Scarano V R
Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX 77030, USA.
Tex Med. 1997 Sep;93(9):59-65.
Organized medicine has spent a great deal of time, energy, and money attempting to revise the legal tort system. Yet, change, if any, has been incredibly slow. There are many reasons for this. Tort law has been a part of American jurisprudence for hundreds of years. In addition, most state legislatures are populated with large numbers of attorneys. This paper explores the economic factors that underlie the litigation process in medical negligence/malpractice cases. It suggests that the current tort system is not as antimedicine as physicians commonly believe; rather, it is physician-friendly. Presented here is a more efficient and cost-effective method of addressing medical negligence/malpractice cases. An exclusive relationship between the liability insurance carrier and a defense law firm is proposed. Rather than using the old billable hours system to charge for its services, the defense law firm negotiates a yearly retainer based upon a percentage of the annual liability insurance premiums paid. How this relationship would result in a more efficient and cost-effective approach to the present tort system is examined.
有组织的医学界花费了大量的时间、精力和金钱试图修订法律侵权制度。然而，即便有变化，也是极其缓慢的。原因有很多。侵权法数百年来一直是美国法学的一部分。此外，大多数州立法机构中有大量律师。本文探讨了医疗过失/医疗事故案件诉讼过程背后的经济因素。研究表明，当前的侵权制度并不像医生普遍认为的那样反医学；相反，它对医生有利。本文提出了一种更高效且具成本效益的处理医疗过失/医疗事故案件的方法。建议责任保险公司与一家辩护律师事务所建立独家关系。辩护律师事务所不再采用旧的按计费小时收费的方式，而是根据支付的年度责任保险费的一定比例协商年度 retainer（此处retainer 可理解为聘用费之类的费用，具体含义需结合上下文确定准确译法）。本文研究了这种关系如何能为当前的侵权制度带来更高效且具成本效益的方法。
