Archives: June 2018

June 2018 Newsletter

Liability reform empowers physicians to avoid defensive medicine While evidence strongly suggests that the potential for liability lawsuits results in treatments and tests that may not be otherwise necessary, new data shows that medical liability reform may be empowering physicians to go on the offensive together with their patients. A newly published analysis compared diagnosis and treatment patterns in patients suspected of having coronary artery disease between states where liability reforms have been adopted and states without non-economic damage limits in place. The study included 36,647 physicians in nine states with reasonable limits adopted between 2003 and 2005, and 39,154 in states that had not taken any action to utilize limits on non-economic damages to rein in lawsuits. Physicians in states with reasonable liability limits were less prone to rely on angiography as a first diagnostic test and more likely to order noninvasive stress testing, the report found. In addition, fewer patients were referred for angiography following initial stress testing. These physicians also performed fewer percutaneous coronary intervention (PCI) procedures after ischemic evaluation, with indications that these patients were offered medical therapy as an alternative. “Our study suggests that physicians who face lower malpractice risk may be less concerned with…

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Op-ed urges Arkansans to make informed choices on liability ballot measure

In 1987 I had a baby girl in Houston, Texas. She was born a month early, and despite complications, she was delivered at a little over five pounds. We were lucky at that time because we lived in Houston, home of one of the greatest medical centers in the world. But Texas had a problem. Texas had a doctor shortage, especially in high-risk services such as labor and delivery, neurosurgery and trauma. More than 150 counties had no local obstetrics care, and services were sometimes more than 100 miles away. Physicians were leaving Texas for states that were less litigious or they were quitting medical practice altogether. By 2003 the exodus of doctors was such a crisis the state of Texas initiated, and passed, tort reform to rein in the cost of practicing medicine. The landmark reforms created an almost immediate turnaround, starting with pediatric subspecialties increasing 300 percent in the following 10 years. Emergency doctors in rural areas increased 64 percent, more than 10 times the growth in those areas. Thirty-five rural counties added at least one OB-GYN, almost half of which never had one. You can find similar stories in more than 30 states that have implemented tort…

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Pennsylvania physicians could face more medical negligence cases

Pennsylvania doctors could be held liable for harm even in cases where the patient suffered a known complication if the state’s Supreme Court doesn’t overturn a lower court ruling. In a case before the Pennsylvania Supreme Court, Mitchell v. Shikora, justices will determine whether trial judges can suppress expert witness testimony on the known complications of a medical procedure. If the state’s high court allows trial judges to bar that testimony, the state’s legal landscape would change and become even less favorable to physicians who already face unlimited noneconomic damages and other legal hurdles, the Litigation Center of the American Medical Association and State Medical Societies, the Pennsylvania Medical Society and other state physician organizations said in an amicus brief filed with the Pennsylvania Supreme Court. “The upshot will be that any patient can sue a surgeon or physician for any complication or unavoidable risk and a patient will be able to recover against a physician in the absence of negligence where the complication that occurred could not have been avoided even with the utmost care,” the brief states. The case stems from a laparoscopic hysterectomy where the patient’s bowel was perforated. The patient, Lanette Mitchell, sued obstetrician-gynecologist Evan Shikora, DO, for medical…

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Malpractice Award Caps May Alter CAD Testing, Management

Physicians in states that limit the amount juries can award for noneconomic damage in medical malpractice suits conduct fewer invasive tests for suspected coronary artery disease (CAD) and referred fewer patients for revascularization than their counterparts in states with no caps on medical liability. Results of a study led by Steven A. Farmer, MD, from the Center for Healthcare Innovation and Policy Research at George Washington University, Washington, DC, show that physicians in nine “new-cap” states substantially changed their approach to CAD testing and management compared with physicians in 20 states with no caps. “To our knowledge, ours is the first paper to show changes in clinical behavior following up cap adoption in the particular setting of CAD testing and treatment,” the authors write. “Our study suggests that physicians who face lower malpractice risk may be less concerned with that risk, and thus more receptive to new care delivery strategies associated with alternate payment models,” they conclude. The difference-in-differences study, conducted jointly by researchers at George Washington and Northwestern universities, was published online June 6 in JAMA Cardiology. Defensive Medicine Physicians often report practicing “defensive” medicine to reduce malpractice risk, including performing expensive but marginally beneficial tests and procedures, the researchers write. Many…

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