Can a rise in malpractice rates adversely affect patient safety?
“The way medicine is structured, your income really depends on how many operations you do,” said Dr. Roger Hardl, a neurosurgeon at New York Presbyterian Hospital. “That means that you are put into a position where you have to operate more. I’m not sure that’s in the best interests of the public. I’m not sure that’s in the best interests of practicing good medicine.”Hardl blames the problem on the lack of a cap for medical malpractice lawsuits in New York state.
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How much longer until physicians blame global warming on the inability to screw the injured?
Special legal privileges for providers is always the answer!
The current tort system is only affordable because it is underutilized by the public. Even very modest increased in the rates of seeking litigation in suspected malpractice can result in rapid escalation of unsustainable costs.
As an example, take something like Schizophrenia, which has a 20% lifetiime rate of suicide. If a suicide occurs while someone is in treatement, to a growing number of people, that presents a strong suspicion of liability by the physician. The way the current system offers to dispel that is a lawsuit. If the cost of defending unmerited suits is about $30,000 (a common figure), that would work out to $6000 per schizophrenic treated in average malpractice defense cost solely for the defense cost of the unmerited cases for this one tort alone. About 20% or malpractice claims are lost by physicians. If the system was more effective in offering a shot at justice for everyone, with the current parameters and a payout of 1,000,000 for each life lost deemed due to malpractice, the cost then comes to 1,000,000 X 20% X 20% or 40,000 per patient for the payouts for malpractice for that one particular adverse event. $46,0000 per patient for the defense and compensation costs for that one adverse risk.
Before you defend the status quo, think about how capricious it towards patients, rewarding not the injured but only that small subset of injured embittered and persistent enought to endure a prolonged and painful tort system. The current no-limit tort system is a jackpot for the few which does nothing for most of the medically injured and little to nothing to improve quality because it is to sporadic in application for the latter. If it were less sporadic, if it were applied systemically in achieving a higher penetrance of examination of adverse outcomes for malpractice-enough to really improve quality–then medical care would be completely unavoidable.
We will ultimately have to decide whether it is more important to have the righty to sue for unlimited damages where care goes wrong, or to have access to care that we can afford. That is not a defense of anyones “right” to screw the injured. There is a vast descrepancy between what we want to and can pay for medical care and what we think a loss or impairment is worth when it goes wrong.
The chances that the explosive, dyspeptic Governor Spitzer can reform this crisis are zero to none. The reason is that the NY State Assembly is headed by one Sheldon Silver (D, Manhattan).
Mr. Silver is reported to earn a seven figure yearly income as a partner in a notorious gigantic liability law firm. It has proven completely impossible to get even the most minimal reform past this gatekeeper. Actually, Mr. Silver is forever ramming legislation through the Assembly EXPANDING physician liability (it dies in the Republican Senate).
” The way the current system offers to dispel that is a lawsuit. If the cost of defending unmerited suits is about $30,000 (a common figure), that would work out to $6000 per schizophrenic treated in average malpractice defense cost solely for the defense cost of the unmerited cases for this one tort alone. “
Ahh, but you forget there are several filters before that $30,000 can even be started – namely, the attorneys and the necessity of finding an expert. Further, once a particular type of claim is determined not to be actionable by an appellate court, you’ve kicked all those cases out.
As for the capriciousness, you seem to be saying it’s capricious because not everyone uses it, which implies that there are more people that should. That defeats your argument for it being cheaper.
As to there being “no limit”, why should there be any limit other than the jury, and of course the judge on remittur, and the appellate court? If you want to track adverse outcomes and work on quality improvement, you need not “reform” the legal system by making it harder for those who do wish to file suit to recover, you need only track these events within the medical system and improve your quality.
“We will ultimately have to decide whether it is more important to have the righty to sue for unlimited damages where care goes wrong, or to have access to care that we can afford.”
No, we really won’t. At most, malpractice costs, at least the ones that are measurable, are less than 2% of the total cost of healthcare, and at least a portion of those payments go right back into the system, or back to the health insurers in the form of subrogation.
I’m not sure how you figured $1,000,000 per claimant, when the average verdict now is less than 1/2 that. And that’s verdict, not actual payout. As for a “jackpot”, given that much of the money in a million dollar malpractice claim will go back to the providers for past and future care, or reimburse a health insurer, and much of the rest of the balance will make up for income the plaintiff would have earned anyway, and the rest in such cases is usually for a pretty catastrophic injury, I think it’s safe to say that such a medical malpractice award may be one of the few “jackpots” no one wants.
A far more important, and more relevant debate when it comes to care, is how care will be funded and to what extent should we all have access to care near the end of our lives. In terms of determining affordability, those issues tower over any malpractice debates.
“Actually, Mr. Silver is forever ramming legislation through the Assembly EXPANDING physician liability (it dies in the Republican Senate).”
What legislation is that?
Only a tiny fraction of frank malpractice results in a lawsuit, much less a claim. If every actual victim sought redress in the current system, malpractice costs would be ten to a hundred times what they are now.
The current system is only affordable because very few of those who could do so actually use it.
“Only a tiny fraction of frank malpractice results in a lawsuit, much less a claim. If every actual victim sought redress in the current system, malpractice costs would be ten to a hundred times what they are now.”
Please do give any data to support thisstatement. Otherwise it is just your opinion.
And yet every other country in the world with a no-fault system pays far, far less money in malpractice costs. So either the lawyers are claiming US physicians are uniquely incompetent or … shockingly … the lottery system by jury is a stupid way of dealing with medical injuries.
Where is the source for your “every country in the world” claim?
Do you think that IF other countries pay less for malpractice, it might have something to do with the fact that they don’t reimburse for past and future medical care because they have universal coverage? Are you advocating universal coverage to reduce malpractice costs?
A little critical thinking goes a long way. Try it.
Past and future medical care is an economic damage unrelated to the controversial non-economic damages that would be capped in tort reform proposals.
That’s true. However, it doesn’t negate the point that IF other countries pay less, it’s largely due to the fact that they don’t reimburse for medical care. Thta’s the bulk of most damages in personal injury cases.
Here’s a question surely a “reformer” can answer – if there was a cap in every case that resulted in a PAYOUT of in excess of $250,000 in pain and suffering damages, how much money would be saved, on average, per year over the last 20?
I am still waiting for legal malpractice to catch up. That way you can sue your lawyer when you dont win a case or you don’t win enough or you just want to sue.
If attorneys don’t want to reform, then lets have them play by their own rules.
These posts do not address the fact that I am now going to have to pay 14 percent more for my insurance, and I have never been sued or accused of malpractice.
In addition, the article linked to quotes NYS Insurance Dept as saying it was necessary b/c of liability costs.
So either they are lying, or ther eis a crisis. Either way I as a doctor get screwed. The cost of everything to run a medical office keeps going up ,and our reimbursement stays the same or goes down. Does anyone have an answer for that (besides the odious universal health care?)
Who is your insurer? What is their reserve and does it appear to be in line with their claims’ payouts? Also, are they insuring people with multiple payouts in the same pool as you? What is their return on their investment over the last 1, 3, 5, 10 years? It’s not like they’re going to tell you that their own screwups have caused them to have to raise rates. Also, are their increases in line with medical inflation?
And no, no one has a solution other than universal healthcare.
“I am still waiting for legal malpractice to catch up. That way you can sue your lawyer when you dont win a case or you don’t win enough or you just want to sue. “
You can. In fact it’s easier than suing a doc in many states because you don’t need the “certificate of merit.”
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