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Bill
Short Nonfiction: Commentary

Every now and then I feel impelled to write a short commentary on some issue. They're longer than Letters to the Editor and shorter than Opeds. Fortunately, there's a place for them in the Commentary pages of the Philadelphia Inquirer.

Tort Reform in Health Care

Tort reform in health care is a complex problem with no simple solution.  Participants must stop pointing fingers of blame and start working together to improve a sick system.  Doctors, hospitals, insurance companies (including HMOs), lawyers, legislators (hopefully unbiased), and citizen groups need to address the multiple issues objectively. 

"Protecting our own" has long been a problem with the medical profession.  Self policing doesn't work in an atmosphere of self protection (there, but for the grace of God go I).  Hospital or doctor coverup for errors can encourage a patient to sue.  Those lawyers who look for big fees can increase the problem.  Good doctors pay for the errors of other doctors in their insurance premiums, but the good doctors too often fail to clamp down on poor practice.  Hospitals sometimes look the other way because a high admitter made a mistake.  Hospitals need more admissions, especially in an overbedded community such as ours.  So the good hospitals pay for the lapses of the other hospitals. 

A coordinated system of control is needed with the participation of doctors, medical societies, hospital boards and administrators, quality assurance programs, citizen groups and responsible legislators.  Accountability and improvement require a system that detects problems effectively. 

It's time to stop nibbling at pieces of the problem and attack the whole thing. 

William T. Delamar 
Retired (thankfully) hospital administrator 

- copyright  © 2001; 2002 William T. Delamar

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