Published 4/1/2010

Readers weigh in on tort reform, practice trends

It should be noted that by far the greatest tort benefits of any health reform proposal thus far submitted to Congress would accrue from a single payer system such as improved Medicare for all. All future medical expenses for any personal injury lawsuit would be eliminated, a significant component of economic damages. Not only medical malpractice, but auto insurance, worker’s compensation, perhaps even homeowner’s and commercial insurance would benefit significantly if we had universal coverage with such a system. Current Congressional proposals in the House and Senate do little to address tort concerns.

Raymond Bellamy, MD
Tallahassee, Fla.

I am concerned about a disturbing trend that I have noticed over the past few years regarding medical records. I frequently receive consultation reports that are exceedingly lengthy and are primarily computer-generated garbage. I see this usually in medical records generated by emergency room (ER) physicians, but the trend is beginning to spread to other specialties as well.

I recently consulted on a 34-year-old man who had been seen in the ER for a simple ankle sprain. The ER physician’s consultation was a full 5 pages in length in small print and was basically worthless. The history simply stated that the patient was “injured.” There was no description of the accident or the mechanism of injury. Even though the patient was healthy, it appeared that a complete physical examination was performed in addition to a complete review of systems and family history. Remarkably little attention was paid to his only complaint—his ankle.

I hate to be cynical regarding the motives behind this trend, but I suspect there is a perverse financial incentive to produce a medical record that is lengthy, rather than one that is pertinent.

Clyde A. Farris, MD
Tualatin, Ore.

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