It is no wonder that trial lawyers look at this opportunity so lustfully. We physicians are not immune to these increased costs. After we celebrated the passage of bills mandating length of stay for deliveries and mastectomies, we discovered that these measures affected our ability to control costs within capitated plans. Physicians working in a system of global capitation found that this legislation resulted in greater hospital costs. Net effect on quality If HMOs can be sued for utilization decisions, so can physician groups and independent practice associations.
Physicians know that malpractice is difficult to define and to fight against.
We define malpractice as errors in judgment or performance, but the public defines it as a poor outcome. To many patients, a poor outcome is not the result of the disease or their own behavior but, rather, of errors by the physician, HMO, or hospital. We know how difficult it is to define standard of care, yet we urge lawmakers and judges to define appropriate care for HMOs. Lawyers, courts, and legislators cannot define healthcare quality. It must be defined within the industry with use of outcome objectives and benchmarks.