Malpractice suits: What you think you know
Massive judgments in medical-malpractice cases are soaring, leading to a shortage of physicians and creating a need for "tort reform" in which damages are capped. Right?
Not so much, says Maggie Mahar, referring to a study in the New England Journal of Medicine. Among its findings, Mahar says:
- Only about 2 percent of injured patients sue, even though such injuries may be resulting in up to 98,000 deaths annually.
- A very small fraction of doctors accounts for a great deal of malpractice medical payouts.
Mahar also refers to some other sources to suggest that if there's a crisis in medical-malpractice lawsuits, it's not what we think it is. She suggests that the medical malpractice "crisis" is being played up so it can be used as a sort of stalking horse for people who want to eliminate all personal-injury lawsuits.
Comments (4)
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Lex maybe you could explain why 2 doctors I know have never had a lawsuit, yet their malpractice insurance has soared to over $300,000 a year. They have both quit surgery.
Posted on May 22, 2008 9:55 AM
I don't buy for a second that the medical-malpractice issue is a political scheme by business interests to eliminate lawsuits. However, neither do I agree with business interests that awards must be capped.
When I worked for the AMA in the late '80s and studied "medical liability" (as we were asked to call it), it became clear to me that many claims on both sides were off the mark. For example, it sounds reasonable that the threat of litigation leads to "defensive medicine," but the data have never quite borne that out. Steeply rising malpractice premiums are a big problem, but there's never been much evidence that insurers are gouging doctors. Insurance profits aren't excessive when put in context and compared to such benchmarks as industry capitalization.
The basic fact of medical liability is that we've evolved a legal system that tries to have it both ways. We want to punish doctors who make errors, but we also want to compensate those who are hurt. The problem is that a system that focuses on the former isn't optimal for the latter, and vice versa.
If we cared solely about compensating victims of medical accidents, we'd have no-fault insurance along the lines seen in some states for auto torts. On the other hand, if we cared solely about assigning blame and identifying lower-quality physicians, not all victims would be compensated because not all medical accidents are someone's fault. Our system puts neither objective first, effectively trying to put them both first. And so we have a mish-mash in which blame is sometimes assigned in order to ensure compensation. Even though relatively few injured patients sue, the financial implications are serious.
When I worked at the AMA, the docs blamed the lawyers, the lawyers blamed the docs, and everyone blamed the insurers. But the blame game missed the biggest problem: the confused orientation of medical tort law, which won't be solved with bandaids like caps on certain kinds of awards.
Posted on May 22, 2008 10:49 AM
I cannot explain that, Doug. Any chance you could put me in touch with them?
Posted on May 22, 2008 11:04 AM
Andrew, any idea what a more optimal system might look like? Thanks.
Posted on May 22, 2008 11:09 AM