Medicine: The Urge to Sue

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It was almost midnight as a Denver attorney and two physicians drove home from an outdoor concert in nearby Red Rocks Park. Suddenly, the car's headlights flashed across a hole in the earth at the edge of the road, and the lawyer blinked with astonishment. From the dark hole protruded the legs of a woman. "That woman needs help," he cried, stopping the car. "Drive on," urged the doctors. "We can't afford to get mixed up in this and then get sued for malpractice later." They drove on.

More and more U.S. doctors are resorting to just such callous measures, as they learn a bitter lesson: medicine is an inexact science, but there is little room for error as far as the courts are concerned. One in every seven U.S. physicians, says the American Medical Association, has been sued for giving treatment that a court may decide is contrary to accepted rules and injurious to the patient. Last year alone, 6,000 doctors were sued. Jury awards in malpractice suits have nearly trebled since 1950; lawyers' fees, court costs, damages and out-of-court settlements in last year's cases totaled an estimated $50 million. Good Samaritan cases, such as the Denver doctors dodged, form a small but rich field for suits, because emergencies demand haste, often catch the doctor ill-equipped and ill-prepared.

Doctors v. Lawyers. The result is that almost 95% of all U.S. doctors carry malpractice insurance and many feel like sitting pigeons for unscrupulous patients and lawyers. General Counsel C. Joseph Stetler of the A.M.A. blames exaggerated stories of new drugs, methods of treatment and "miracle" surgery, which "lead the public to believe that anything less than a perfect result is per se evidence of negligence." Result: an increased urge to sue. Some doctors insist that only 10% of all malpractice suits have any merit; the rest, they claim, are nothing more than "legalized blackmail."

Not so, say trial attorneys like San Francisco's Melvin M. ("King of Torts") Belli, whose courtroom success once moved a California physician to speculate: "If Melvin Belli were removed from the California malpractice scene, our insurance rates* would drop 50%." Quickwitted and Darrowesque, Lawyer Belli estimates that he has filed more than 1,000 malpractice suits (75 actually went to trial), relieved doctors and insurance companies of $8,000,000 in judgments and out-of-court settlements.

Belli says that "most of the verdicts are justified, because judges and the law have put so many safeguards around doctors." He points out that in some states (e.g., Arizona, New Mexico) malpractice cases are "very rare indeed," because doctors flatly refuse to give testimony that would show medical negligence by their colleagues. Says Belli: "It's the damnedest conspiracy, but it's understandable: the doctors fear reprisals—their insurance can be yanked, or they can be bumped off the hospital staff or find empty chairs beside them at the medical banquets." Doctors' self-imposed silence has prompted two states—Massachusetts and Nevada—to permit use of standard medical textbooks in court to establish prudent practices.