Malpractice lawsuit awards are at an all-time low, according to an analysis from the consumer watchdog group Public Citizen.
But the news isn’t all good. Despite the fact that malpractice awards fell 28.8% between 2003 and 2012, the drop in payments isn’t translating into a decline in overall health care costs or improvements in safety, according to Public Citizen.
"We now have a decade’s worth of data debunking the litigation canard," said Taylor Lincoln, research director for Public Citizen’s Congress Watch division and the report’s author. "Policy makers need to focus on reducing medical errors, not reducing accountability for medical errors."
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State laws that impose caps on the amount of noneconomic damages that patients can receive may have contributed to a drop in malpractice awards.
Examining data from the National Practitioner Data Bank, Public Citizen found that in 2012, both the number of awards (9,379) and the amount of those payouts ($3.1 billion) was the lowest on record, once adjusted for inflation. In 2012, the average payment was about $335,000.
The big driver for the drop in malpractice awards is likely state laws that have imposed caps on the amount of noneconomic damages that patients can receive, according to Public Citizen.
The decline in litigation awards appears to be good news for doctors, who overall experienced a decrease in medical liability insurance premiums during the same period. Physician premiums fell to 0.36% of health care costs, the lowest amount in a decade, the report said.
But consumers are losing out, Public Citizen argued, because health care costs are up 58.3% over the last decade. And reports continue to be published showing high rates of adverse events in U.S. hospitals.
Public Citizen cited a 2010 report from the inspector general of the federal Department of Health and Human Services that found that one in seven hospitalized Medicare beneficiaries experienced a serious adverse event, which contributed to death in 1.5% of patients.
But Texas Medical Association President Stephen L. Brotherton countered that medical liability reform actually creates a safer health care environment by improving access to care.
Texas voters approved comprehensive medical liability reform in 2003, including a cap on noneconomic damages. Before that law was enacted, the state had been losing physicians who couldn’t afford their rising malpractice premiums or feared the personal and professional upheaval of a lawsuit, said Dr. Brotherton, an orthopedic surgeon in Fort Worth.
"We were losing people in the prime of their practice," Dr. Brotherton explained.
Many Texas counties had no access to high-risk specialty care, including ob.gyns and neurosurgeons, he noted. And hospitals were having difficulty finding physicians willing to take call in the emergency department. As a result, patients in rural areas couldn’t get access to high-risk specialty care, and some physicians were increasing the volume in their practice to unsafe levels to meet financial pressures from rising insurance premiums, Dr. Brotherton said.
A decade after medical liability reform was passed, physicians are returning to Texas, according to the TMA. Since Texas voters passed Proposition 12 in 2003, Texas has licensed more than 28,000 new physicians, an average of about 3,135 per year. And many of these new doctors are filling the gaps in high-risk areas such as obstetrics, Dr. Brotherton said. Since 2003, 35 rural counties have added at least one obstetrician, including 16 counties that previously had no obstetricians.
There’s no evidence that having an active plaintiff’s bar in a state promotes safer medicine, Dr. Brotherton asserted. "Good doctors are going to where they are wanted," he said.
Dr. Brotherton didn’t dispute the Public Citizen charge that medical liability reform has not brought down health care costs. There are many factors driving rising health care costs, he said, from lifestyle and diet to medication compliance. But reducing overall health care costs was never an argument in favor of reforming the tort system, at least not in Texas, he said.
"No tort reform in the world is going to reduce the number of diabetics," Dr. Brotherton noted.
mschneider@frontlinemedcom.com
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