Malpractice and the vascular surgeon

The theme of presidential addresses has varied to include political, historical, and clinical topics. I suspect that the most vexing problem for presidents is the choice of topics. I can recall my former chairman, Dr. Paul Adkins, thoughtfully discussing various approaches for his presidential address to the Society of Thoracic Surgery in the winter of 1981. For me, however, the choice was easy. At the time of my selection as president, I was involved with two major lawsuits. For 12 years before these lawsuits, I had no legal problems not even requests for medical records. Within 8 months the exaggerated confidence I had in my clinical abilities and interpersonal skills with my patients was shattered by the filing of three major lawsuits. One suit was so frivolous that the plaintiffs attorney withdrew it after being threatened with disciplinary action and a countersuit. The other two would not disappear and dominated my thoughts for 4 long, painful years; this reminded me of the condemned man's comments as he approached his rendezvous with the gallows, "It certainly focuses one's attention." I hope this lecture will give you basic information on the malpractice tort system. I do not want this address to be a diatribe against the system, but please excuse me if some anger and bitterness break through. I have tried to gather as much factual information as possible to give an objective evaluation. Toward that goal I have mostly but not exclusively relied on three major studies that have focused on the numbers and characteristics of adverse