Oge Young MD, FACOG, lives in Concord.

Dr. Nick Perencevich’s My Turn “Why HB 322 is important” provided an informative history of the NH Board of Medicine and emphasized the importance of medical peer review. His dedication to safe health care in New Hampshire is commendable. It seems a travesty that presently the Board of Medicine is in disarray, and that review of medical care complaints are now in the hands of lawyers working for the state. Eliminating the Board of Medicine and medical peer review is counterintuitive to the betterment of patients and physicians.

The quality of a physician’s care should be judged by his/her peers. Our medical malpractice system has never improved medical care. As Dr. Perencevich points out, “In a trial the experts on both sides are often highly paid, out-of-state physicians, commonly known as hired guns.” Jury trials are not about the truth. They are decided by which side can best twist facts to be most convincing. ‘Hired guns’ have been known to lie in front of juries.

The appropriateness of care should be decided by physicians who truly understand the medical issues. Physicians are often very critical of another doctor’s medical care. Our medical malpractice system serves us poorly. It is expensive and unfair. Unjustly, over forty percent of malpractice premiums ($80,000 annually for New Hampshire obstetricians), are paid to attorneys and “expert” witnesses. Small injury malpractice claims are not taken on by plaintiff lawyers because of the small returns for their work.

Even a greater expense of our medical malpractice system is the practice of defensive medicine. It is estimated that lab tests, imaging and unnecessary surgery amount to 30% of the $3 trillion spent annually on healthcare. Look no further than our C-section rate which has risen from 10% to 35% in the past 40 years. This increased rate is not a sign of better care. Obstetricians are keenly aware that if a baby suffers a bad outcome, their defense is often dependent on performing a “timely” C- section. Yet, 90% of cerebral palsy occurs as a result of events long before labor and delivery.

Our malpractice system never has made us better physicians. The greatest cost of medical malpractice for doctors is emotional. Well-trained physicians have quit practicing medicine despite having been defended successfully, because of the trauma and continuous threat of malpractice. Our medical malpractice system undermines the trust between a patient and care provider, so fundamental to good medical care.

As Dr. Perencevich argues, we must do all we can do to protect medical peer review. A means by which there is a knowledgeable evaluation of a provider’s medical care and awards all injured patients fairly, without incurring the financial and emotional costs of our present malpractice system, would benefit all of us.