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Analysis of Medical Claims

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A.J. Lennon


English 1100/43

Ms. Thompson

Analysis of Medical Claims

        When Henrietta Lacks went to the hospital she was taken advantage of, which got me wondering if such things happen today.  I believed it could still occur today, but am very unsure. As I did my research I discovered medical crimes still happen to this day. Professionals continue to work to prevent these incidents from occurring, but time and time again similar cases continue to arise. One might ask, “Why is it that our society has not rid itself of this issue?” There are a few common reasons for malpractices in today’s age. Sometimes people tend to believe they will receive unrealistic results. Medical personnel do all they can, but sometimes there will always be a scar, no matter how skilled a surgeon is. Often people do not understand the treatment to the full extent and after going through with the treatment there are regrets. Those people feel the doctor should have better informed them and in retaliation they file claims. The third most common reason is diagnosis error. It is always best for a patient to receive a second or even third opinion before receiving any treatment. In the articles “Characteristics of Medical Professional Liability in Patients Treated by Family Medicine Physician” and “Malpractice Claims Involving Pediatrics: Epidemiology and Etiology”, Aaron E. Carroll, Jennifer L. Buddenbaum, Frank T. Flannery, Parul D. Parikb, and William J. Oetgen use ethos, pathos, and logos to shed light on medical malpractice.

        The first article was about the reasoning for claims to be filed against personnel in the medical field. It alliterated on what kinds of medical issues people had when they filed the claims. The article was to inform people on claims and explaining them, in attempt to prevent future cases. The article presents a lot of number charts, to compare and contrast claims easily without having to do much work. The article got the information from claims dating form PIAA, which released medical records but did not give the identities of the patients. If the data were to identify the patients it would become highly illegal. The article provides methods of avoiding being involved in claims. These claims suggest things like getting more than one professional opinion before taking any risky treatment, and for doctors to give all the proper information and forms to a patient prior to any treatments.

The second article I found useful was about where in the medical field most claims come from. The data that was recorded was form a twenty-year time frame from 1985-2005. The article concludes how the claims resulted, informing the reader on how faking a claim, or insurance fraud, is near impossible. It puts all of the information into graphs to give a visual image of the information. Sixty-eight percent of all claims are dropped according to Aaron E. Carroll. Only one percent of all the claims were ordered in favor of the patient. The most common doctors to be found in these claims are pediatricians. Pediatricians may be more at risk due to lack of communication abilities, or having a third party, the parents, involved. A child might not be able to fairly describe the issue, or parents may have an issue with some treatment the doctor recommends for the child.  Try to imagine being a doctor and a shy, frightened child walks in to the office needing to be diagnosed correctly. That is a task that can be nearly impossible at times. The article also discusses how much money the claims usually draw out. The claim that statistically brings the patient the most money is when the doctor fails to monitor or follow up on a case.

                 The first article was packed with information. It had many examples of ethos, pathos, and logos. The first example is was Ethos, when I read saw the article was based on the perspective of pediatrics. Pediatrics are widely respected and known to be very well educated. The article discussed the “PIAA” which is an insurance agency. There is a deep upsetting example of pathos when the article talks about the condition of the patients involved in the claims. My source states, “The conditions most commonly seen in malpractice claims are brain-damage infant”. When I first read this it had a huge effect on me. It made me pause and think; what would I do if I had a brain-damaged infant, a child who never gets to experience life at all? What if I was born brain damaged, and could not function? The author did a fantastic job of throwing in an emotional spin to his article. There is a ton of logos in my resource. One can look in any paragraph of any page of m source and you will find at least one example of logos. The author places numbers everywhere such as when he says, “ The 2 most prevalent medical conditions associated with the medical misadventure of improper performance are brain-damaged infant (10.44%) and circumcision (5.11%)”.  Numbers like this always make a reader feel like they are receiving the best and most reliable information possible.

The articles were extremely similar, and very well written. The second article had so much ethos, pathos, and logos. The ethos was when the article referenced groups such as “PIAA”, which is also mentioned in article 1, or “American Medical Association”. The article named these groups then explained what they were defining there knowledge and credibility. The article states “Almost one third of closed claims (29.4%) were associated with the patients death”. The majority of the article is facts but then death comes up and it makes one think that these numbers are actually people’s lives. When thinking about the people involved, it becomes very personal and emotional. The article has an extreme amount of logos. The article says, “of all diagnostic error claims that were closed, 44% of these total claims were paid”. The paper is filled with numbered statistics, supplying logos to the reader. The article is also filled with tons of charts to give visual references to the information listed.



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