02/09/2009 05:12 am ET Updated Dec 06, 2017

I Am Not A Perp!

"I am not a crook." "I did not have sexual relations with that woman." Whenever someone in authority loudly proclaims their innocence, we believe like Shakespeare, that they "doth protest too much." Well, I am not a perp and you need to believe me.

I, along with almost one million doctors, over 2 million nurses, and almost 3 million allied health personnel resent being treated like perps (perpetrators). We are trying to help. Most of the time, we do help. Occasionally, we make mistakes. Sometimes patients suffer because of our mistakes. Sometimes they suffer even though we did all the right things, but never do we intend harm. We are not PERPS.

The reasoning behind our entire medical malpractice system is simple (and flawed): when a patient suffers an adverse outcome, it is because someone made a mistake. The solution: find the guilty party; punish him, her or it; and that takes care of that.

No, No, and No.


• Most bad medical outcomes are due to lack of perfect answers for medical problems.
• Errors DO occur and some injure patients (many do not).
• Care providers are human and therefore can never be perfect.
• Most decisions by care providers (99+%) are correct but that <1% can still kill patients.
Regulations intended to help and protect patients actually hurt them.

The system we have fails to:

1. Protect the patients;
2. Compensate patients who are injured.
3. Help the providers deliver care;
4. Encourage learning so the providers can improve patient outcomes.

I am not a perp but since you treat me like one, I must behave defensively. That is why we have defensive medicine: doing things to make the medical record look good rather than simply what the patient needs. That is why care providers try to avoid non-compliant or high-risk patients. When (not if) a bad outcome occurs, the care provider will be automatically held accountable; will be guilty until proven innocent...and never proven innocent; and will "pay the price."

If you want providers who are not defensive; if you want systematic protections; if you want financial help when you are injured; if you want continuously improving medical outcomes, you must demand a radical change in the whole medical malpractice system to a No-Fault approach.

Treating Providers like Perps Gets You What you Have Now.
Do You Like It? If not, change to a No-Fault system!