Analysis of an Artifact

Medical Malpractice Reform

The Malpractice Methodology article is an editorial from the New York Times written by Peter

Orszag. The article addresses the lack of attention and need for reform of medical malpractice

laws. Malpractice comes into play when a practicing licensed medical professional deviates

from accepted standards of practice in the medical community that may cause injury or death to

the patient. Through the use of evidence-based guidelines, doctors would decrease or shield from

malpractice liability. That means all doctors would be required to follow the same procedures but

ensure quicker results and fewer tests while protecting their integrity and maintaining patient

safety. The article also focuses on the possibility of financial incentives for delivery of higher-

quality care. Narrative theory will be used to show how the author attempted to prove the need

to reform malpractice laws through the use of an editorial.

Narrative Reasoning

Internal Coherence of the artifact shows narrative probability based on the following elements.

The structural coherence is easily comprehendible due to the organization of the information. It

follows a basic plot scheme by presenting the problem and offering a solution. The

author/narrator offers a helping hand by addressing particular areas that should be investigated

for change. The only incompatibility noted within the plot, is it does not provide patients

perspective about the issue.

Cause and effect relationships are clearly stated by pointing out problems with the current set of

laws if a malpractice situation arises and how reforming the laws would then prevent allegations

from being raised without justifiable cause. The facts presented in the story are used as a

foundation for the author to build upon. They are clearly defined with in the context and allows

for proper flow throughout the document. The characters in the narrative do not play as big of

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role as the plot of the story. They help to support the claims made by the author and remain

consistent with the opinions expressed. No changes occur amongst the characters.

The external correspondence holds strong traits to provide a well built foundation of narrative

fidelity. The entire context of the document is organized and delivered to the intended audience.

All of the information included directly affects the audience creating direct awareness of the

issue discussed. The facts are relevant to the audience’s view of the issue considering the

audience is the medical community. If the outcome of the situation were to favor reforming the

malpractice laws it would bring satisfaction to the audience. According to the values or motives

of the author and the medical community, the issue presents an ideal basis for human action.

Medical practitioners view the reforming of the malpractice laws as a long overdue issue that

demands attention as well as a solution.

Elements of Analysis

In this section I will be analyzing the elements that make up the narrative. These include

characters, setting, plot, theme, and the narrative voice, tone, and style.

The first paragraph sets the scene by introducing the subject and the plot. The subject, or topic, is

the issue of malpractice laws. The plot focuses on the lack of attention to malpractice laws and

blames lawmakers for the discrepancy for not seeing the need. As the narrative progresses, the

characters are introduced, the audience is revealed, and the facts are presented.

Characters

Congress is the first character to be introduced. In understanding that congress refers to a group

of lawmakers, I will use ‘they’ to refer them. They are briefly mentioned in the first paragraph

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and while credit is given concerning the health care reform, blame is assigned for not addressing

the malpractice laws. Congress is therefore labeled as a flat character. A flat character is a minor

character and undergoes little change.

The author uses a small piece of President Obama’s speech delivered in June 2009 to the

American Medical Association as the introduction of this character. He is portrayed as a

protagonist character and used to raise awareness and bring attention to the need for reform of

malpractice laws. President Obama’s character is viewed as a protagonist due to the fact that he

appears to be in support of the reform; therefore, in the author’s eyes, Obama’s speech sheds

light on the issue. A secondary label can also be added to the protagonist title: a hero or as a wise

man. This reasoning is because Obama is the Chief Executive of the United States and his

opinion matters. By introducing such an influential character at the beginning of the narrative,

the audience gets the impression that this is an important issue and deserves attention. This

strategy can possess positive qualities on the topic to persuade the audience to support the

reform.

Doctors represent the main character but they also make up most of the audience. This provides a

compelling narrative, it allows for a very persuasive argument. The doctors encounter a conflict

that appears to be an overwhelming issue within the medical field and could possibly be changed

by the outcome; the doctors represent round characters.

Professor James Blumstein would be considered an antagonist. He provides facts that point to a

solution already set in place but notes that organizations have not yet set standards. Professor

Blumstein does not state whether or not he supports the proposition to reform malpractice laws

he simply points to an already developed option. The reason I determined him to be an

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antagonist is because of the factual claim he makes. It leads the audience into rethinking whether

or not there is a need for reform.

Patients are discussed throughout the editorial but not specifically addressed. Due to the lack of

attention it makes it difficult to assign the type of character the patients may be. The artifact

takes the stand for practicing medical professionals, but overall the reforming of the laws affects

the patients. Therefore they have an impact on the main character (doctors), but do not assist

them. Based on that analysis, the patients will be classified as a protagonist, but not defined as a

hero, rather as one of us; they serve to strictly inform the audience of their presence.

The last character to be introduced is the one telling the story; the narrator. At no time does he

formally introduce himself within the narrative, but his name appears as the author. For analysis

of his character, his name will remain anonymous. This character is classified as a protagonist

and a hero and creates the action in the story. He sets the stage for the story by quickly pointing

to the wrongdoers (congress). He then discovers a wise man (Obama) and interprets that Obama

supports his ambitions. This is viewed as the golden key to making progress in his mission. As

his journey continues he comes across more people that support his cause. By the end of the

story, the narrator has gathered enough people in attempt to change the world (reform medical

malpractice laws).

Setting

The setting occurs within the public sphere set in present day. The public sphere reaches out to

anyone that is listening. Because the setting is occurring now it has a deeper meaning to those

involved. It is history in the making. The issue discussed addresses concerns that impact

practicing physicians in the current setting. However, being that setting is only limited by the

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imagination I could picture a speaker at an American Medical Association meeting presenting

this information in order to persuade more professionals that there is a need to reform.

Plot

The plot begins with presenting the problem up front. It then continues by providing a brief

background and adds a few pain staking comments to assist in the persuasion process. It then

confronts the crucial turning point: how doctors might be persuaded to adopt evidence more

quickly. From this point persuasive facts and opinions are presented to the audience to show that

there is a need for reform and why. This would be considered the middle of the plot.

The end of the plot relies on the audience identifying the underlying assumption. It implies that

by addressing the relevance of the issue, that action will soon follow. The overall message is that

reforming the laws will be improving standard medical practices. That statement applies to any

individuals involved with medical care, including patients. By stating an element that appeals to

everyone, it makes it hard for the audience to disagree with the evidence. It therefore leads the

audience to the recognition of a permanent change.

Theme

The theme strongly suggests that there is a need to reform malpractice laws. This could also be

considered as the message. The author focuses on the discrepancies with the current laws and

how they are not entirely set up in favor of medical professionals. By tweaking the laws just a bit

to fit more to the cautions of the occupation rather than stating what is perceived to be the best

for both parties (doctors, patients). The theme is compassionate about the issue presented and

does not provide evidence of what the opponents position is concerning the situation.

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The theme portrays a classic narrative story of conflict and struggle. A group of individuals

failed in some aspects at a mission they set out to do (congress) becoming the bad guys in the

story. The hero emerges shedding light on the problem and chooses to take a journey to resolve

the issue. There are people that he encounters that help to strengthen the hero’s aspirations and

offers motivation to push forward. The ultimate goal is not reached but enough support is

gathered to attempt to change the world (medical malpractice laws).The purpose of the hero’s

journey was to bring awareness to the issue while providing unique relationships amongst the

characters.

Narrative Voice, Tone, and Style

As explained above, the narrator took the role of a character but remains absent in each scene.

This allows the tone to be supportive, positive, and possessing a persuasive attitude. The attitude

expressed throughout the artifact is constant with the narrative that is presented. At no time

during the story does the narrator doubt his thoughts or concerns. He caters to the other

characters needs by maintaining a deep understanding of their internal struggle. He sympathizes

with the need to reform the malpractice laws and provides factual evidence and key witnesses

(doctors) to back up his claim.

The narrator develops the proper ethos for the story. He displays competence with the subject

matter and sympathizes with the other characters. This sympathy can be described as respect for

both the topic and characters. The narrator never addresses himself and uses words such as ‘we’

or ‘you’, this concludes the narrative style used is in second person. The style remains consistent

throughout the narrative.

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Conclusion

Using narrative theory to analyze this artifact proved to be the proper approach. The fact that the

editorial is set up as a narrative helped me to decide which rhetorical theory to use. The

document was broke down into bits and pieces allowing for a deeper understanding of rhetorical

analysis. The story included six characters that assisted throughout the narrative. The

organization and tone of the document supplied the audience with confidence in the speaker and

the subject matter. The topic directly related to the audience which provided compassion toward

the narrator and the story. The purpose of the editorial is to persuade action be taken and at the

very least awareness raised. It was verified that using narrative theory to analyze the editorial

was the best choice.