Doctors and their legal bills
Re Your tax dollars pay doctors’ legal bills, Sept. 15 While the Star raises some significant points of concern regarding Ontario’s malpractice system, I don’t think most readers realize just how dangerous the alternative is.
For just one example, thanks to a relative lack of frivolous malpractice claims, Ontario doctors order roughly half the CT scans that their American counterparts do. This means less radiation exposure to young people, fewer complications when biopsies are done for harmless things that weren’t meant to be found, and patient outcomes that are much better statistically speaking than our neighbours to the south.
It’s tragic when mistakes are made, and settlements should be paid out promptly. However subjecting doctors, who are only human, to public humiliation and shaming is counterproductive and does not lead to the kind of changes that prevent future errors.
At the institutions where I work we have regular “rounds” where we discuss cases and potential solutions in a “no shame, no blame” environment.
Medical care is a complex process and it takes careful teamwork between health professionals and patients to ensure the best outcomes. Plunging the system into endless legal litigation is not the best way to do that. Dr. Kashif Pirzada, Toronto
“In the past three years, (doctors have) had only fee cuts. If we continue to see more of the same, I, at 65, with 2,000 patients, shall retire from active practice. Many more of us will do the same.” DR. GLENN GRIFFIN CARRYING PLACE
A lot of money could be saved if people did not frivolously sue doctors due to ignorance, grief and greed, thinking this is a good way to get lots of cash.
My husband and my son, both eminent doctors, got sued all the time, like other doctors, for no good reason and no payout. But the lawyers have to get paid, and there are court costs.
If doctors have to testify, they must take time away from the practice of medicine. Yes, some doctors should be sued, but the number of lawsuits is not reasonable and a waste of lots of time and cash. The public needs to be better educated. Nancy Oreopoulos, Orangeville, Ont. I have a similar situation, although not as serious. On April 21, I blew an expensive “run flat” tire on my car after hitting a deep pothole on the 401in the Toronto area. These tires cannot be repaired and cost more than $750 to replace.
I put a claim into the province for the cost of the repair within the required time frame. The province sent the claim to an adjuster who indicated that he needed several months to investigate. Several months went by and he advised that the province was not liable. Surprise, surprise.
I then issued a small claims court claim and the province sent that claim to a downtown Toronto law firm to further investigate. Again, the province was declared not to be liable and the law firm submitted a defence. A settlement conference was scheduled by the court and the law firm then served me with a huge bound and tabbed brief containing at least 100 pages of MTO highway inspection reports.
So, instead of paying for my tire or, maybe offering me a portion of the cost to replace it, I am fairly sure that the province has spent over $750 of our tax dollars to defend the claim by hiring an outside adjuster and law firm.
And how many minor claims are dealt with in this manner and take so long to process? It would be interesting to know. David P. Brannan, barrister and solicitor, Toronto Because almost 100 per cent of my income/salary comes from the government, that means everything I purchase comes from taxpayers’ money. This of course is due to the law stating that the government is my paymaster.
Do not blame physicians for this. Many would sooner bill patients directly. Of course, as a sort of government employee, I do not receive usual government employee benefits. Dr. Leonard F.L. Grover, Toronto It is time that the doctors’ legal defence fund came under fire. Until the issue was raised in the Star I doubt most Ontarians knew that they were helping to fund the doctor’s defence fund.
For those of us who have acted for plaintiffs in suing doctors, it is a very difficult chore even in cases of obvious merit. The difficulty, of course, is to get another doctor to testify against the doctor allegedly negligent or who fell below the standard. And even if one is bold enough to come forward, the medical protective association has a multitude of doctors to call on to refute the evidence of the plaintiff’s doctor.
With unlimited resources, the Medical Protective Association
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can put every obstacle in front of the plaintiff’s case knowing that it has the financial backing to wear down the plaintiff and his or her lawyer.
In many cases, with the victim severely disabled as a result of a doctor’s negligence, it falls to the plaintiff’s lawyer to make a sustainable investment to carry the case forward and overcome the imbalance created by the MPA. Bert Raphael, Toronto Let’s see if I understand this subject:
The CMPA on its website says its primary interest and concern is protecting the integrity of its member physicians for whom it mounts a vigorous defence in cases where a physician has not been careless or negligent.
In the case of Felicity Pittana (née Polera), court documents show her physician, Dr. Wade, acknowledged he breached the standard of care owed to her and that said breach caused her injuries and damages. Justice Edward Belobaba concluded there was uncontroverted evidence this was the case.
Despite an admission by the doctor, confirmed by the judge, that Ms. Polera suffered preventable damage, the CMPA says they are both wrong and intends to use some of my tax dollars to say so. I object most strongly and thank lawyer Paul Harte for showing me why I should.
To be fair, it seems that the OMA are not against some legislative revision to the financing of the CMPA. Bring it on. Ron Gibbens, Richmond Hill Your article could also be titled: Taxpayers pay doctors’ fees. We have a singlepayer system and the fees paid doctors are controlled by the government. The cost of malpractice insurance skyrocketed for some doctors like obstetricians and neurosurgeons. All Ontario doctors chose to forgo a further raise to subsidize the increased costs even though these costs are out of their control.
In some U.S. states patients were unable to find doctors to deliver their babies or remove their brain tumours. We were able to avoid this crisis because of the compromise Ontario doctors made.
To twist this generosity into a conspiracy defies reason. Franklin Sheps, Thornhill We pretend that our tax dollars pay for compensation to those whose lives have been damaged by medical negligence. Sadly, don’t we send those tax dollars to the Canadian Medical Protective Association? Isn’t the CMPA an unregulated, private defence fund? Is it not sitting on $3.2 billion of our money? Does it not use our money to stonewall gross and obvious malpractice?
The lawyer defending Felicity Pittana’s case spoke of having admitted that “the standard of care had been breached.” Nice words. Same words, verbatim, as CMPA counsel used in Ornstein vs. Stein, where Ontario Superior Court Master Short found the CMPA used that precise supposed admission to completely thwart the Ornsteins’ right to essential discovery. Master Short punished CMPA use of that ruse.
The supposed admission “the standard of care had been breached” was no real admission at all. It was only the basis of an “apparent intentional strategy of delay . . . with no semblance of any fair or proper purpose.”
Ornstein is good, essential, and basic Ontario Law. Felicity Polera’s case suggests that precisely the same tawdry CMPA tactics are still very much in play.
Between 2011 and today what has really changed? The CMPA is richer? Injured patients are stalled with impunity? Taxpayers are poorer? The courts are still used as a private playground for the privileged, at taxpayer expense?
Has Ontario’s attorney general really answered any serious questions about this scandal? John Legge, Toronto So Mr. Harte thinks it’s disingenuous that money paid to doctors is paid to the CMPA because doctors are paid by the public? Newsflash, Mr. Harte, it’s called our health-care system. Doctors are paid by the government. It’s their money not the public’s because they earned it. It is not just handed to them.
And that “almost $200 million in legal defence fees” paid out last year can also be attributed to frivolous lawsuits perpetrated by disingenuous lawyers handing out one-sided truths and chasing the almighty dollar. Andy Ma, Scarborough It is almost impossible to win in court against an opponent with a bottomless pit of money. Not only can they hire the best lawyers who likely know the judges well, but our legal system allows many tactics for delaying a final verdict almost forever.
Almost no one can hold out that long, or pay the enormous legal fees required to do so. The legal system is set up that way for the benefit of the lawyers and the wealthy.
Why not reform the system so that all appeals and delays are restricted to three weeks each, and the number of motions and appeals is restricted to three? From start to finish in a maximum of two months. Edward A. Collis, Burlington, Ont. All I could do was shake my head upon reading this story. Then I turn the page to see an ad from Canada’s children’s hospitals seeking donations for cancer research. How unjust is that? Sadly, it seems taxpayers are subject to news like this daily. Ron Salmon, Kingston, Ont. As an Ontario family physician, I am old enough to remember the many years from the mid 1980s to the 1990s when physicians faced high annual inflation rates and no fee increases while medical malpractice insurance fees skyrocketed.
Doctors, faced with no OHIP fee increases but with inflationary increases in the cost of managing a medical practice and rapidly increasing malpractice fees, protested. In lieu of fee increases the government agreed to subsidize (not pay the full amount) the high cost of malpractice insurance.
In the past three years, we’ve had only fee cuts. If we continue to see more of the same, I, at 65, with 2,000 patients, shall retire from active practice. Many more of us will do the same. Dr. Glenn Griffin, Carrying Place, Ont.