Better Doctors, Less Litigation

While watching an episode of Aqua Teens dealing with the horrors of cheap Mexican plastic surgery, I felt thankful for the superiority of the quality of medical care in America. There should be no reason for me to worry about doctors excising pounds of flesh from my body during a surgery… right?

As it turns out, it is true that I don’t have to worry about that most of the time. However, it’s no secret that medical malpractice in the United States is a big problem. According to HealthGrades, roughly 195,000 people die every year due to preventable hospital errors and many other are injured. 

Should we be concerned? Dr. Samantha Collier, vice president of HeathGrades’ medical affairs division, thinks so. She likens the current medical malpractice crisis to ‘The equivalent of 390 jumbo jets full of people are dying each year due to likely preventable, in-hospital medical errors, making this one of the leading killers in the U.S.’ This is more than the number of people that die from car accidents, AIDS, breast cancer, and both intentional and unintentional shootings each year combined. And this only counts the number of reported cases; the actual number of people hurt by a doctor’s negligence may be much higher.

No wonder insurance companies are charging doctors such high premiums. In fact, it’s readily acknowledged that medical malpractice insurance is one of the most risky and unprofitable ventures for insurance companies to undertake. In 2005, for every dollar paid to the insurance companies for medical liability insurance, the insurance company would spend a little more than a dollar on malpractice claims and other expenses.

This is also expensive for doctors and patients. One study found that medical liability costs and the expense of practicing defensive medicine, in which doctors order more tests and make more referrals to protect themselves from negligence suits, have gotten so high that they account for 10 percent of total medical care costs. This may not seem like a burdensome statistic, but these costs have been cited by 49 percent of Rhode Island doctors as the reason for the discontinuation of their medical services. Of that percentage, a further 48 percent will either leave the state to practice where medical liability costs are not so high or will give up clinical practice altogether.

Clearly, this is bigger than many other issues on the agenda, although public interest in the subject may be lower due to the lack of a ‘wow factor’ that the other methods of death have. But perhaps the reason that medical malpractice isn’t as scary as AIDS is the fact that it can easily be eliminated. No new research needs to be done and the effects should be immediate.

Many of the solutions proposed by states have involved limiting the scope of the damages awarded by medical malpractice suits. One such solution, the 1975 Californian Medical Injury Compensation Reform Act (MICRA), became the prototype for all future medical malpractice reform laws. While the MICRA did bring some much needed change to the new field of medical malpractice, it also mandated strict limits on how much plaintiffs could collect from negligence suits.

Rather than aiming at the root of the problem by reducing doctor negligence, states are providing damage control on behalf of the insurance companies. Though the MICRA has the beneficial effect of reducing liability premiums, it comes at the cost of a patient’s ability to recover damages from incompetent doctors. While I’m no fan of frivolous lawsuits, ambulance chasing lawyers, and excessive penalties for the ‘mental anguish’ of the plaintiffs, medical malpractice cases should not be treated as the problem.

Instead, the emphasis should be placed on making sure the injury doesn’t occur in the first place. Extra safety procedures and better implementation of technology in hospitals can make practicing defensive medicine much cheaper than it is. Measures as simple as an electronic drug prescription system could potentially prevent 7,000 deaths due to the notoriously bad handwriting of physicians and would not limit a patient’s ability to recover damages from malpractice suits.

In principle, it’s not right to make it harder to get an adequate legal remedy for an injury caused by the negligence of a doctor whose profession is based on taking care of the patient.  If the jury believes that a person’s injury justifies very large damage payments, then so be it. All such legislative efforts to reduce recovery of these damages seem to place a price cap on human suffering and furthermore sacrifice the patient’s interests for economic convenience.