Michael Critelli

Michael Critelli

Michael J. Critelli served as the chief executive officer at Pitney Bowes, a mailstream solutions company, for 11 years, where he innovated in employer-based health care.

Incentives for Quality, Not for Quick Answers

The issue of malpractice liability is part of a broader problem with the way government, the insurance industry and consumers look at medicine. The most common misconception about medicine is that it is a formulaic, cut-and-dried activity, with a "right" way to treat a situation and a "wrong" way. For the clear-cut examples, there would be little disagreement that patient safety and the failure to meet a minimum standard of care should trigger malpractice liability and an appropriate level of damages. However, there are many areas in which quick judgments have to be made with incomplete information, and in which the choices involve trade-offs among risks and outcomes. Prostate cancer is a good example. Sometimes there are multiple alternatives for treatment and there is usually no clear best choice from among them. In cases like these, we should equip patients with complete information on the available choices and prompt them to make well-informed decisions.

We will significantly reduce the frequency of many diagnosis and treatment malpractice lawsuits by paying medical professionals to take time to do proper diagnosis and treatment. The current Medicare and private insurance payment systems encourage professionals to rush through patient encounters and get quick answers, since health care professionals earn more by doing more activity, and earn nothing extra for better quality.

Some doctors practice defensive medicine, but the work compiled in the Dartmouth Atlas survey would indicate that this is only one of many contributors to excess medical costs. Excess care is more often the result of local practice preferences and an excess supply of hospital beds, technology and providers.

Therefore, I favor malpractice reform, but I believe more broad-based informed patient consent practices, combined with payment reform that drives physicians to spend more quality time with patients and a re-examination of discretionary care will have a bigger impact.

By Michael Critelli  |  September 16, 2009; 7:56 PM ET  | Category:  Health Care Reform , Health costs , Malpractice , Public policy Save & Share:  Send E-mail   Facebook   Twitter   Digg   Yahoo Buzz   Del.icio.us   StumbleUpon   Technorati  
Previous: A Growing Circle in the Pond of Medicine | Next: Malpractice Matters. We Can Do Better.

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