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 that risk, and thus more receptive to new care delivery strategies associated with alternate payment models,” the authors of the report conclude.
The study, while preliminary and with some limitations, adds to mounting evidence that limits on non-economic damages are successful in encouraging physicians to practice appropriate care rather than defensive medicine.
To read more about the study on defensive medicine from the Center for Healthcare Innovation and Policy Research at George Washington University, click here.

Pennsylvania patients, physicians left vulnerable by ruling on medical risks

A Pennsylvania lower court ruling under review by the state Supreme Court threatens to open physicians up to becoming targets of medical lawsuit abuse, while patients will be left with fewer access to care options.
The ruling stemmed from a case in which an expert witness testified about the known risks associated with a specific type of surgery, even when it was performed properly. The lower court ruled that such testimony biased the jury and ordered a new trial in which the jury would not be informed about such risks associated with the procedure. The state Supreme Court is now reviewing whether trial judges can suppress expert witness testimony on the known complications of a medical procedure.
“Everyday physicians in this Commonwealth are required to perform surgeries that involve inherent risk of non-negligent complications in emergent (or other less-than-ideal) circumstances where the likelihood of complications is real,” a brief from the Litigation Center of the American Medical Association, the Pennsylvania Medical Society and several Pennsylvania specialty societies stated. “Holding physicians strictly liable simply because a patient has suffered a complication or experienced an adverse result because of a complication—even where the physician prudently performed the procedure and could not control the outcome—will make physicians less likely to perform these procedures.”
Without a reversal by the state Supreme Court, Pennsylvania physicians would likely see an increase in lawsuits for injuries resulting from medical complications that don’t involve negligence.
To read more about the impact to patients and physicians if the ruling is upheld, click here.

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

Having seen the extent of the liability crisis in Texas before reforms were passed in 2003, an op-ed writer now living in Arkansas cites the potential increase in life-saving access to care for patients across the state if November’s liability ballot measure is successful.
In 1987, Toni Rose experienced the premature birth of her daughter and was lucky to be in the hands of specialists in Houston. But mothers elsewhere in Texas weren’t faring as well, with limited access to physicians who were offering care to high-risk patients.
Medical liability reform brought doctors back to Texas, with pediatric subspecialties increasing 300 percent in the following 10 years, and Rose knows it can do the same for Arkansas.
“Issue 1 allows voters in Arkansas to attract more much-needed doctors and health-care professionals to our state,” she wrote.
Issue 1 is a ballot initiative that would amend the state constitution to place reasonable limits on attorney contingency fees and non-economic damages, creating a better environment for healthcare professionals to practice and improving the provider-patient relationship.
“Thousands of women and their unborn children in rural Arkansas are at risk due to the lack of care and the many miles to an OB-GYN..,” Rose wrote, highlighting the impact to women’s care across the state.
To read the op-ed and grassroots support for Issue 1 in Arkansas, click here.