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Hope Looms Large for Liability Reform
While medical liability claims and rates rise and fall, and uncertainty regarding the threat of meritless lawsuits remains on the minds of physicians across the country, a recent Medscape article confirms that hope may be on the horizon for those who continue to push for a solution to the medical liability crisis.
In states where comprehensive reforms have passed the situation is looking up for patients in search of access to quality, affordable care.
According to a report published by the Robert Wood Johnson Foundation, reasonable limits of $250,000 on noneconomic damages have reduced average awards by 20 to 30 percent in states that have passed patient-focused liability reforms, with physicians’ premiums rising 6 to 13 percent more slowly than in states that have not.
While data has been insufficient to determine the full impact of other types of reforms, promising results are being seen in “Sorry” laws and an early offer initiative currently in place through the University of Michigan Health System. With a goal of compensating quickly and fairly when unreasonable medical care causes injury, and defending medically reasonable care, the practice reduces meritless lawsuits and strengthens the doctor-patient relationship.
In addition, Brian Atchinson, CEO of PIAA shared news from the Agency for Healthcare Research and Quality (AHRQ). The agency is responsible for funding three year demonstration projects on patient safety and medical liability reform innovations, preventing harm through best practices, improving communication with patients, and offering alternative methods of dispute resolution. Atchinson said “that the preliminary findings from the demo projects were positive.”
To read more about Medscape’s review of positive developments on the forefront of medical liability reform, click here.
Time in Courtroom Exceeds Time in Classroom for Most Physicians
Time consuming and emotionally draining could describe both medical school and the experience of dealing with a meritless liability lawsuit, but what differentiates the two is that the average physician spends more time engaged in litigation than he or she did in medical school.
Regardless of the outcome (in which physicians overwhelmingly prevail over personal injury attorneys) physicians spend significant time fighting lawsuits. According to an excerpt from a new book, “So Long, Marcus Welby, M.D.: How Today’s Health Care Is Suffocating Independent Physicians—and How Some Changed to Thrive,” the average litigated claim lingered for 25 months, with those that were ultimately dismissed still lasting 20 months. Claims going to trial took approximately 39 months, and doctors who were victorious in court spent an average of 44 months in litigation.
While aspiring health care providers find themselves in the medical school classroom by choice, the same cannot be said for physicians forced to defend themselves against lawsuits without merit, which is increasingly more likely for high-risk specialists.
The likelihood that a physician will be sued is about 5 percent in any given year for those practicing in low-risk specialties, such as psychiatry and pediatrics, with a cumulative career risk of about 75 percent. In high-risk specialties, such as neurosurgery and cardiac surgery, the annual likelihood of being sued increases to about 20 percent and cumulative career risk reaches 99 percent.
The time spent in the courtroom defending a frivolous lawsuit leaves a physician less accessible to patients and passes higher costs through the health care system. To read more about the significant time spent by physicians tied up in medical liability litigation, click here.
Operating Room Black Box Protecting Patients
Canadian physicians have taken steps to improve upon patient safety measures with operating room devices that track surgical operations and prevent avoidable medical errors.
Three microphones and three cameras began recording all of Dr. Teodor Grantcharov’s surgeries at the end of April as part of the black box project. Two of the cameras filmed the operating room, while a third internal camera recorded what was happening inside the patient’s body while the surgeon and his team perform minimally invasive surgeries.
One goal of the pilot project was to promote a culture of safety where physicans and patients can speak freely about adverse outcomes and point out things they believe could be done better.
That information initially gathered was very valuable, Dr. Grantcharov said, and a team is now working on creating educational tools based on the data. “If we know where the errors happen, then we will know what to do to avoid them in the future.”
To read more about the technology being implemented to further improve patient safety and recoveries, click here.
California’s Proposition 46 Implications Brought To Light
The broad implications of California’s Proposition 46, which seeks to quadruple the current cap on medical liability lawsuits to $1.1 million with annual increases going forward, are becoming clearer, as are the effects the initiative will have on patient access to care.
Since the state’s Medical Injury Compensation Reform Act’s (MICRA) inception, legal watchdog groups like Citizens Against Lawsuit Abuse (CALA) contend the act has simultaneously worked to lower the cost of medical liability premiums to keep physicians in the state and curb the number of meritless lawsuits filed, ultimately putting an end to a crisis that embroiled the state in the early 1970s and left patients with few options for critical care.
However, despite the law’s state-wide success, Jon Opelt of the Texas Alliance for Patient Access believes there’s a chance California voters could approve the measure, creating a “legitimate concern” that the passing of Proposition 46 will catch the eyes of personal injury lawyers in other states where limits on non-economic damages remain in place, and lead to a domino effect.
“If proposition 46 passes, it would put pressure on other states to increase their cap,” Opelt said.
“If this thing passes, trial lawyers just got a green light from the eighth largest economic power—they will make a run across the United States to get rid of or inflate caps,” said CALA Executive Director Tom Scott said. “What happens in California doesn’t stay in California.”
Click here to read more about recent developments related to the California ballot initiative to repeal MICRA.