LettersWrite to The Editor, AAOS Bulletin, 6300 North River Road, Rosemont, Ill. 60018-4262
I am displeased with the conclusion propagated in your article, "Femur Fracture: Care Frequent Cause of Lawsuit" in the February edition of the Bulletin. The lower right hand portion of this article states, "It is possible with all of the technology available, orthopedists are forgetting the basic principles of fracture care." The article is deficient in that it does not state the name of the author of this quotation. A series of variables and controls must be considered before formulating a conclusion.
The variables in this case include the fact that malpractice is an industry and not a public service. Plaintiff attorneys are better at suing doctors than doctors are at defending themselves against malpractice suits. In our cyber age the technology of suing doctors is escalating more rapidly than the caring for patient.
I read your article hoping to gain some valuable insight into the malpractice issue and came away from it with the same canned platitudes that I have been fed for my entire practice.
Brian R. Altman, MD
I would like to thank Dr. Altman for his thoughtful letter, which was referred to me for response. I regret that he was displeased with the conclusion of the article, but must point out that he does misquote the article as stating "It is possible...." Actually, the article poses the question "Is it possible ... ?" This makes a significant difference: the statement may be arguable, but given the data quoted, the question is a reasonable one to ask.
It is difficult to respond to the assertion that the technology of suing doctors is escalating more rapidly than that of caring for the patient. I should point out that of cases that go to jury trial, the majority is won by the defense, and this has not changed over he past few decades.
Dr. Altmans assertion that controls must be considered is puzzling. This data is based on retrospective review of records of literally hundreds of actual malpractice claims. I do not know of any way to conduct a study of a controlled series of malpractice claims.
The criticism that no author is listed is in my opinion a valid one.
I regret that Dr. Altman did not gain insight into the malpractice issue generally. That was far beyond the scope of this brief report, the purpose of which was to note some common causes of malpractice claims in a few limited clinical areas. For a wider view of malpractice risk generally, I respectfully direct his attention to the publication Managing Orthopaedic Malpractice Risk, written by the Academys Committee on Professional Liability. It contains the data referred to, and a great deal more. It was available free to all fellows during the recent Annual Meeting, and is still available for sale through the AAOS Customer Service (800) 626-6726.
Jack C. Childers Jr., MD
Chairman, AAOS Professional
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