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<p><a href=“http://www.davispolk.com/files/News/38883a41-0045-4b27-b6b6-158be20c0ae7/Presentation/NewsAttachment/1b506a6e-a117-491b-a46f-19370397ecf1/In.The.Red.Zone.AmLaw.January.FOR.DISTRIBUTION.pdf[/url]”>http://www.davispolk.com/files/News/38883a41-0045-4b27-b6b6-158be20c0ae7/Presentation/NewsAttachment/1b506a6e-a117-491b-a46f-19370397ecf1/In.The.Red.Zone.AmLaw.January.FOR.DISTRIBUTION.pdf</a></p>
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<p>Pretty much all the things you describe have been going on for years. For a long time there have been many clients who scrutinize the bill line-by-line; who resist overstaffing; and so on.</p>
<p>I remember when I started working at the law firm in the late 90s, there were clients who had rules about how many attorneys could participate in a conference and so forth. </p>
<p>And for a long time people have been predicting that this sort of cost-cutting would humble BIGLAW. Which I really hope happens, by the way.</p>
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<p>This statement is curious. I happen to know some firms that do not even itemize their invoices.</p>
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<p>Not really . . . seems to me you have the burden of proof here. You are the one claiming that the current downturn is special. </p>
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<p>Can you quote the actual measurement which supports your claim that unemployment will take years to get back to normal? TIA</p>
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<p>When exactly did the derivative phenomenon start? And why exactly does the regulatory dillema you describe apply only to derivatives?</p>
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<p>We had a few firms like that, but gave them an ultimatum: issue itemized bills or we’ll take our business elsewhere. They whined, we didn’t budge, they gave in. </p>
<p>Not surprisingly our fees to them dropped quite a bit… when they actually had to detail what we were paying for–and with them knowing we had them under the microscope–suddenly our bills were full of a lot less ‘padding.’</p>
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<p>I’m a little confused. Do you agree that some firms do itemize their invoices? And do you agree that some clients do scrutinize their itemized invoices?</p>
<p>Just mentioning a interesting tidbit.</p>
<p>you know-
i sort of don’t care how anyone tries to qualify the necessity for the size/bulk of the legal sector in america. it needs to be overhauled completely… along with the financial system and the overarching democratic “ideals” that make it possible for idiots to have a chance at upper office and have an equal say in the direction of a very large/complex country when they have limited reasoning/cognitive ability.</p>
<p>democracy is flawed. there. i said it. all people are created equal but not all ideas are. therefore, not all ideas should carry the same weight. </p>
<p>also, you are NOT entitled to the “american dream”. the house with the dog and the white picket fence was a post-war theme that put entitlement into the minds of all americans. sorry plumbers and handymen, you should be making $25/hr not $100/hr. sorry medical patients, you don’t have the right to sue unless the doctor did something terribly wrong outside the basic standards of care. sorry everyone, unless you provide some sort of necessary service or create some wealth in society you aren’t entitled to the big house and fancy car. nope, not everyone should go to college. 70% of college students blow it off anyway. don’t even get me started on schooling. we waste much of our youth’s time by forcing them in a classroom 5 days a week. how much do you think they learn when they don’t want to be there? they do the absolute minimum to get by. the learning efficiency is probably around 10%.</p>
<p>this whole society is f-ed up and if you care to defend it with words of principles then you are just a deranged puppet in this illusion, as freud would put it. (although, i don’t like freudian analysis but i’d agree with the basic premise of “the future of an illusion”)</p>
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<p>And respectfully, your ideas do not deserve much weight. Although you claim I misunderstand you, it seems to me that you are just offering vague complaints without much in the way of specifics or careful thought.</p>
<p>But maybe I am wrong. Why not answer my questions?</p>
<p>First, in your view, would “social liberals” support or oppose workplace anti-discrimination laws? In your view, would “social liberals” support a system where someone who is denied welfare benefits is entitled to a hearing? </p>
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<p>Can you give me an example of something currently considered medical malpractice which is not “terribly wrong” in your view?</p>
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<p>Are you proposing some kind of government board which would decide on and set the appropriate level of compensation for each job category? How exactly would your idea be enforced?</p>
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<p>Again, how would you enforce this? Some kind of IQ test for voters? Or do you just think that “conservatives” must be pretty stupid and therefore should be barred from voting?</p>
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<p>Who exactly are you talking to here? Who claimed they were “entitled to the ‘american dream’”?</p>
<p>“sorry [sic] medical patients, you don’t have the right to sue unless the doctor did something terribly wrong outside the basic standards of care.” </p>
<p>How do you determine what the doctor did,and whether it complied with basic standards of care, without allowing the patient to state his claim to the court? </p>
<p>That makes about as much sense as declaring that “you can’t ask a question if the answer is ‘no’.” How do you know the answer before you’ve heard the question?</p>
<p>Sorry, rocketDA, but after 13 years of working with engineers to draft licensing agreements, my patience has grown a little thin for the subset of members of that profession whose hubris leads them to make grand pronouncements about domains they haven’t troubled themselves to examine.</p>
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<p>One thing about law is that almost everyone has experience dealing with rules and thinking about what’s right and wrong. So it’s easy to fall into the trap failing to appreciate your own naivety.</p>
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<p>Peer review.</p>
<p>That wouldn’t really work though, because there could easily be cover ups etc. </p>
<p>But I think malpractice insurance is insane. Agreed?</p>
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<p>How exactly would this work? Would there be a board of physicians to whom medical malpractice claims must be presented? Assuming there is some board of physicians which would decide if medical malpractice claims have merit, would a claimant have the right to present evidence in the form of witnesses or documents to this board? Would a claimant have the right to subpoena such evidence in advance? Would a claimant have the right to question witnesses presented by the doctor he wants to sue?</p>
<p>Would the board of physicians have to issue a written decision explaining its reasoning?</p>
<p>Who would pay for this board of physicians (and their administrative staff) to hear and pass judgment on medical malpractice claims? </p>
<p>Oh, and would claimants (and respondents) have the right to hire an attorney to represent them before this board of physicians?</p>
<p>Or maybe it would work something like this:</p>
<p>Dear Claimant:</p>
<p>I am the Chief of Staff at the hospital where Doctor X works. Although you allege that Doctor X engaged in medical malpractice when he treated you, I have looked at your medical records and I disagree. Therefore your claim is denied. You have no right to appeal or challenge this decision in any way. But have a nice day.</p>
<p>Sincerely,</p>
<p>Doctor Y</p>
<p>P.S. Please be sure to pay your bill in full within the next 30 days or we shall exercise our right to sue you in a court of law.</p>
<p>There are medical peer review boards already in place with regard to licensure, accreditation etc. issues, though they are certainly not perfect. Who is better to judge the standard of care than other MDs? The only question is impartiality, but IMO they would be more motivated to be honest and fair than a paid expert witness (for either side!). If it was deemed that malpractice was committed, then send it to a jury to assess damages or settle.</p>
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<p>So again my earlier questions:</p>
<ol>
<li><p>Would a claimant have the right to present evidence in the form of witnesses or documents to this board? </p></li>
<li><p>Would a claimant have the right to subpoena such evidence in advance? </p></li>
<li><p>Would a claimant have the right to question witnesses presented by the doctor he wants to sue?</p></li>
<li><p>Would the board of physicians have to issue a written decision explaining its reasoning?</p></li>
<li><p>Who would pay for this board of physicians (and their administrative staff) to hear and pass judgment on medical malpractice claims? </p></li>
<li><p>Would claimants (and respondents) have the right to hire an attorney to represent them before this board of physicians?</p></li>
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<p>As long as I get to make the rules:</p>
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<li><p>Would a claimant have the right to present evidence in the form of witnesses or documents to this board? No</p></li>
<li><p>Would a claimant have the right to subpoena such evidence in advance? No, the review board would do this</p></li>
<li><p>Would a claimant have the right to question witnesses presented by the doctor he wants to sue? No</p></li>
<li><p>Would the board of physicians have to issue a written decision explaining its reasoning? Would be nice, but decision could be one of three: no finding of malpractice–goodbye; possible malpractice–get an attorney if you want to pursue it; definite malpractice–your phone will start ringing off the hook with lawyers who want to represent you or your heirs. In the latter case, the MD would also be called before the licensure board.</p></li>
<li><p>Who would pay for this board of physicians (and their administrative staff) to hear and pass judgment on medical malpractice claims? ** I am open to suggestions on this. Could be taxpayers, MD license fees, or assessments on malpractice insurance firms.**</p></li>
<li><p>Would claimants (and respondents) have the right to hire an attorney to represent them before this board of physicians? No</p></li>
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<p>In the current system, a plaintiff’s attorney subpoenas evidence and decides which cases will line his pocket sufficiently. It makes more sense to have a dispassionate panel of experts deciding which medical malpractice cases may have merit, don’t you think?</p>
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<p>Clearly no, since your system will still have plaintiff’s attorneys deciding which cases are worth pursuing. “Possible” is a very low standard. I would imagine that in at least 99.9% of medical malpractice cases which are actually filed, it is “possible” that there was medical malpractice.</p>
<p>By way of illustration, I get calls on a regular basis from people with “possible” medical malpractice claims which I refer to a medical malpractice attorney. So far he has turned down every case I sent him. He has told me that the cases I have sent him, while colorable, are too weak and/or difficult to prove to be worth pursuing. Or that the potential damages are too small.</p>
<p>The biggest obstacle to pursuing a medical malpractice case is the huge costs involved, which include hiring expert witnesses. It’s easy to drop $30,000 or more prosecuting such a case. A competent medical malpractice attorney is not going to front that kind of money simply because medical malpractice is “possible.”</p>
<p>So basically your proposed board will add another layer of delay,complexity, and cost to the system without actually accomplishing much.</p>
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<p>So how many more lawyers do the clients have to call before they find one willing to take the case?</p>
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<p>Unfortunately, there are those who will take it on in the hopes of a quick nuisance settlement with the insurance company. There are also those who know they can play on a jury’s sympathies to get a nice judgment, whether or not malpractice was actually committed. I know a plaintiff’s attorney specializing in obstetrics who made a fortune that way.</p>
<p>IMO, tort reform would help a lot of the problems health care reform is trying to solve. I know that trial lawyers such as yourself will never agree.</p>