Medical liability reform – an issue of Price

With Tom Price at the helm of the Department of Health and Human Services, and Congress likely to make systematic health care changes, chances for medical liability reform are stronger than ever.  So say several experts in the field.

Writing in the New England Journal of Medicine, noted medical liability system scholars Michelle M. Mello, J.D., Ph.D., Allen Kachalia, M.D., J.D., and David M. Studdert, LL.B., Sc.D convey their opinions on the opportunities that lie ahead for proponents of medical liability reform with Secretary Price as an advocate.

Citing medical liability in his confirmation hearings, as “a really difficult challenge,” Secretary Price has long been a champion of reforms that reduce medical lawsuit abuse.

Acknowledging that “the liability system has well-documented problems, and its reform was omitted from the Affordable Care Act,” the authors support a way forward in the near term.

While the current liability system is no longer at the precipice of crisis, Mello, Kachalia, and Studdert agree that “a period of calm in liability insurance markets is the best time to proceed with sensible reform.”

The deck is stacked in support of reasonable limits on non-economic damages, with the authors citing high strength of evidence that such limits lead to reductions in certain types of defensive medicine, substantial reduction in average compensation amounts, and modest increase in physician supply. No other individual type of reform could alone garner such favorable evidence.

To read the full analysis of this administration’s prospects for medical liability reform, click here.


A medical liability system that’s no joke

Dr. Stuart Weinstein, a pediatric orthopaedic surgeon and spokesperson for the Health Coalition on Liability and Access, was recently featured on the American Association of Neurosurgeons’ Neurosurgery Blog citing similarities between the two practices and the serious issue of medical lawsuit abuse.

“As a pediatric orthopaedic surgeon practicing for more than 40 years in Iowa City, I’ve seen countless colleagues forced to defend their treatment decisions and reputations — leaving less time for patients — only for the lawsuits to be dropped, dismissed or withdrawn for lack of merit,” Dr. Weinstein writes.
And he knows that these lawsuits – and the lawyers that bring them forward – are creating a divide between patients and their doctors.

“Our medical liability system costs too much, takes too long, undermines the doctor-patient relationship and does not serve the needs of patients or physicians,” he continues.

“This is clear from a glimpse of how OB/GYNs are feeling the pressure of threatening lawsuits. Recent surveys found that liability concerns were forcing 40 percent of all OB/GYNs to make changes in their practice, with 14 percent of OB/GYN respondents no longer taking on high-risk obstetric patients.”

With solutions on the horizon, two bills that would reduce lawsuit abuse – and the costs that come with them – are working their way through Congress as the legislature considers overhauling our nation’s health care system.

“Most importantly, passing reform legislation will ensure that the physician-patient relationship is strengthened and the personal injury lawyers are no longer looming large in the exam and operating rooms,” Dr. Weinstein concludes.
American Association of Neurosurgeons’ Neurosurgery Blog invites guests to contribute to their reporting of how healthcare policy affects patients, physicians and medical practice – beyond brain surgery.

Click here to read Dr. Weinstein’s recent post, and follow along weekly at www.neurosurgeryblog.org.


Pushing back on medical liability misconceptions

A recent New York Times article incorrectly asserted that medical liability reform efforts pending in Congress would make it harder for patients to win lawsuits, drawing a challenge from HCLA leadership and its physician spokesperson, Dr. Stuart Weinstein.

Writing on behalf of the HCLA, co-Chairs Mike Stinson and Katie Orrico responded to the New York Times by highlighting how the current system helps neither patients requiring care nor the physicians working to treat them.

“Meritless lawsuits are the heart of the problem,” Stinson and Orrico wrote in their response. “More than two-thirds of liability claims are dropped, dismissed, or withdrawn, but still waste significant health care and legal resources.”
“Medical liability reform legislation recently introduced in Congress won’t make it harder to win a legitimate lawsuit, but it will help filter out meritless claims that should never have been brought in the first place—saving time, money, and emotional energy.”

Knowing how he and his colleagues have to implement defensive medicine to lessen the threat of a liability lawsuit, Dr. Weinstein in his letter to the editor encouraged readers to consider the impact of our broken liability systems on health care costs and the changes they force in physician behaviors.

“More than 90% of physicians engage in defensive medicine by practicing assurance behavior; ordering tests, particularly imaging tests, performing diagnostic procedures and referring patients for consultation,” Dr. Weinstein wrote. “These behaviors have become standard of care.”

“…Passing these sensible reforms represents a critical first step in restoring the appropriate practice of medicine where physicians make decisions based only on the patients well being,” Dr. Weinstein concluded.

Click here to read the HCLA letter to the editor, and here for the letter from Dr. Stuart Weinstein.


Trial attorneys maintain tight grip in Washington

Despite the general consensus that our liability system requires a federal fix to reduce defensive medicine and medical lawsuit abuse, the group who stands to lose the most if reforms are enacted – trial lawyers – maintain a tight grip on legislators.

Feeling threatened by the progress of medical liability reform, a Houston personal injury law firm hosted a fundraiser for Senator Lindsay Graham, specifically citing the fight they hope he wages on their behalf in Washington.

“Our goal is to show Senator Graham an appreciation from both sides of the bar for what he can help do, especially with tort reform running rampant from the house,” wrote attorney Mark Lanier in a fundraising email. And it’s no surprise why – his law firm has been on the receiving end of fees for $13 billion in liability lawsuits.

Senator Graham’s long-running opposition of liability reform has left him well-funded by personal injury attorneys – to the tune of $3.7 million over his 24-year Senate career.

While the trial bar continues to bankroll many legislators that tow their line of opposition to medical liability reform efforts, the HCLA and our grassroots network will continue to work on federal solutions that ensure the system works for patients – not personal injury attorneys.

To read more about how personal injury attorneys are mobilizing against liability reform, click here