Wednesday, August 26, 2009

Them that has gets. Gets what?

It can be hard to avoid considering the wealth (or poverty) and income of a patient. Do they deserve sliding scale or no fee at all? Will the fee be a hardship? Can the patient afford weekly visits, a newly released medication? Will they pay my bill? Will I have to send them to collection?

When we consider the patient’s financial well-being in the context of professional liability, we might wonder whether the patient or their survivors would more likely sue for purely financial reasons, and we like to think that another good thing about wealthy patients is that they already have so much money they probably would not bother. In most cases it seems that wealthy (whether by virtue of assets or income) patients might be preferred, all other things being equal.

The John Ritter malpractice case raises questions about this assumption. According to media accounts of his wrongful death suit plaintiffs demanded approximately $40 million in damages based at least in part on an estimate of Ritter’s future income potential. This makes the usual $1 million/$3 million professional liability coverage look pretty inadequate.

Of course plaintiffs who win lawsuits do not always get what they demand. Had they prevailed in the Ritter case the award might have come from the policies of more than one physician. And maybe other factors would have protected the defendant physicians’ assets. Still it makes me wonder whether the risk attendant to treating patients with high earned income might be greater in a way I had not previously considered. Maybe we should not be so eager to have them as patients.

Presumably already wealthy patients who no longer earn might not qualify for so great a judgment. Maybe “them who has gets” a doctor, but not necessarily a bigger damage award. And maybe there is a small advantage in not making too much money.

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