for various reasons, such as they lack money or sufficient health insurance coverage. These cases are fraught with risk for doctors and could lead to lawsuits for missed diagnosis or the wrong diagnosis.

As O'Reilly explains in his book, the dramatic changes to mean the field must change too. He says cases where a patient goes to court directly against his or her family practitioner will become more of a rarity.

Instead, patients seeking compensation for medical mistakes will increasingly be pitted against large hospital-based accountable care organizations or federally backed health centers – and lawyers must adapt accordingly. Taking on the federal system in Washington, D.C., or a mega-hospital's cadre of lawyers requires a much different approach than the traditional lawsuit against a neighborhood doctor in local common pleas court.

"The ultimate end point is people injured by mistakes should be compensated by the people accountable for the mistake. I think everybody can agree to that," O'Reilly says. "It's just a much more diverse set of defendants and a much more complicated decision for compensation."

Explore further: ACA could change costs for auto, malpractice and other insurance, study finds

Related Stories

ACA could change costs for auto, malpractice and other insurance, study finds

April 9, 2014
The expansion of health insurance accomplished under the Affordable Care Act may alter costs for several major types of liability insurance, although any such changes are likely to be modest, according to a new RAND Corporation ...

British executive accused in China drug bribery

May 14, 2014
Chinese police Wednesday accused a British executive of GlaxoSmithKline of leading a sprawling scheme to bribe doctors and hospitals to use its drugs.

Massachusetts primary care malpractice claims related to alleged misdiagnoses

September 30, 2013
Most of the primary care malpractice claims filed in Massachusetts are related to alleged misdiagnoses, according to study in JAMA Internal Medicine by Gordon D. Schiff, M.D., of the Harvard Medical School and Brigham and ...

Pending malpractice litigation may bias parents' reports

April 4, 2014
(HealthDay)—Following neonatal brachial plexus palsy, medical malpractice litigation is associated with worse parent reports of their child's function and pain, according to a study published in the March 5 issue of The ...

Telemedicine represents enhanced care model

November 8, 2013
(HealthDay)—Telemedicine may represent an effective care model but there are associated concerns, specifically relating to reimbursement and legal issues, according to an article published Oct. 25 in Medical Economics.

Recommended for you

To reduce postoperative pain, consider sleep—and caffeine

August 18, 2017
Sleep is essential for good mental and physical health, and chronic insufficient sleep increases the risk for several chronic health problems.

Despite benefits, half of parents against later school start times

August 18, 2017
Leading pediatrics and sleep associations agree: Teens shouldn't start school so early.

Doctors exploring how to prescribe income security

August 18, 2017
Physicians at St. Michael's Hospital are studying how full-time income support workers hired by health-care clinics can help vulnerable patients or those living in poverty improve their finances and their health.

Schoolchildren who use e-cigarettes are more likely to try tobacco

August 17, 2017
Vaping - or the use of e-cigarettes - is widely accepted as a safer option for people who are already smoking.

Federal snack program does not yield expected impacts, researchers find

August 17, 2017
A well-intentioned government regulation designed to offer healthier options in school vending machines has failed to instill better snacking habits in a sample of schools in Appalachian Virginia, according to a study by ...

Study shows cigarette makers shifted stance on nicotine patches, gum

August 17, 2017
The use of nicotine patches, gum, lozenges, inhalers or nasal sprays—together called "nicotine replacement therapy," or NRT—came into play in 1984 as prescription medicine, which when combined with counseling, helped ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.