Your article regarding medical malpractice was both disappointing and disingenuous ("As the malpractice crisis enters year two, doctors and insurers fleeing some markets," April ACP-ASIM Observer, page 1). The crisis arises from three facts the article does not mention.
First, two widely recognized and accepted studies, one from the Harvard School of Public Health (1991) and the other from the Institute of Medicine (1999), have shown that over 90,000 Americans die each year due to medical negligence. If any other industry had a mortality rate like that, it would be shut down.
Second, neither medical students nor residents are educated about patients' legal rights or their own legal rights and responsibilities as physicians. How do you expect to guard against negligence without instruction in the subject?
Third, we are having another "malpractice crisis" because medical malpractice insurance carriers have poorly managed their investments. Rather than admit fault, they seek a scapegoat. These carriers do a poor job of running their companies, but are quite skilled at deflecting criticism.
You want tort reform? With 90,000 deaths a year, how about holding physicians strictly liable for injury to and the deaths of their patients? That approach seems to work well with airlines and bus companies.
Lee J. Dunn Jr., LLM
Editor's notes: The author is a previous member of the College's Ethics Committee and frequently speaks at Annual Session.
Results of the two studies Mr. Dunn cites have been disputed. For more information, see "Estimating Hospital Deaths Due to Medical Errors," from the Journal of the American Medical Association (July 25, 2001).
Volunteering in Afghanistan
The problems with Afghanistan's health care system are well known. ("In Afghanistan, health care is competing with chaos," March ACP-ASIM Observer, page 6.) I call it a "ruined house." The needs there run the gamut from basics like food to major infrastructure.
I have been involved with Afghan refugees in Peshawar, Pakistan since the Russians invaded. I established a small clinic near Naser Bagh refugee camp, which has served Afghans for the past 15 years. In 1998, I tried to establish an organization to build girls' schools and small medical clinics, but the Taliban killed the project.
Since the Taliban's demise, I have resurrected this program, called Afghanistan's Health, Education, and Reconstruction Organization (AHERO), under the auspices of the United Nations.
AHERO's goal is to establish teaching hospitals with satellite clinics. We need people and supplies to build and equip our facilities and help train our physicians, nurses and medical students.
Consider how you can help us rebuild Afghanistan's health system and put an end to the country's 30 years of misery. For more information, see our Web site.
Aziz Kamali, MD
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