However, the settlement is likely cold comfort for the family, and the families of other babies negligently delivered by these midwives (including three deaths).  This is because the clinic and the providers practiced without medical malpractice insurance. This practice, called “going bare,” is more common that most patients realize.

Realistically, the family is unlikely to recover very much of the settlement amount because it is rare that providers have sufficient personal assets to cover a verdict or settlement amount.  According to the plaintiffs’ attorney, the defendants in this case are planning to seek bankruptcy protection.

Many people are unaware that their providers sometimes practice without malpractice insurance.  This includes doctors, midwives, and other health care professionals.

Look for providers with affiliations and privileges at hospitals in your area; most hospitals require that providers carry a minimum level of insurance, or provide it as part of employment.  If in doubt, ask the simple question:  “Do you carry liability insurance?”

Regulating Pain Pills:  How Do We Decide Who Gets What?

The Washington State Association for Justice has been a staunch advocate of this legislation.  Our attorneys are proud to be members of this organization.  Contact the attorneys at MKT if you suspect Medicare or Medicaid billing fraud in your workplace.  All contacts are confidential.

Below is a link to a great editorial written by Jim Alderson.  Mr. Alderson was a whistle blower in the US Department of Justice’s Columbia/HCA fraud investigation, which resulted in over $2 billion in criminal fines and settlements, following years of unlawful charges to government programs and other fraudulent practices.  This piece ran in the Seattle Times this spring.  Jim explains why qui tam protections make recovery of stolen funds possible.

Seattle Times editorial by Jim Alderson

Click here to view.

It appears that Washington State medical malpractice insurers had a relatively large number of relatively small payouts in 2011.

From the study’s results:  “Contrary to popular perception…poor patients, in fact, tend to sue physicians less often. This may be related to a relative lack of access to legal resources and the nature of the contingency fee system in medical malpractice claims.”

Most of the myths surrounding civil lawsuits malign plaintiffs as being motivated by greed or vengeance.  For a fresh look at the civil justice system, watch Hot Coffee, a documentary film that uncovers the truth about cases like the infamous McDonald’s coffee burn lawsuit.

Unfortunately, there is no simple way to research a doctor’s malpractice rap sheet.  You may have heard of a “public” national database.  Yes, such a thing exists, called the National Practitioners Data Bank.  Most settlements and verdicts must be reported and entered into this database.  However, it is not “public” in the sense that just anyone (aka, the public) can research a particular provider; only hospitals, state licensing boards, and other eligible entities can retrieve results for a particular individual.

One way to dig for information in our state is to check the Washington Courts website.  To get meaningful information from this search, though, you need some degree of legal knowledge.  It is hard for someone without legal saavy to sort out the parking tickets from medical malpractice cases, although it is possible if you spend some time with the system.   You can find this search at  www.courts.wa.gov.  From the choices on the left side of the page, choose “Search Case Records.”  Under “Search for a Person,” click “Name Search,” and you are on your way.  That is the simplest way to get started, but it takes a lot more than a quick search to sort out whether the person has been sued for malpractice and what the results may have been.  Remember, good doctors get involved in litigation sometimes, and bad doctors can fly under the radar for a long time.  And, of course, it only gives you information about cases in Washington State courts, not other states or federal court.

What about Yelp, Avvo, Angie’s List, and other consumer feedback sites?  It never hurts to check.  You cannot necessarily trust the information you retrieve, good or bad, but you might see red flags that help you know whether other patients have had concerns with this provider.  Keep in mind that plaintiffs in legal cases are often instructed not to post anything about their case, and many settlement agreements expressly prohibit them from doing so.  Some patients have even faced charges of libel for writing negative reviews about doctors.  In other words, there are many reasons that searching for reviews on a doctor is different than searching for reviews on a restaurant or a plumber.

Thus, even in a world of instant information and feedback, we are still left in the dark (or at least the shadows) when it comes to researching doctors.  But there are some simple things you can do, beyond digital sleuthing.

1. Ask around.  If you know people in the medical field, they can be a particularly good source of information about reputation.
2. Consider experience.  If you need a bypass surgery, you probably want a surgeon who has done hundreds of bypass surgeries.  Ask how many the doctor has performed, and what the outcomes have been.
3. Look for doctors who are board certified in their area of practice.
4. Advocate for yourself.  If you are not comfortable with the doctor assigned to your care, ask for a second opinion. You should not have to feel apologetic for doing so.  If you are faced with needing an elective procedure, take the time to look around to see who the experts are in the area.  You do not have to stay with a doctor you do not feel good about.

#1:  Check with the medical board

To do this, you need to go to the website for your state’s medical board.  In Washington, we have the Medical Quality Assurance Commission (MQAC).

Click here to check on Washington providers.

You will need the physician’s last name, and at least the first initial of his or her first name.  This also works for nurses, podiatrists, and other licensed providers.

Click on the correct provider, once you see his or her name.  If the provider has been investigated and disciplined in Washington (i.e., if there has been any action on the license), you will see a red YES under the column for “action taken.”  For actions taken in the last decade or so, some of the documents may be linked below, such as the Statement of Allegations.  For older actions, you will need to call the Customer Service Center at (360) 236-4700.  Don’t be shy about calling them!

Even if you see a “NO” under action taken, you still do not know whether the provider has been or is currently being investigated.  You have to call the state at the number above, and ask “does this provider have any investigations, open or closed?”  They will send you to the correct commission (e.g., nursing, medicine, etc.).  If they say yes, there are investigations, you can ask for the date and the basis of the investigation(s).  You may also make a public records request for more information.  The latter is a process that can take a lot of time, so be sure to ask for all the information you can get over the phone before deciding to order records.

Remember:   You have to check for each state separately.  And most importantly, you must remember that the provider could have been sued for malpractice without any investigation or action by the state.  Civil lawsuits and state license investigations are usually completely separate.

To learn more about how to find out whether your doctor has been sued, stay tuned for the next post.

This week, in the wake of his own experience with negligent care, actor James Woods will testify before the Rhode Island legislature concerning a law to protect apologies made by health care providers.  Sadly, James Woods’ brother, Michael, died after a 2006 heart attack in a Rhode Island hospital, where he presented with vomiting and a sore throat.  The family sued, alleging negligent management of his symptoms resulting in his death.  The case settled before trial, for an undisclosed amount, after the president of the hospital called him and apologized.  Now Mr. Woods is speaking out in favor of apology legislation.

The coverage this week slightly skews the issue, however.  The AP article states:

Woods’ brother, Michael, died of a heart attack at Kent Hospital in 2006. Woods sued the hospital accusing emergency room staff of not doing enough to save his brother, but he settled the lawsuit after a hospital executive apologized and agreed to start an institute in Michael Woods’ name.

From this blurb, it almost sounds as though the Woods family dropped the lawsuit due to the apology. Actually, there was also a monetary payment to the family (according to Woods, who couldn’t discuss the total amount, his brother’s children “will be provided for” under the settlement).

Although laws protecting apologetic statements might make it easier to bear the emotional fallout of a catastrophic error, it is incorrect to think this type of law removes the need for civil lawsuits.  An apology doesn’t cover the earnings of a lost parent, doesn’t pay for the additional health care costs of a missed diagnosis, and doesn’t provide tangible accountability for the effect of the negligence.

Nonetheless, I applaud James Woods for talking about these issues publicly and encouraging providers to talk about mistakes with their patients.  It is encouraging to see those in the spotlight speaking out about patient safety.

Tomorrow (2/15), the Washington State House Committee on Judiciary is scheduled for a public hearing on a bill that would allow an individual whistleblower to file a suit against a Medicaid-contracting provider for fraudulent billing of our state’s Medicaid program.  The Senate passed its version of the bill last week.

This new law would give the “relator” (a.k.a whistleblower) with inside information the power to bring a civil suit through his or her own attorney; the Office of the Attorney General could then review the suit (which would be filed under seal) and choose whether to intervene in the suit on the state’s behalf.  What is most remarkable about this bill is that a relator can receive between 15% to 30% of the recovery, if any.  This gives whistleblowers big financial incentive to call out billing fraud perpetrated by their employers.

I blogged last week about the high percentage of medical errors that go unreported.  When you know something went wrong, do not assume that the error triggers action on by the hospital, clinic, or practice group. All too often, errors are unreported and there is no investigation whatsoever.

But what if you aren’t sure? Doesn’t the doctor or hospital have a duty to tell you if something goes wrong with your care?  It turns out that about 1/3 of doctors do not think it is important to disclose serious medical errors to their patients.

In the wake of the recent Health Affairs survey that gave us this insight, Dr. Otis Brawley wrote a nice piece for CNN (Dishonest Doctors, Why Physicians Lie).  “Some doctors do not admit error out of fear of litigation,” Dr. Brawley says. “But my experience is that the discomfort of addressing one’s own failings or weakness is more commonly the reason for not coming forward.”

In my experience in litigation, I also see providers looking out for each other and not disclosing errors because it may implicate coworkers.  While this may be well-intentioned, it leaves patients in the dark about their own care and safety.  In the worst cases, providers actually lie to to patients and their families, rather than admit what has happened.  Once the lie is told, it is even harder to come clean and inform the patient of errors.

Dealing with suspicion in your own care can be tricky.  Patients worry about their ongoing relationship with a provider if they ask too many questions.  Plus, no one wants to place blame where none is due.  If you don’t feel like your doctor is being honest with you, you are not alone.   This is why it is good to call an attorney you can trust to discuss your situation confidentially.