Medical malpractice study finds high payouts not a huge drain
5/17/2013 COMMENTS (0)
By Terry Baynes
(Reuters) - Large medical malpractice payouts by doctors account for only a fraction of the nation’s healthcare expenditures, according to a recent study by a group of researchers at the Johns Hopkins University School of Medicine.
Using the National Practitioner Data Bank, a government database that lists all paid medical malpractice claims, the Hopkins’ researchers looked at all awards over $1 million, so-called “catastrophic” payouts by U.S. doctors, between 2004 and 2010.
Their findings, published in the Journal for Healthcare Quality, showed that catastrophic payouts tended to attract the most attention from the public, media and tort reform advocates, but that they accounted for an insignificant percentage of healthcare expenditures. The high payouts added up to roughly $1.4 billion a year, or .05 percent of U.S. healthcare expenditures, the study found.
“The real problem is that far too many tests and procedures are being performed in the name of defensive medicine, as physicians fear they could be sued if they don’t order them,” said Marty Makary, one of the researchers on the study and an associate professor of surgery and health policy at Johns Hopkins. Makary said that the costs of unnecessary services can run upwards of $60 billion a year.
Instead of trying to impose medical malpractice caps, which have only a “minimal impact” on overall healthcare expenditures, tort reform efforts should focus on defining the so-called “standard of care” that doctors are measured against in medical malpractice cases, Makary said. That standard should focus less on what is the practice of the average doctor and rather on what is reasonable.
‘VERY VAGUE’ STANDARD
Christopher Robinette, a tort law professor at Widener Law School, said the legal standard of care in medical malpractice cases is “very vague” about whether a doctor acted reasonably.
“It leaves a lot of room for interpretation, so doctors may feel driven to engage in tests that may not be required,” he said. The uncertainty can also lead to drawn-out legal battles, with the average medical malpractice case lasting from four to six years.
Tort reform efforts generally have not focused on the doctor’s standard of care, said Robinette. Some states, such as Georgia, have passed legislation requiring plaintiffs in malpractice cases against emergency room physicians to prove by “clear and convincing evidence” that the doctor was grossly negligent.
In addition to the cost findings, the study also reported that many of the high payouts involved injuries to infants and newborns. The odds of a large award also increase if a patient suffers quadriplegia, brain damage or needs lifelong care, or when the claim results from a problem with anesthesia, the researchers found.
A physicians’ number of years in practice did not affect the likelihood of a catastrophic payment, the study found. It wasn’t the new or the senior doctors but rather the ones in between who tended to see the most patients that had the most high payouts, said Makary.
The finding that liability was not tied to length of experience could be fodder for tort reform proponents, said Robinette, as evidence that the system may be more random than rational.