Well, now, one of the *most* BF-friendly and evidence-base-conscious docs I
know, Lactnet's own Alla Gordina, is making me put on my lawyer hat today
and take up for all those plaintiffs' tort lawyers out there, with her
statement "the c/sections (at least in part) should be blamed not on OB's,
but on lawyers."

I respectfully beg to differ.

Those of us in lactation wail every day about HCPs who are offering
just-plain-flat-out wrong information and advice on pregnancy, birthing,
and BFg.  If litigation is such a "common" occurrence, where are all the
lawsuits against these doctors, nurses, IBCLCs, etc?

In April 2012 I attended one of the most thought-provoking continuing
education days of my professional life.  It was called "Navigating the
Current Medical-Legal Environment: Continuing the Dialogue", and it offered
*both* CMEs and CLEs (continuing education points for doctors AND lawyers).

One of the speakers was a very successful and well-known plaintiffs'
attorney here in the Philly area. Like any good attorney, he evaluates
whether a case is worth litigating before he takes on the client.  For
medical malpractice, that means (1) injury (and pretty bad injury), (2)
clear causation of action-to-injury, and (3) duty of care by the "bad
actor" to the person injured.

He takes ONE in 75 cases that come through his door.  In other words, 74
folks have marched in saying "Let's sue the bad guys!," and he, in his
learned opinion, has said, "This case is not suitable for litigation."

Here is the part I found compelling: Of those cases he *does* take, *most*
("a disproportionate number" were his exact words) are brought by doctors,
or their family members.  In other words: If you are a slip-shod doctor,
you had best hope that your patient is not a doctor, or related to one.

Now, that makes a certain amount of sense, doesn't it?  If you are a
doctor, you know and recognize when lousy care has occurred, and know
enough to say, "They botched grandma's eye surgery!! Let's sue the bad
guys!"

But here is the *real* issue: The panel ALL agreed (lawyers and doctors
alike) that there are plenty of meritorious claims out there that are NOT
being brought.  Folks who got bad injuries, without question, from a doctor
who had a duty not to harm the patient.

But the injuries occurred to people with low resources, low education, low
empowerment.  Those who do not even know where to begin, or even that they
*should* begin, a lawsuit.  Like so much in life, classism affects medical
care and jurisprudence ... and the divide between the "haves" and the
"have-nots" is widening.

I do firmly believe that those of us in healthcare *think* we are going to
get sued every time we sneeze, but the legal dockets just do not bear that
out.  Yes, a lot of malpractice suits get filed .. but compare that to the
amount of healthcare that happens in every clinic, hospital,  surgery
center, imaging center, rehab facility, assisted care residence, school
nurse office and doctor's office in the land.

In 2008 -- before the ACA -- 18% of our entire economy in the USA was spent
on healthcare.  http://www.justfacts.com/healthcare.basics.asp#spending.
 And of all the money spent on healthcare, less than 2% is attributed to
medical malpractice claims and awards.
http://navixmarketplace.com/blog/malpractice-lawsuits-and-medical-costs/

I do firmly also believe that much of our healthcare practice (in the USA)
is designed to "prevent" these phantom lawsuits.  (Ask yourself: is the
electronic charting in your facility designed to "prove you were there and
did what you are supposed to," or is it designed to provide seamless,
compassionate information and care from one HCP to the next?)

I like to say: Everyone loves to hate a lawyer. Until they get arrested or
sued.

-- 
Liz Brooks, JD, IBCLC, FILCA
Wyndmoor, PA, USA

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