Lee: Some simple yes or no questions.

Do you support allowing adverse third parties to sue lawyers for legal malpractice when a deviation from professional standards by the careless lawyer has caused them damage, as certified by an expert in the lawyer's specialty? If you say no, can you name a better approach to lawyer regulation than torts?

You now have expensive medmal litigation, mostly frivolous, mostly rejected by jurors, with 70% of verdicts for the doctors. You have massive damage from medical error. Does current medmal litigation help reduce medical error? Where is the evidence if you say, yes?

Do you agree that 10% of health care cost goes to defensive medicine, and if redirected, could provide top of the line insurance coverage for most of the ininsured?

you ask:

"

Lee: Some simple yes or no questions.

Do you support allowing adverse third parties to sue lawyers for legal malpractice when a deviation from professional standards by the careless lawyer has caused them damage, as certified by an expert in the lawyer's specialty? If you say no, can you name a better approach to lawyer regulation than torts?

You now have expensive medmal litigation, mostly frivolous, mostly rejected by jurors, with 70% of verdicts for the doctors. You have massive damage from medical error. Does current medmal litigation help reduce medical error? Where is the evidence if you say, yes?

Do you agree that 10% of health care cost goes to defensive medicine, and if redirected, could provide top of the line insurance coverage for most of the ininsured?"

I really am not certain what you are asking. Malpractice is a breach of a duty owed to the plaintiff. Lawyers owe no professional duties to defendants.

Perhaps you want to give some examples. These days, lawyers have to carefully line up experts before even filing suit. We always have in the past, since I have been with my firm.

I disagree with the premise that 10% of healthcare dollars going for defensive medicine.

The statistics with which I am familiar are that 30% of healthcare costs go for medical errors. Litigation costs are sometimes estimated as less than 1 % of healthcare dollars. However you feel about these statistics, and you can cite whatever you want, major American corporations know that medical errors are far more expensive than litigation costs.

The most recent statistics from the IHI, cited above, are that out of 100 hospital stays, there are between 40 and 50 injury causing errors.

I want to work with everyone to eliminate the errors. If you want to reduce the significant costs on society, eliminate the 30% or reduce the 30%. You can choose to focus on the 1% if you want. Doing so is irrational.

I am not current on the recent statistics regarding the uninsured. I believe the figures were that about 40 million Americans were uninsured, but I will check on that.

There is no way that eliminating litigation costs would pay to insure the uninsured.

Eliminating the errors might.

Correction

I wrote

"Lawyers owe no professional duties to defendants."

it should read

"generally speaking, lawyers do not owe professional duties to adverse parties."

Lee: Thank you for summarizing the lawless state of affairs of the self-dealt, unconscionable immunities granted by pro-lawyer biased, cult criminals on the bench.

"...generally speaking, lawyers do not owe professional duties to adverse parties."

What about the expressly enumerated duties to the defendant in the Rules of Conduct, the Rules of Evidence, the Rules of Civil Procedure and Criminal Procedure? What about this long list of duties in the law?

Who else has had a privity obstacle to professional duties for the past 100 years?

I would welcome your suggested change in the law. Plaintiff lawyers spend most of their time and huge sums of money overcoming bogus proximate cause defenses. Here is an article I wrote in this regard.

Med Health Care Philos. 2006;9(2):243-7.

The Temporal Stage fallacy: A novel statistical fallacy in the medical
literature.

Shier D, Tilson JL.

Department of Philosophy, Washington State University, P O Box 645130, Pullman,
WA 99164-5130, USA.

Celebrated for disproving the traditional view that lack of oxygen at birth
(perinatal asphyxia) contributes significantly to cerebral palsy, a 1986 New
England Journal of Medicine article by Karin Nelson and Jonas Ellenberg
engineered a new consensus in the medical community: that lack of oxygen at
birth rarely causes cerebral palsy. We demonstrate that the article's central
argument relies on straightforwardly fallacious statistical reasoning, and we
discuss significant implications--e.g. how carefully fetuses are monitored
during labor and delivery, expert testimony in malpractice cases, and public
policy decisions.

You may want to look at ACOG Technical Bulletin 163. Some of the footnotes contradict the propositions for which they are cited.

If your change in the law was adopted, It would make my life a lot easier.

You have to think this through carefully before you act. Such dramatic changes in the law can have a profound, unforeseen impact.

Do you really want to do this? Does it apply to both sides?

Lee: The phrase, adverse third party, is neutral. A plaintiff is welcome to sue a defense attorney for a frivolous defense motion, once the plaintiff has a certificate of merit from a defense lawyering expert.

You disagree with the view of your fellow trial lawyers.

If you agree to such a statute, do you agree, all attorneys should carry legal malpractice insurance as a condition of renewal or granting of licensing?

Lee: You ask if we agree that medical errors need reduction. I have been the victim of such, and entirely agree they should.

Lawyer run medmal has failed if one of its aims is to reduce medical errors. The lawyer is in utter failure in all its own self-declared goals. Name a subject of the law, its goals, measure. Utter failure in every goal of the law. The lawyer must be fired for this failure.

The mirror image of your question is whether you support accuracy in litigation. I don't know if legal malpractice claims are the best path to that.

Because I believe that lawmaking, whether statutory or case law, is ghoulish human experimentation, any new proposal must be tested a few years in a small jurisdiction. If it succeeds, move to a bigger jurisdiction. If validated again, move it to a large region, then the nation.

Doesn't it make sense then, if the goal is to reduce medical errors, to look to the efforts that have been most successful in reducing medical errors?

It sure does. Only continual system improvement, continual training, and new technology will reduce medical errors.

Torts 1) induces a cover up; 2) settles medical controversies at the point of a gun after a contest of trial fairy tales and rhetoric, pandering to emotions, and charisma; 3) irresponsibly forces defensive medicine, or ineffective medicine on an entire jurisdiction; 4) yes, deters, deters doctors from entering high risk specialties, taking high risk, desperate patients, or students from entering medicine at all.

If medical error reduction is the goal, immunize from discovery all defects found in investigations that have been remediated, including past data, from before the injury.

Doctors will not like insiders second guessing them, harassing them until changes take place, and following up on whether the error has been stopped. Now, uninformed lawyers take 1 of 50 cases of real malpractice, usually based on the cuteness of the plaintiff, and do nothing for the majority of patients. Worse, their coerced standards of due care hurt unseen, uncounted patients.

Lawyers will not like the loss of income. Doctors will not like the nightmarish second guessing and hounding by knowledgeable insiders.

Only patients will like this scheme.

In fact, the most successful effort to reduce medical errors is the Anesthesia Closed Claims Project.

The project considers data from closed tort cases, studies the cases, and makes recommendations for how to prevent injuries. It has been extremely successful in reducing malpractice liability of Anesthesiologists.

It reduced the rate of anesthesia errors from 1 in 5,000 procedures to 1 in 300,000.

A recent article by University of Michigan obstetrician Dr. Pearlman suggested a closed claims project for obstetrics.

I have not been able to find any other effort nearly so successful as the Anesthesia Closed Claims Project at reducing injuries and errors. Perhaps you can. We have enough errors to go around.

The starting point of the project is closed tort cases.

We need the tort system. We need to learn the lessons of the tort system if we want to reduce errors. It works.

Eliminate the tort system and you eliminate the possibility of such successful efforts to reduce errors and injuries.

Lee: All of medicine has improved, at a pace where all doctors are doing 10% of what they were doing 5 years ago. The idea that the miniscule chance of being sued causes improvement is such a surprising idea that it needs more confirmation. Torts induces a cover up, and slows progress. What can be shown is that torts cause defensive medicine, increased costs, unnecessary distrust between doctor and patient, and reduced access for dubious patients. If you want to reassure yourself that a lawyer, employing an inexperienced academic verifier as his bitch, imposing an obsolete standard of care at the point of a gun on all the doctors of a jurisdiction is helping anyone but himself, if you need that masking ideology to prevent your shooting yourself for the evil you do, go ahead, kid yourself.

Dozens of times a day, a desperate patient faces a desperate doctor. A single case experimental design follows. What works spreads throughout a specialty within days or weeks. many years later, an academic gets a grant, does a study, gets published, and verifies the medicine of 7 years ago. Whatever the anesthesiologists have improved stems from the fear of injuring the patient, not the fear of being sued. That fear likely slowed what had to be done.

When we say medicine has improved, contrast to the utter failure, Scholasticist, supernatural quagmire in which the law finds itself. What the lawyer does is supernatural, superstitious garbage resulting in failure of every goal of every subject with one exception, the seeking of the rent. Yours is a technical field, an essential utility product, the rule of law, as necessary as water and electricity. That you still operate as they did in 1250 AD is ridiculous.

That you boys all have IQ's of 300 makes this failure unforgivable. The lawyer must be removed from all benches, all legislatures, all policy positions in the executive. As the felon is barred from these positions, anyone who has completed 1L must be barred for the survival of our nation.

This is nothing more than a series of ad hominem attacks dressed up with big words.

Look up the anesthesia closed claims database. It works.

Lee: Which appropriate characterization did you find inaccurate?

If the lawyer, at the point of gun, has induced an increase in C-sections based on the false testimony of academic prostitutes, then the lawyer is responsible for a serious increase in the rates of asthma, and of intestinal diarrhea, requiring hospital treatment in infants. Who is taking responsibility for this false testimony? No one. The lawyer on the Supreme Court dealt the plaintiff bar total immunity from their irresponsible coercion of medical care in 1880. The lawyer of today has benefited from this lawlessness. The lawyer of today should be made to disgorge all unlawful and unconscionable profits, as a class.

You ask:

Lee: Which appropriate characterization did you find inaccurate?

Lee's response: I do nto object to the appropriate characterizations, but to the inappropriate ones.

The complaint that a comment is an ad hominem is not a complaint that something is inaccurate. Go look up ad hominem. It means that something is a personal attack.

I pointed out some real, provable, concrete good that has resulted from the tort system: a reduction in anesthesia claims as the direct result of the closed claims project. You did not provide a meaningful response to that point.

While many of your claims are inaccurate, what I was pointing out were the following irrelevant personal attacks:

inexperienced academic verifier as his bitch

shooting yourself for the evil you do

the utter failure, Scholasticist, supernatural quagmire in which the law finds itself.

What the lawyer does is supernatural, superstitious garbage resulting in failure of every goal of every subject with one exception

That you still operate as they did in 1250 AD is ridiculous.

As the felon is barred from these positions, anyone who has completed 1L must be barred for the survival of our nation.

most plaintiff experts are well known bitches for your profession

after lawyer rhetoric and fairy tale spinning

mentally crippled by his legal education

There is ample evidence that the Anesthesia Closed Claims Project has reduced anesthesia accidents.

Either you agree or disagree.

If you agree, I will go on to the next point.

If you disagree, I will cite the evidence.

Which is it?

I like a good personal insult. One of my favorite insults is "morally inferior to pond scum." I believe I made it up, but am unsure. Insults are fun.

But they are ad hominems.

Yes of no.

Do you agree that the Anesthesia Closed Claims Project has reduced anesthesia accidents dramatically.

Lee: Each of those "ad hominems" is a constitutional tort. They are not personal. They are future business between us. Once the self-dealt immunities of the criminal cult enterprise are reversed by statute, look for them in massive class litigation against your criminal cult enterprise.

No. I intubate the esophagus, I have just seen the end of my reason for being an anesthesiologist. I will do everything I have to to never let that happen again. No lawyer, no study is of the slightest influence. The second time it happens, no nurse, no surgeon will allow me in the OR. The surgeon? All my bonehead mistakes are his. Did you ever see a surgeon when someone interferes with his masterpiece? The third time? They kick my ass behind the dumpster. I am invited to go to another town. The anesthesiology community is a really small town. Everyone knows everything, and within hours. I will have nowhere to hide in this country. Law suit or no law suit.

Your claim about a study of law claim having the slightest influence is so outlandish it requires some evidence from other than self-dealing, left wing ideologues with zero credibility.

Here is a logic question. There are massive numbers of medical errors. Torts is meant to reduce medical errors. Why is this conclusion false? Torts fails to reduce medical errors.

I am sorry for your circumstances.

You might want to look up the Anesthesia Closed Claims Project. It is not a study by lawyers. It is a medical project that has dramatically reduced anesthesia errors. If you want citations, I will send them.

In reply to your logic question, I would note as follows. Annual physical exams are thought to improve health and reduce unnecessary deaths. I don't know if it is true.

Suppose one thousand people obtained annual physical exams, but then completely ignored the results.

Would it make sense to say that the annual physical exams did no good at all? If we ignore the exams and results, does it follow that the exams are useless and should be abolished?

Suppose the people who paid attention to the results of exams improved their health dramatically.

Do you believe the exams should be abolished? People who heed the results get better, people who ignore them do not?

Isn't that the case here? When someone studies the results of the tort system and try to learn and improve, the injuries decrease?

Granted, the circumstances are not perfectly analoguous. But isn't the logic the same?

What have I missed here?

Lee: I am the one who believes in torts and juries so much, I want to bring their benefit to the lawyer profession by eliminating all artificial, and unjust impediments to adverse third party claims of legal malpractice. Why won't the lawyer trust the jury to regulate him? Why does he impose a separate mechanism of regulation run by his pals on the Supreme Court of the state? Why is a jury not good enough to judge a lawyer's compliance witih professional stnadards of due careful lawyer care?

I believe that a study of closed anesthesiology cases helps with valuable information about errors. We disagree as to the strength of the influence compared to immediate patient-on-the-table catastrophes. Nothing scares nor motivates the doc more than that. Second, comes the massive pressure from peers to not have a repetition. Third, come studies and the practices of peers. Lastly, comes the fear of litigation. This is on a day to day basis. Cumulative frivolous litigation eventually induces wasteful and dangerous defensive medicine. For example, if you are like Edwards, your bogus attack on natural birth, and the lawyer caused explosion of unnecessary, dangerous and costly C-Sections also caused the asthma and diarrhea epidemics requiring inpatient IV therapy and steroid treatment. The lawyers and their biased judges who allowed it should pay the class of wheezing babies with the runs to the last button on the last shirt.

Lawyers are not alone in their rent seeking. Annual exams are not justified in asymptomatic adults. Primary care physicians (PCP's) believe otherwise.

Arch Intern Med. 2005 Jun 27;165(12):1347-52.

Comment in:
Arch Intern Med. 2006 Feb 13;166(3):368.

Support of evidence-based guidelines for the annual physical examination: a survey of primary care providers.

* Prochazka AV,
* Lundahl K,
* Pearson W,
* Oboler SK,
* Anderson RJ.

Ambulatory Care Section, Denver Veterans Affairs Medical Center, Denver 80220, USA. Allan.Prochazka@med.va.gov

BACKGROUND: Current evidence does not support an annual screening physical examination for asymptomatic adults, but little is known about primary care provider (PCP) attitudes and practices regarding an annual physical examination. METHODS: We conducted a postal survey (32 items) of attitudes and practices regarding the annual physical examination (in asymptomatic patients 18 years or older) of a random sample of PCPs (specializing in internal medicine, family practice, and obstetrics/gynecology) from 3 geographic areas (Boston, Mass; Denver, Colo; and San Diego, Calif). RESULTS: Respondents included 783 (47%) of 1679 PCPs. Overall, 430 (65%) of 664 agreed that an annual physical examination is necessary. Three hundred ninety-three (55%) of 712 disagreed with the statement that national organizations do not recommend an annual physical examination, and 641 (88%) of 726 perform such examinations. Most PCPs agreed that an annual physical examination provides time to counsel patients about preventive health services (696/739 [94%]), improves patient-physician relationships (693/737 [94%]), and is desired by most patients (572/737 [78%]). Most also believe that an annual physical examination improves detection of subclinical illness (545/738 [74%]) and is of proven value (461/736 [63%]). Many believed that tests should be part of an annual physical examination, including mammography (44%), a lipid panel (48%), urinalysis (44%), testing of blood glucose level (46%), and complete blood cell count (39%). CONCLUSIONS: Despite contrary evidence, most PCPs believe an annual physical examination detects subclinical illness, and many report performing unproven screening laboratory tests. Primary care providers do not appear to accept recommendations that annual physical examinations be abandoned in favor of a more selective approach to preventing health problems.