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Interview With Donald Palmisano

Aired January 02, 2003 - 13:06   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


KYRA PHILLIPS, CNN ANCHOR: So why is the cost of medical malpractice insurance a controversy? Well, joining me to talk about how your own medical care might be impacted is Dr. Donald Palmisano. He's a surgeon in New Orleans and president-elect of the American Medical Association.
Doctor, thanks for being with us.

DR. DONALD PALMISANO, AMERICAN MEDICAL ASSN.: Thank you. It's a privilege to be here on behalf of AMA.

PHILLIPS: Well, we've been talking about the protesting, these out of control malpractice insurance premiums, as folks there -- doctors have been saying.

Let's talk about medical mistakes, though. We drew up some national numbers from the Institute of Medicine. They put out these figures. In 1999, up to 98,000 Americans die in hospitals each year due to preventable medical errors.

And if you look at the numbers, more than death by motor vehicles, breast cancer and AIDS.

So let me ask you, instead of raising premiums, shouldn't the issue of medical mistakes be dealt with first?

PALMISANO: Well, Institute of Medicine report has been criticized as far as those particular numbers, but the American Medical Association agrees that one error that harms a patient is one error too many. And that's why, way before the Institute of Medicine report, we found that, with others, the National Patient Safety Foundation. It's a not for profit group of 50 people on the board, nurses, physicians, lawyers, human factor experts, consumers and we're working to measurably improve patient safety, mpsf.org.

We also know that when experts look at the legal system that President Bush says is broken, and we agree, we find that awards -- both settlements and awards have no correlation to negligence. So it's not a true measure of negligence.

What you have is a correlation with disability. So this system's not working. What we're concerned about -- the majority of people who won't be able to find a physician if we don't fix the system and we have 12 states in crisis. And of course, West Virginia is one of the 12 and Pennsylvania is one of the 12. PHILLIPS: All right. We'll talk about the patients' right to sue and get into the legal aspects in a moment.

PALMISANO: Yes.

PHILLIPS: But let's get back to medical mistakes. How are they investigated? Are the cases -- I mean, is it a backlogged situation, where there are not enough investigators? What's the problem? Because with 98,000 nationally, that's a lot of cases of mistakes.

PALMISANO: Well, again, you're making that as a standard; 98, 000 is a fact. That fact is disputed by other experts. What we're saying is one error is one error too many.

And the points that we want to make -- we need a system instead of shame and blame, we need a system that allows openness or, if I have a near miss in the operating room, I can report that. Even though no patient is harmed, I can report that to an agency or to a safety group and they will study why the system put the patient in that situation.

PHILLIPS: So that doesn't happen, doctor? That doesn't happen right now? When there is a medical mistake, does it just get slipped under the table?

PALMISANO: No, it doesn't get put under the table, but what we find is there's a reluctance to fully investigate because immediately --as soon as you have a conference it, some body wants to file a suit and we get into the shame and blame mentality.

The aviation safety reporting system is a perfect example of a system that works, that makes the airlines. You can call up, in a non-punitive way, they will look at the potential problem, fix it, and disseminate the information. And there are bills in Congress right now that would allow that to happen. Those two bills -- one is Senate 2590 and the other one is HR 4889. Those are the ones in last year's Congress. And those bills would allow this confidential reporting with review by experts with feedback. So we're in favor of that.

What we're not in favor of is a system that allows suits to be filed. Over 80 percent of the suits -- suits to be filed without the responsibility, if you don't do your homework, and the fact that 80 percent are filed and no payment is rendered shows there's not good screening of those suits, and we'd like to see accountable at that end, too.

PHILLIPS: And you've been a part of something -- when talking about the patients' right to sue. Haven't you been a part of an organization pushing to have more accountability when it comes to enough evidence to have a credible lawsuit?

PALMISANO: Well, the American Medical Association believes that people should be responsible if they file a suit, and the person that should be most responsible is the attorney, and the attorney is the one who's the expert and advises the patient, who may be distraught because of a bad outcome. So we want to put some responsibility on the attorney to make sure that these cases are properly screened.

But the law that AMA is advocating -- the health law in the last Congress, which passed the House of Representatives, which was favored by President Bush and Secretary Thompson and the American public, I might add, did not make it out of the Senate. It does not restrict anyone's right to sue. What it does is put reasonable limits on noneconomic damages. It acts like the law in California, MICRA, which has been successful for over a quarter of a century. And those rates now are much lower than the rest of the nation when you look at the fact that they have only increased 167 percent over a quarter of a century, and the rest of the nation went up 505 percent.

PHILLIPS: So, doctor -- my final question. We've heard accusations. We've heard -- I'm looking here at doctors' mistakes, greedy insurance companies, lawyers chasing every medical complaint. Is it all of these or is there one that's worse than another?

PALMISANO: Well, what we have to do is we can't just use rhetoric here. We got to look at the facts. And the fact's that the insurance companies did not lose money in the stock market as the opponents of tort reform claim. They actually made a little money, if you go to AM Best and see, because they're bound by law to be in very stable investments.

But do we need a system that encourages early reporting and review by experts. The president's system just results in more lawsuits, more fear, intimidation and as a result, the patients get hurt. This is a patient issue more than it is a physician issue. And we're going to lose physicians, and you just can't go to the store and say, Give me two neurosurgeons, give me five obstetricians. It is a shame that physicians are retiring early, limiting their practice and moving to a state that has more stable liability reforms.

PHILLIPS: And also we don't want to lose patients through medical mistakes. That's for sure.

PALMISANO: Well, we certainly want to investigate that and we also want to have every body call our hotline number, 1-800-833-354 and you can get connected to your senator and representative and give your opinion on it.

PHILLIPS: Dr. Donald Palmisano, thank you so much.

PALMISANO: Thank you.

PHILLIPS: We appreciate your time, sir.

PALMISANO: Terrific. It's a pleasure to be here. Thank you.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com







Aired January 2, 2003 - 13:06   ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
KYRA PHILLIPS, CNN ANCHOR: So why is the cost of medical malpractice insurance a controversy? Well, joining me to talk about how your own medical care might be impacted is Dr. Donald Palmisano. He's a surgeon in New Orleans and president-elect of the American Medical Association.
Doctor, thanks for being with us.

DR. DONALD PALMISANO, AMERICAN MEDICAL ASSN.: Thank you. It's a privilege to be here on behalf of AMA.

PHILLIPS: Well, we've been talking about the protesting, these out of control malpractice insurance premiums, as folks there -- doctors have been saying.

Let's talk about medical mistakes, though. We drew up some national numbers from the Institute of Medicine. They put out these figures. In 1999, up to 98,000 Americans die in hospitals each year due to preventable medical errors.

And if you look at the numbers, more than death by motor vehicles, breast cancer and AIDS.

So let me ask you, instead of raising premiums, shouldn't the issue of medical mistakes be dealt with first?

PALMISANO: Well, Institute of Medicine report has been criticized as far as those particular numbers, but the American Medical Association agrees that one error that harms a patient is one error too many. And that's why, way before the Institute of Medicine report, we found that, with others, the National Patient Safety Foundation. It's a not for profit group of 50 people on the board, nurses, physicians, lawyers, human factor experts, consumers and we're working to measurably improve patient safety, mpsf.org.

We also know that when experts look at the legal system that President Bush says is broken, and we agree, we find that awards -- both settlements and awards have no correlation to negligence. So it's not a true measure of negligence.

What you have is a correlation with disability. So this system's not working. What we're concerned about -- the majority of people who won't be able to find a physician if we don't fix the system and we have 12 states in crisis. And of course, West Virginia is one of the 12 and Pennsylvania is one of the 12. PHILLIPS: All right. We'll talk about the patients' right to sue and get into the legal aspects in a moment.

PALMISANO: Yes.

PHILLIPS: But let's get back to medical mistakes. How are they investigated? Are the cases -- I mean, is it a backlogged situation, where there are not enough investigators? What's the problem? Because with 98,000 nationally, that's a lot of cases of mistakes.

PALMISANO: Well, again, you're making that as a standard; 98, 000 is a fact. That fact is disputed by other experts. What we're saying is one error is one error too many.

And the points that we want to make -- we need a system instead of shame and blame, we need a system that allows openness or, if I have a near miss in the operating room, I can report that. Even though no patient is harmed, I can report that to an agency or to a safety group and they will study why the system put the patient in that situation.

PHILLIPS: So that doesn't happen, doctor? That doesn't happen right now? When there is a medical mistake, does it just get slipped under the table?

PALMISANO: No, it doesn't get put under the table, but what we find is there's a reluctance to fully investigate because immediately --as soon as you have a conference it, some body wants to file a suit and we get into the shame and blame mentality.

The aviation safety reporting system is a perfect example of a system that works, that makes the airlines. You can call up, in a non-punitive way, they will look at the potential problem, fix it, and disseminate the information. And there are bills in Congress right now that would allow that to happen. Those two bills -- one is Senate 2590 and the other one is HR 4889. Those are the ones in last year's Congress. And those bills would allow this confidential reporting with review by experts with feedback. So we're in favor of that.

What we're not in favor of is a system that allows suits to be filed. Over 80 percent of the suits -- suits to be filed without the responsibility, if you don't do your homework, and the fact that 80 percent are filed and no payment is rendered shows there's not good screening of those suits, and we'd like to see accountable at that end, too.

PHILLIPS: And you've been a part of something -- when talking about the patients' right to sue. Haven't you been a part of an organization pushing to have more accountability when it comes to enough evidence to have a credible lawsuit?

PALMISANO: Well, the American Medical Association believes that people should be responsible if they file a suit, and the person that should be most responsible is the attorney, and the attorney is the one who's the expert and advises the patient, who may be distraught because of a bad outcome. So we want to put some responsibility on the attorney to make sure that these cases are properly screened.

But the law that AMA is advocating -- the health law in the last Congress, which passed the House of Representatives, which was favored by President Bush and Secretary Thompson and the American public, I might add, did not make it out of the Senate. It does not restrict anyone's right to sue. What it does is put reasonable limits on noneconomic damages. It acts like the law in California, MICRA, which has been successful for over a quarter of a century. And those rates now are much lower than the rest of the nation when you look at the fact that they have only increased 167 percent over a quarter of a century, and the rest of the nation went up 505 percent.

PHILLIPS: So, doctor -- my final question. We've heard accusations. We've heard -- I'm looking here at doctors' mistakes, greedy insurance companies, lawyers chasing every medical complaint. Is it all of these or is there one that's worse than another?

PALMISANO: Well, what we have to do is we can't just use rhetoric here. We got to look at the facts. And the fact's that the insurance companies did not lose money in the stock market as the opponents of tort reform claim. They actually made a little money, if you go to AM Best and see, because they're bound by law to be in very stable investments.

But do we need a system that encourages early reporting and review by experts. The president's system just results in more lawsuits, more fear, intimidation and as a result, the patients get hurt. This is a patient issue more than it is a physician issue. And we're going to lose physicians, and you just can't go to the store and say, Give me two neurosurgeons, give me five obstetricians. It is a shame that physicians are retiring early, limiting their practice and moving to a state that has more stable liability reforms.

PHILLIPS: And also we don't want to lose patients through medical mistakes. That's for sure.

PALMISANO: Well, we certainly want to investigate that and we also want to have every body call our hotline number, 1-800-833-354 and you can get connected to your senator and representative and give your opinion on it.

PHILLIPS: Dr. Donald Palmisano, thank you so much.

PALMISANO: Thank you.

PHILLIPS: We appreciate your time, sir.

PALMISANO: Terrific. It's a pleasure to be here. Thank you.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com