Editore"s Note
Tilting at Windmills

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December 7, 2005
By: Kevin Drum

THE MEDICAL MALPRACTICE MYTH....Here's a book recommendation for you if you're (a) interested in medical malpractice and (b) really interested in medical malpractice. It's The Medical Malpractice Myth, by Tom Baker, and it's a terrific, readable, fact-filled analysis of what we know and don't know about medical malpractice. And it's less than 200 pages long!

Here's a bullet point summary of Baker's case:

  1. There's a lot more genuine medical malpractice than you think. A long string of studies has shown that about 1 out of 100 hospitalized patients are victims of negligent malpractice. These studies were supervised by doctors and used a very strict definition of "negligent."

  2. Most victims never sue. Less than 5% of patients who are victims of negligence file a claim.

  3. Patients who bring weak claims usually do so only because hospitals refuse to disclose information about their quality of care unless they are taken to court. Patients who learn that their care was reasonable usually drop their claims.

  4. What's more, contrary to myth, insurance companies very seldom pay off weak claims even if patients continue to pursue them.

  5. Rising malpractice awards are not responsible for skyrocketing insurance premiums. The insurance cycle is.

  6. In any case, the evidence that fear of malpractice suits produces significant amounts of defensive medicine is pretty thin although a small amount of defensive medicine does exist. Likewise, the evidence that malpractice payouts are driving doctors out of practice is low and mostly restricted to doctors in rural areas which have been losing doctors for decades for financial reasons anyway.

Baker also has a proposed solution, which he calls the Patient Protection and Healthcare Responsibility Act. The four main goals of PPHRA are to reduce the actual amount of malpractice; provide patients with more information up front so they can decide if they are the victims of malpractice; make compensation for medical injuries fairer; and regulate the boom-and-bust insurance cycle that's responsible for the skyrocketing insurance premiums that are so disruptive for doctors.

Yes, this is a very wonky subject. But Baker's approach is both comprehensive and heavily evidence based, relying on peer-reviewed research and exhaustive studies. There are no polemics here, just a concentrated dose of facts and common sense.

Highly recommended for doctors and anyone else interested in cutting through the noise machine that mostly surrounds the medical malpractice debate.

NOTE: An excerpt from the book is here.

Kevin Drum 8:57 PM Permalink | Trackbacks

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