Medical roundup

  • Study: doctors who use more resources are less likely to face malpractice claims [British Medical Journal]
  • “Obesity is not in fact a public health problem. It may be a widespread health problem, but you can’t catch obesity from doorknobs or molecules in the air. [David Boaz, Cato]
  • Contingency-fee law enforcement creates bad incentives, part MCXXXVI, health outlay recoupment division [W$J on Medicare auditors]
  • Welcome to Canada, skilled one, unless your spouse is ill. What that says about the welfare state [Bryan Caplan]
  • “Jury awards $16.7 million in swine flu death of pregnant Puyallup mother” [Tacoma News-Tribune]
  • Doc convicted of murder after patient overdoses: “Some experts worried that a conviction would have a chilling effect on worried doctors and keep powerful painkillers from patients who need them.” [L.A. Times via Jacob Sullum]


  • The $16M swine flu verdict for failure to prescribe Tamiflu sounds tragic: it is precisely the type of verdict that distorts physician incentives and directly harms patient care. That said, the details in the article are (as usual) too sketchy to determine much from it with certainty.

    I have never understood why these newspapers don’t just link to the record and some of the main briefs, rather than (or in addition to) inserting all these quotations from interested parties. It would be cheaper and more useful.

  • BMJ article on malpractice claims.

    Spending more resources on patients inevitably involves more providers. Question remains whether high resource utilizing physicians are diffusing claims throughout the healthcare system. E.g. I send patient with atypical chest pain for cardiac cath. My risk for missing a diagnosis based on clinical judgement drops. But the patient has an embolism stroke as a result of the cath, with long term disability. Cardiologist gets the lawsuit, but not me.
    Study does not address such a scenario, where I can increase utilization, the patient is exposed to greater risk, but greater risk is distributed among more physicians.
    The associations noted in the article are interesting, but still need to follow the patient through the process as the point of analysis to see whether receiving greater resources leads to more/less disability, and more/less use of litigation.

  • If the standard by which we judge whether something is a public health problem is whether you can catch it from doorknobs or molecules in the air, then Alzheimer’s Disease, heart disease, and most forms of cancer aren’t public health problems. You can’t catch HIV from a doorknob or molecules in the air either. I’d expect better from Cato.

    • Regardless of the terminology used, things like obesity and Alzheimer’s and heart disease and cancer are on a different level from things like polio or meningitis or influenza or ebola.

      The government can step in and require immunizations, or even quarantines, to protect the public at large. They shouldn’t be able to step in and demand you change your diet because you’re too fat.

  • if for no other reason than that you can potentially transmit polio or influenza, or ebola, or meningitis or what-have-you to the public at large, while they are in no danger of catching your heart disease, obesity, Alzheimer’s, or diabetes from your close presence.

    There is a significant difference in the state restricting one’s activities to protect other citizens from some reasonable likelihood of harm, and the state restricting your own activities “for your own protection”. Nor do I believe the state can properly “back door” an ability to dictate personal acts affecting only oneself by first volunteering to provide benefits to society at large (like health insurance). That’s a slippery slope we have rushed far enough down already, thank you.