Escaping the Shadow of Malpractice Law

Abinovich-Einy addresses several constituencies operating at the meeting point of alternative dispute resolution (ADR), communication theory, healthcare policy, and medical-malpractice doctrine. From an ADR perspective, the need for, and barriers to, addressing non-litigable disputes, for which the alternative route is the only one, is explored. It is shown that ADR mechanisms may not take root when introduced into an environment that is resistant to collaborative and open discourse without additional incentives and measures being adopted

Escaping the Shadow of Malpractice Law

Abinovich-Einy addresses several constituencies operating at the meeting point of alternative dispute resolution (ADR), communication theory, healthcare policy, and medical-malpractice doctrine. From an ADR perspective, the need for, and barriers to, addressing non-litigable disputes, for which the alternative route is the only one, is explored. It is shown that ADR mechanisms may not take root when introduced into an environment that is resistant to collaborative and open discourse without additional incentives and measures being adopted

Do Physicians Respond to Liability Standards?

In this paper, we explore the sensitivity in the clinical decisions of physicians to the standards of care expected of them under the law, drawing on the abandonment by states over time of rules holding physicians to standards determined by local customs and the contemporaneous adoption of national-standard rules. Using data on broad rates of surgical interventions at the county-by-year level from the Area Resource File, we find that local surgery rates converge towards national surgery rates upon the adoption of national-standard rules. Moreover, we find that these effects are more pronounced among rural counties

Medical Malpractice Standard-Setting: Developing Malpractice Safe Harbors as a New Role for QIOs?

Concern about medical malpractice issues has reemerged, again stemming from escalating costs in some geographic regions and sectors of medical practice. The Bush Administration has (so far unsuccessfully) supported a cap on noneconomic loss as a strategy for coping with the cost aspects of those medical malpractice concerns, the model being the California approach. Although the overall initiative for reform has considerable merit, the damage-cap has its opponents and its drawbacks. The damage-cap approach is remedy-centric, focusing on the scope of remedy as a vehicle for containing costs in the area of medical malpractice. By concentrating on remedies, the reform of damage caps assumes that a plaintiff can establish liability, as remedial issues traditionally follow in the wake of and as a consequence of a finding of liability. In earlier work, colleagues and I have addressed the remedy issue, focusing on damages for noneconomic loss. The objective was to develop a way to improve the system for awarding damages for noneconomic loss. The approach to reform put forward in this Article looks at the medical-malpractice cost-containment issue in a different way. Like the work on noneconomic damages, it is designed to improve the functioning of the system; unlike that earlier work, however, its focus is not on the remedy-damages issues-but on the determination of liability. The systemic improvement is designed to allow for the appropriate consideration of trade-offs between quality and risk on the one hand and cost on the other

Does Medical Malpractice Law Improve Health Care Quality?

Despite the fundamental role of deterrence in justifying a system of medical malpractice law, surprisingly little evidence has been put forth to date bearing on the relationship between medical liability forces on the one hand and medical errors and health care quality on the other. In this paper, we estimate this relationship using clinically validated measures of health care treatment quality constructed using data from the 1979 to 2005 National Hospital Discharge Surveys and the 1987 to 2008 Behavioral Risk Factor Surveillance System records. Drawing upon traditional, remedy-centric tort reforms — e.g., damage caps — we estimate that the current liability system plays at most a modest role in inducing higher levels of health care quality. We contend that this limited independent role for medical liability may be a reflection upon the structural nature of the present system of liability rules, which largely hold physicians to standards determined according to industry customs. We find evidence suggesting, however, that physician practices may respond more significantly upon a substantive alteration of this system altogether — i.e., upon a change in the clinical standards to which physicians are held in the first instance. The literature to date has largely failed to appreciate the substantive nature of liability rules and may thus be drawing limited inferences based solely on our experiences to date with damage-caps and related reforms

Indemnification and Advancement Through an Agency Lens

DeMott discusses the doctrines that define entitlements to indemnification. In the corporate context, indemnification is better grounded, as in the Model Business Corporation Act (MBCA), in the necessity of furnishing corporate directors with appropriate protection against personal risk. To be sure, as the MBCA\u27s official comments implicitly acknowledge, the position of officers, especially senior executive officers, does not fit neatly and exclusively into either an agent or a non-agent category for indemnification purposes

Further Perspectives on Corporate Wrongdoing, In Pari Delicto, and Auditor Malpractice

In recent years, instant messaging (IM) has started to replace short message service (SMS) in communication. IM offers more functionality but there is a great downside. IM demands more power and drains the mobile device battery faster. This paper shows the energy consumption of  IM when the user is not using the application and how the consumption  can be reduced by enabling mobile sensors and sending fewer packets by the application. We began by investigating the various sensors that are supported by mobile devices. With the retrieved vendor information, we evaluated the different sensors and chose two sensors, light sensor and proximity sensor in order to study their use for reduction of energy in  an instant messaging scenario. These two sensors can together estimate if the mobile device is placed in the pocket of the user. The development of a simple IM application was completed and sensors were used to create an extension to the application. The extension would lengthen the interval between the updates of the automatic update function when the mobile was inactive, reducing the energy consumption. Two types of tests were performed. The first test evaluated if the extension would correctly deduce that the mobile device was placed inside a pocket. The mobile device with the pocket-aware application was used in different common situations and the tests showed that the extension made a correct computation in seven of nine situations. The faulty situations were when the mobile device is placed with the screen faced down to a surface. The second test compared the energy consumed by a pocket-aware application compared to a mobile device without our extension. Based on the results that we retrieved, we estimated that during a one minute period the pocket-aware application with an update interval of ten seconds could save on average 12% and could save on average 62% when the update interval was increased to fifteen seconds