We have 3 amendments on the Florida ballot Tuesday that need very close scrutiny.

On amendments 3, 7 and 8.

I am reluctant to amend the constitution with legislative issues. There are times when it is almost forced on us, but generally it is a bad idea. i.e. the "bullet train" (Amendment 1 in 2000) that forces billions in state funding regardless of resources, potentially reducing funding to discretionary but necessary state funding or 2002 Amendment 10 that established the "proper housing" of pregnant pigs. We are trying to repeal the ill begot "bullet train" amendment this year with a "Yes" vote on Amendment 6.

Amendment 3 will not limit access to litigation for those who feel they've been harmed a medical practitioner. It will limit the amount of compensation an attorney can take out of the jury award to 30% of the first $250,000 and 10% of the amount above that, plus expenses. This will in effect increase the amount the injured party can keep.

This is an issue that should have been addressed in the legislature but repeatedly has not. If the bonanza of medical litigation is not controlled in Florida, it will have the effect of increasing costs to the practitioner, costs that will be passed on to the patient.

The trial attorneys are against this because it will directly affect the amount they can demand from the litigant. In effect, it could reduce access, but only because the attorneys will think twice before taking an incident to trial if they are only, for instance, going to get $100,000 plus expenses instead of the currently more common $175,000 plus expenses in a case where the award is $500,000. They are going to make sure the case is strong to commit their time to instead of taking the "splatter against the wall and see what sticks" theory of litigation. Vote "Yes"

Amendments 7 and 8 were initiated and promoted by Florida trial lawyers who have raised almost $44 million to push this to ballot approval.

Amendment 7 "Patients Right to Know" concerns me because while the patient has a right to know, they need to have good, complete and full information. This amendment would seem to throw all information out there, without investigation or understanding of the circumstances, for the public, most of which are uninformed on medical issues and unable to seriously analyze the information. Face it, our education system fails to teach students how to critically analyze data, this results in poor decisions.

The reality is that there is much information available online about the Florida Department of Health web site. Information about practitioners is in a searchable database on the MQA Practitioner Profile page

The FMA asserts this amendment will put raw, un-investigated information before a public that often has little understanding of medical practice, who may very well react adversely to information that is incomplete and perhaps even wrong. It will, in their estimation, serve to limit if not eliminate the peer review process because practitioners will be reluctant to post information on incidents that will be available to the public before it is investigated.

In criminal justice the accused is presumed innocent until proven guilty, this will have the affect of allowing an uninformed public to presume guilt without opportunity of investigation, defense or explanation.

The bottom line question is, "why do the trial lawyers want this?" It's my contention they see it as a way of increasing fear and distrust among the public towards medical practitioners, resulting in more business for them and increasing medical costs to the public. Vote "No"

Amendment 8, " Public Protection from Repeated Medical Malpractice," would portend to protect the public from physicians who repeatedly practice bad medicine. In practice, it puts in place a "very low bar" that will ensure that, regardless of the degree of the incident, whether is results in loss of life or a disagreement over treatment modalities, if the physician is charged with a 3rd incident of malpractice, he/she will be barred from practice in the state.

Sounds good? Certain specialties are very high risk, neuro-surgery, trauma and ob/gyns for instance. In all areas, but especially the high risk areas of medicine, doctors are going to be reluctant to set up practice in a state they are at extreme risk of losing their license for reasons that are at the very basis of their practice.

High-risk medicine means high exposure to this amendment, they will look more favorably to other states to practice medicine. Patients will lose as practitioners choose to go elsewhere, limiting doctor choice and resulting in increased costs for those who remain. Those costs will be passed on to the patient who's cost of medicine will escalate even more.

The Florida Board of Medicine Disciplinary board is ranked number 1 in the nation for the percentage of licensed physicians disciplined. We already have stringent review and discipline of physicians and this information is available to the public. So why do the lawyers want this?

Remember, John Edwards made his millions suing ob/gyns in North Carolina, there's lots of money to be made for the trial lawyers. Won't this limit their pool of doctors to litigate against as the bad ones leave?

This, in my estimation, is a reaction to Amendment 3. If lawyers’ income per incident is limited by law and made more reasonable by layman’s standards, they are going to want to create a loophole for recouping that perceived loss of income. This goes hand in hand with Amendment 7, which is designed to increase public distrust of and anger towards the medical profession, increasing the potential pool for trial lawyers to litigate.

The FMA asserts that doctors, to try and avoid the malpractice strikes and loss of license, will be even more accepting of legal settlements, avoiding court litigation and the potential of an adverse ruling. A settlement would not only protect the doctor's license to practice in the state by avoiding a malpractice conviction, it would make for quick litigation on the part of the trial lawyers who would begin churning out even more frivolous suits, knowing most will be settled instead of litigated.

Because of the increase in settlements, liability insurance costs will increase for medical practices, costs that will be passed on to and borne by the public. There will be little if any reduction in the numbers of "bad" physicians in the state, our Discipline Board currently takes care of that, the trial attorneys get access to quick, easy settlements with physicians who are more willing to do so and the public will pay the bill. The winners, the trial lawyers. Vote "No"

Summary:
If Amend 3 passes and 7 and 8 fail the public will win.

If Amend 3 passes and 7 and 8 passes, the trial lawyers will get a break-even and the public loses.

If Amend 3 fails and 7 and 8 passes, the trial lawyers will get a bonanza and the public will end up paying more and more for medicine while gaining nothing in the way of protections.

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