Category Archives: National

A Missed Opportunity for the Malpractice System to Improve Health Care

SOURCE: The New York Times The American medical malpractice system is doing almost nothing to improve the quality of health care, research suggests. What may be more concerning is that there is very little discussion, much less action, on reform. Despite worries among doctors that they are at financial risk from large payouts to plaintiffs, it turns out that a small percentage are responsible for a huge number of claims. A new study, confirming earlier research, found that about 2 percent of doctors accounted for about 39 percent of all claims in the United States. The study contained other valuable information about a system that not only compensates patients who have been harmed, but is also supposed to identify physicians who may be performing poorly and need correction. First, these doctors quit at higher rates than other physicians. This is considered good news by the medical profession. These doctors also tend not to pick up and move somewhere else to start fresh (which many thought they’d do given that licenses and malpractice are regulated at the state level). But the overwhelming majority of doctors who had five or more paid claims kept on going. And they also moved to solo…

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June 2019 Newsletter

Lifting liability limits in New Mexico could take medical system from bad to worse Already ranking two spots from the bottom on access to health care when compared to all U.S. states, New Mexico patients now face another obstacle if personal injury attorneys have their way. Challenges stemming from a rural landscape, an aging population, and low physician pay influencing recruitment already make it difficult for patients to access affordable health care. Making things worse is an attempt to raise reasonable limits on non-economic damages to $2 million for individual physicians and $25 million for medical entities, which includes many small practices. Michael Kaufman, MD, of Taos Medical Group, who has practiced internal medicine in Taos for more than 40 years, expressed what many fellow practitioners were feeling: “If this goes through, we’re out of here.” Dr. Kaufman cited an impossible operating environment for a four-physician, three-nurse practitioner practice due to higher insurance premiums required to remain covered under an increased limit. While the measure was defeated – for now – due to overwhelming opposition by the healthcare community demonstrating their concern for their patients’ access to healthcare, it remains likely to be introduced again in the future. Click here…

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May 2019 Newsletter

Minnesota liability ruling trends towards dangerous precedent for patients Setting a troubling precedent that could limit collaborative patient care efforts, the Minnesota Supreme Court recently ruled in favor of expanding liability and opening the door for an increase in medical lawsuit abuse. In mid-April, the Court issued a ruling case of Warren v. Dinter, reversing precedent and stating that the existence of a physician-patient relationship was not a prerequisite for bringing forth a medical liability lawsuit. The Court declared that legal actions could proceed if the harm suffered by an individual — even if they were not considered a patient of the physician — was a “reasonably foreseeable consequence” of the physician’s actions. Supporting the defendant were the American Medical Association (AMA), Minnesota Medical Association (MMA), and the Minnesota Hospital Association (MHA), on the basis that this new precedent could expose physicians and other health professionals to expanded liability risks in situations that were previously protected, including unbilled consultations, and discourage collaboration. “The overall expansive language in the Court’s opinion does raise concerns,” said Mark Fogg, general counsel of COPIC, MMA’s endorsed medical professional liability insurance provider. “We respectfully believe that it is important that a physician-patient relationship be established…

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April 2019 Newsletter

Risky business: Lawsuit venue shopping harms access to care An overview of Pennsylvania’s recent proposed changes to lawsuit venue filing rules highlights the risk it adds to accessible and affordable care. Following a surge of liability lawsuits in locations that were seen as ruling favorably to plaintiffs, the Pennsylvania Supreme Court issued a rule that required a plaintiff to file the lawsuit in the county where the alleged medical error occurred. When recent discussions on changes to this rule to allow for “venue shopping” were made public, justices agreed to delay any changes until a legislative study could be done on the matter. A public hearing made the position of access to care advocates clear: “…Doctors and hospitals would be reluctant to partner with facilities located in a city where juries tend to favor plaintiffs over defendants, rewarding the former with sizable judgments,” a recent Medscape article reflected. Restrictions on venue shopping have reduced medical lawsuit abuse in the state of Pennsylvania, bringing the state’s medical liability compensation fund to a record surplus. The risks of venue shopping “will need to [be weighed] carefully before deciding whether the venue rule should stand as it is or be altered,” the article…

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Here’s how to bring down the rate of malpractice claims

SOURCE: Pittsburgh Post-Gazette More than a third of all physicians have had at least one malpractice suit filed against them, which helps explain why malpractice insurance can run into the six figures. And now, after decades of relative stability and even declines in premiums, the American Medical Association reports that they have been trending up for many specialties since 2015. These costs are ultimately borne by patients, of course, which means that health care may become even more expensive. The good news is that we have developed a far better understanding in recent years about why malpractice claims arise in the first place — it turns out that they often have more to do with poor communication than bad medicine. And reforms and new approaches are underway that are reducing malpractice claims and improving patient outcomes. Although large jury awards get the most attention, they account for a tiny fraction of cases. An AMA policy report for 2006 through 2015 found that only 7 percent of claims were resolved by a trial verdict, and defendants won 87 percent of those cases; 23 percent of claims were settled before trial. Significantly, a large majority of claims — 68.2 percent — were…

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March 2019 Newsletter

Supreme Court changes could improve Florida’s liability climate The liability climate may be changing for the better in Florida, where access to care advocates are optimistic that new state Supreme Court justices will rule in favor of reform. Recently dubbed as the nation’s second worst “judicial hellhole” by the American Tort Reform Association, prior sitting justices voted in 2014 and 2017 to overturn medical liability legislation passed by the state legislature. With three new justices recently appointed to the court, advocates across the state have reason to be hopeful. State Rep. Tom Leek hopes that comprehensive medical liability reforms, including reasonable limits on non-economic damages, will bring justice to deserving patients and help keep health care costs affordable for the state’s aging population. With medical liability reform, “you provide predictability,” Leek said. “You allow insurance carriers to have a better understanding of what their exposure is and with that they can set premiums that are reasonable.” Leek’s recently introduced legislation is supported by the state business community thanks to the positive impact it would have on health care affordability and reduced medical lawsuit abuse, but still faces a high hurdle of opposition. To read more about the renewed push for…

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February 2019 Newsletter

PA Supreme Court avoids rush to judgement on liability rule changes The Pennsylvania Supreme Court announced it would delay a proposal that could encourage medical lawsuit abuse across the state. At issue is a proposed rule change that would allow lawsuits to be filed outside of the county where the incident in question occurred. The announcement followed a request by the state Senate to study the issue further before any changes are made. The legislature’s Budget and Finance Committee will look at how the location where liability lawsuits are filed impacts access to care, costs, and compensation. Fifteen years ago, lawsuits could be brought forth in any county where the doctor or hospital did business. Philadelphia, which built up a reputation for its litigious environment, became the city of choice for personal injury attorneys “venue shopping” their lawsuit. The Senate’s report is due to the Pennsylvania Supreme Court by Jan. 1, putting a hold on any changes this year. To read more about the proposed changes in Pennsylvania’s liability laws, click here. Costs remain crippling even as liability lawsuits decline While the frequency of medical liability claims show a positive downward trend, the cost of defending a lawsuit and average…

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Medical malpractice claims down, payouts up: Study

SOURCE: Business Insurance The frequency of medical malpractice claims has dropped substantially, but average case management expenses and indemnity payments continue to rise, according to a report. The rate of medical professional liability claims declined 27% from 5.1 cases per 100 physicians to 3.7 cases from 2007 to 2016, according to a report issued on Tuesday by CRICO Strategies called Medical Malpractice in America: A 10-year Assessment with Insights that examines national trends in claims frequency, payment and root causes of preventable harm. The report analyzed events affecting 124,000 patients. “For the roughly one million physicians across the country, this trend signals a dramatic change in their risk of being named in an MPL case,” the report stated. “While no single factor can be aligned with an across-the-board reduction, changes in the tort environment, improved patient safety, and increasing financial risk for plaintiffs’ attorneys likely contributed.” The report highlighted positive trends in the obstetricians/gynecologists specialty, whose physicians historically face higher claim rates than the average of all doctors, with the risk of a claim or lawsuit against these physicians declining 44% to 5.1 cases per 100 physicians, according to the report by the Boston-based company, which is a division of…

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January 2019 Newsletter

Pennsylvania liability rule change could lead to increase in lawsuit abuse A rule that helped stabilize the medical liability market in Pennsylvania faces the threat of repeal, bringing worry that medical lawsuit abuse could return. Implemented in 2002, reforms mandated that medical liability claims could only stand trial in the county where the alleged medical error occurred to avoid “venue shopping” lawsuits to courts that had a history of favoring large verdicts and personal injury attorneys. The Pennsylvania Supreme Court now proposes eliminating that rule, allowing victims to file lawsuits in any county where the defendant does business — even if the incident in question occurred elsewhere. A coalition that includes the Pennsylvania Medical Society (PAMED), the Hospital and Healthsystem Association of Pennsylvania (HAP), and the Pennsylvania Coalition for Civil Justice Reform (PCCJR) cites this rule as the primary reason the system has stabilized to its current point. “If history is any indication, this could have devastating effects on patient care,” said Danae Powers, MD, president of PAMED. “In the years before we restricted venue shopping, medical liability premiums rose so quickly that some physicians couldn’t obtain the insurance they needed to treat patients. Others chose to leave Pennsylvania or…

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New Malpractice Risks in Your EHR

SOURCE: Medscape New Malpractice Risks and Electronic Health Records Malpractice liability risks for physicians, practices, and healthcare organizations (HCOs) continually change, owing to a variety of healthcare and technology issues. From changes in treatment and care strategies to the ability of your electronic health record (EHR) to support new patient service tactics and care responsibilities, you need to be aware of these risks. You also need to manage your EHR use to address potential malpractice-related risks. On the plus side, as more patient care tools are built into EHRs and as more active patient care interventions become part of your patient treatment routine, EHRs may help you manage patients and your clinical activities. However, built-in EHR features that display warnings and advisories can produce a cacophony of visual and auditory noise that can be distracting. Physicians need to be able to control and manage them. EHR-generated advisories that are misleading or inappropriate could disrupt patient service, confuse physicians, and undermine confidence in the EHR. If a malpractice case arises, the plaintiff could see evidence that’s residing within your EHR, and use it against you. For example, EHR drug interaction warnings as well as notifications of incoming secure messages are tracked…

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