August 2018 Newsletter

The reality of defensive medicine

With projections about the cost implications of defensive medicine in the hundreds of millions of dollars, a new study showed greater insight into how physicians treated patients when they were not subject to the threat of lawsuits.
The reality of defensive medicine became apparent when researchers from Duke and MIT, on behalf of the National Bureau of Economic Research, focused on active-duty military who were treated by government health care systems that are protected from medical liability lawsuits.
When compared to treatment received by active-duty military from civilian medical professionals who are subject to liability, the study found “suggestive evidence that liability immunity reduces inpatient spending by 5% with no measurable negative effect on patient outcomes.”
The study did an in-depth analysis on quality indicators to be sure doctors weren’t providing substandard care, and found no instances where the quality of care in the military health care facilities appeared to be worse.
“Our analysis demonstrates that the active duty receiving care on the base are treated notably less intensively, without any health outcome consequences. Considering the lack of liability recourse for his treatment group, this pattern of results is suggestive of a strong degree of defensive medicine,” the study concludes.
Click here to read an overview of the research and conclusion, and here for the study in full.

What drives liability insurance costs?

The components that make up medical professional liability insurance premiums are not always well understood, but an expert from the orthopaedic community is trying to help clarify what drives costs.
Michael R. Marks, MD, MBA, a member of both the AAOS Medical Liability and Patient Safety Committees, as well as a mentor in the AAOS Communications Skills Mentoring Program, did a deep dive past the basic “cost of risk” associated with practicing medicine in a recent edition of AAOS Now.
“Even practices that have avoided expensive lawsuits or claims are not shielded from rising premiums,” Marks wrote. “Often, it seems that rising medical malpractice premiums are like death and taxes: inevitable.”
Marks commented on the cost of operations, the gray area of non-economic damages, the fluctuation of insurance companies entering and exiting the market, and the inefficiency of the current liability system as reasons why liability insurance bills are so high.
“The length of time it takes to resolve a lawsuit, coupled with the rising costs of skilled attorneys and experts, has been a primary factor driving costs for medical malpractice lawsuits,” said Marks.
With no way around liability insurance bills (or death, or taxes), Marks hopes his work will help physicians better understand the contributing factors.
To read Dr. Marks’ commentary in AAOS Now, click here.

Take action: Contact Congress to support Good Samaritan legislation

There is still an opportunity to urge your Senator to support an important, bi-partisan medical liability reform bill making its way through Congress.
The House Energy & Commerce Committee has included key language from the Good Samaritan Health Professionals Act in the Pandemic and All-Hazards Preparedness Reauthorization Act (PAHPA) to ensure patients have access to vital, on-site medical services in the wake of a natural or man-made disaster. However, the Senate Health Education Labor & Pensions (HELP) Committee’s version of this legislation would not provide the same protections.
Patients and physicians can show support for the Good Samaritan Health Professionals Act by using the tools in our Action Center to urge their Senators to sign on as a cosponsor of this important legislation, and, if they sit on the HELP Committee, to include Good Samaritan language in the Senate version of the PAHPA legislation.
Click here to contact your Senator and support the passage of common-sense fixes to our liability system and ensure disaster victims have access to quality care.

Liability reforms at risk of repeal in Kentucky

Incremental improvements to Kentucky’s liability climate face an uncertain future, leading patients and physicians across the state to worry that meritless lawsuits could become more common.
The state’s Medical Review Panel (MRP) process was set up to create a more efficient system for patients with legitimate claims by having a panel of medical professionals review liability lawsuits prior to legal proceedings.
“If finally given the chance to work, free of confusing and unnecessary legal challenges, MRPs will expose frivolous suits and help meritorious claims by providing an impartial review and acknowledgement of the supposed harm,” writes David Adkisson, president and CEO of the Kentucky Chamber of Commerce; Mike Rust, president and CEO of the Kentucky Hospital Association; and Patrick Padgett, executive vice president of the Kentucky Medical Association, in a recent op-ed.
Now, the Kentucky Supreme Court has heard arguments, pushed through by personal injury attorneys, that seek to overturn the process and return to a system fraught with meritless lawsuits and jackpot justice that led to high costs and lower access to care.
“Removing the incentive to send frivolous cases to juries will improve the legal climate and afford businesses, health care providers and health care professionals some much needed certainty and eliminate an advantage other states have when courting investment and caregivers,” the authors state.
To read more about the implications for patients across the state if the law is repealed, click here.