Briefing Book: Medical Malpractice by the Numbers is a yearly compilation by the Center for Justice and Democracy of all recently published statistics and research related to Medical Malpractice in the US. The Briefing book cover Medical Malpractice Litigation, Health Care Costs and “Defensive Medicine” , Tort Reform, Medical Malpractice Insurance, Patient Safety and a special chapter related to Army Medicine.
Medical Malpractice Litigation
Recent studies added to the briefing book confirm that a very low percentage of individuals are filing claims or lawsuits when medical malpractice is being committed against them or a family member. A 2014 analysis of National Practitioner Data Bank(NPDB) by Public Citizen indicates that between 93 and 98 percent of deaths from medical negligence did not result in any liability payment. Compared to 2001, the year in which the most medical malpractice payments were made, the number and size of medical malpractice claims, lawsuits and payments stayed at an historical low in recent years. Most of the compensation theses days is made for serious personal injury or wrongful death and high verdicts are almost always reduced.
Tort reform such as damage caps that artificially reduce plaintiffs’ damage awards also reduce attorney’s fees and as a result many legitimate cases are being refused by attorneys because they don’t make economic sense for personal injury law firms to accept them (“Uncovering the Silent Victims of the American Medical Liability System,” Emory University Associate Law Professor Joanna Shepherd, 2014.) Additionally, according to a recent study entitled “The Impact of Tort Reform and Quality Improvements on Medical Liability Claims: A Tale of 2 States” published in 2015 by the Orthopedic Surgery Division of the Southern Illinois University Medical School and led by the Orthopedic Surgery Division Chief Khaled J. Saleh, M.D., with or without tort reform, the best way to reduce medical malpractice is quality of care which seems to be pretty obvious.
In 2014 several analysis also pointed fingers at the state medical boards and the federal government for not holding accountable incompetent physicians. In New York 77% of doctors sanctioned for negligence continued to practice and most of their patients don’t even know it. Medicare is turning a blind eye on incompetent doctors approving payments to physicians who’d been disciplined for gross malpractice, battery and violating prescription drug laws and some practitioners who had their state license removed just went to practice in another state according to federal records. Another worrisome fact that was highlighted by USA Today in April 2014 is rampant drug addiction among the medical staff and the fact that there are very few safeguards such as regular drug tests in healthcare facilities to prevent this issue.
Health Care Costs and Defensive Medicine
Recent studies show that tort reform doesn’t have much impact on reducing health care costs and that the reason why a doctor is ordering additional tests or procedures is not so much to protect himself from a lawsuit but more to increase his workload and revenue.
Physician Supply and Access to Health Care
A recent study that compared physician supply in States that adopted caps compared to States with no caps show “no evidence that cap adoption predicts an increase in total patient care physicians, in specialties that face high med mal risk (except plastic surgeons), or in rural physicians.” Another study that provides an in depth analysis of the effect of Tort Reform in Texas on physician supply substantially undermines the empirical case for the conventional wisdom that Texas’s 2003 reforms against medical malpractice lawsuits attracted more doctors to Texas.
Medical Malpractice Insurance
Since the last 12 years medical malpractice insurers have seen their business booming. Payments made to victims of medical malpractice are down, lawsuits filed against doctors and hospitals continue to plummet, and the industry in 2014 posted an underwriting profit for the ninth straight year. As a result premiums are also declining irrespective of whether tort reform has been enacted in any particular state.
A flurry of new articles and studies published this year indicates that patient safety is worsening. Deadly infections, often a sign of poor in-patient care, are invading hospitals increasing medicare costs drastically. In 2013, the second-greatest hospital Medicare expense, “$5.6 billion, went for 398,004 cases of septicemia, or blood poisoning. Low volume hospitals continue to have a higher risk of medical malpractice and operating rooms continue to be a scary place with every year an average of 500 patients being operated on a wrong body part and 5000 surgical items unintentionally left in patient’s bodies. An article published in the New York Times at the beginning of the year also indicates that hospital boards are much more preoccupied by financial performance than quality of care and that most of them are unable to accurately assess their institution’s quality. When asked, more than half of hospitals with low quality thought they were
actually above average.
The Briefing Book also highlights some particularly unsafe aspects of healthcare such as:
- higher rate of medical malpractice in hospitals during the weekend
- high frequency of deadly misdiagnosis in Intensive Care Units
- frequent negligent adverse events in emergency rooms
- high rate of misdiagnosis in skilled nursing units as well as in clinics and doctors’offices such as office based surgery practices
- high rate of medical malpractice in hospice care with patients left to die without much care or attention.
Studies and articles published this year continue to indicate that hospitals are actually increasing their profit by providing unsafe medical care and that a lot of them do not report major medical errors which is making the situation worse.
In a study published this year entitled “The Deterrent Effect of Tort Law: Evidence from Medical Malpractice Reform,” Professor Bernard S. Black from Northwestern University Law School and Kellogg School of Management and P.h.D. Candidate Zenon Zabinski from Northwestern University Department of Economics confirm that litigation is the best way to improve patient safety while tort reform worsens it.
Special Problems for Vets and Military Families
Recent VA reports have confirmed severe dysfunctions or mistreatment of veterans at VA facilities and an in-depth investigation by Sharon LaFraniere from the New York Times reveals a system where service members have a very high risk of being exposed to medical malpractice and can’t be treated elsewhere without specific approval. If something goes wrong they are unable to sue and get compensation.