Does tort reform harm innovation?

The answer appears to be yes according to an NBER working paper by Galasso and Luo: We find that, on average, laws that limit the liability exposure of healthcare providers are associated with a significant reduction in medical device patenting and that the effect is predominantly driven by innovators located in the states passing the…

Does defensive medicine work?

Dr. Anupam B. Jena, a Harvard professor and colleague of mine at PHE, has an interesting interview at the Cunningham Group.  Dr. Jena discusses his study published in BMJ, which finds that higher resource use by physicians is associated with fewer malpractice claims.  In other words, defensive medicine “works” for physicians even if it may…

Does defensive medicine work?

According to a paper by Jena, Schoemaker, Bhattacharya, and Seabury (2015), the answer is yes. Across specialties, greater average spending by physicians was associated with reduced risk of incurring a malpractice claim. For example, among internists, the probability of experiencing an alleged malpractice incident in the following year ranged from 1.5% (95% confidence interval 1.2%…

Do doctors make mistakes?

The answer, unsurprisingly, is yes.  However, you may be surprised at the frequency with which doctors make mistakes according to a recent article in JAMA. The study reports that more than 2 in 5 patients receives at least one misdiagnosis. In 190 cases, a total of 68 unique diagnoses were missed. Most missed diagnoses were…

Who has the highest malpractice premiums?

Which specialties face the highest malpractice premiums? Premiums are a function of the expected cost to insure a physician against potential malpractice suits. Thus, premiums are higher for specialties that have a higher risk of having a claim filed against them or specialties where the average payout conditional on having a claim is higher. A…

Malpractice Insurance Caps

Many people support malpractice insurance caps.  They believe that malpractice insurance award caps will reduce medical costs in two ways: i) by decreasing malpractice premiums and ii) by decreasing the amount of defensive medicine physicians practice to avoid lawsuits.  An article by Shirley Svorny, however, argues that malpractice awards are bad medicine.  Physicians who are…

Is ‘Loser Pays’ the solution for frivolous Medical Malpractice Lawsuits?

Frivolous lawsuits may increase medical spending in two ways: i) they increase the cost for physicians to practice medicine by raising malpractice insurance premiums, and ii) they increase utilization of unnecessary services when physicians practice ‘defensive medicine’. Creating a ‘loser pays’ tort system may be the best way to stop frivolous lawsuits. Loser-pays in the U.S.…

Does Health Reform Change the Malpractice System

Health Reform (a.k.a. Patient Protection and Affordable Care Act [PPACA]) provides two small provisions that will affect malpractice costs.  Randall Bobvjerg explains: “As enacted, PPACA contained only two, quite limited malpractice provisions.  Section 10607 authorized malpractice demonstrations by states, and section 10608 extended federal malpractice protections to free clinics’ nonmedical personnel. The demonstration authority comes…

Malpractice in China

In the U.S., physicians often fear that if a patient experiences a bad health outcome, the physician will be liable for millions of dollars as part of a malpractice suit.  Although the malpractice system in the U.S. may be far from perfect, most physicians would certainly prefer it over the more informal forms of “malpractice”…