Fear of Malpractice Litigation

Lots of people fear visiting the doctor's office for a variety of reasons, among them not wanting to deal with potentially uncomfortable situations, bad news, for instance.

And doctors, what do they fear?

The judge's gavel, for one thing. A recent report in Health Affairs is a reminder how physicians say the threat of malpractice lawsuits forces them to practice defensive medicine, which in turn raises the cost of healthcare by reinforcing needless procedures. This has been a constant over the years, and not exactly startling, as one of the authors, James D. Reschovsky, acknowledged to me.

But Reschovsy, a senior health researcher for the Center for Studying Health System Change, says what is surprising is that it appears to make not much difference in states where there is tort reform their fear of malpractice remains.

The report, "Physicians' Fears of Malpractice Lawsuits Are not Assuaged by Tort Reforms," says that there were high levels of malpractice concerns even when risks are relatively low. Reschovsky reported on the study along with Emily R. Carrier, Michelle M. Mello, Ralph C. Mayrell, and David Katz that individual physician concerns' about their own malpractice risks are pervasive and vary across specialists. 

The report is among three published as a themed issue co
ntaining several articles exploring controversial topics of medical mistakes, malpractice lawsuits, and their defense and the patient-provider atmosphere that can provoke them, as Cheryl Clark of HealthLeaders Media wrote on Sept. 7.

The price tag for malpractice liability and defensive medicine comes to $55.6 billion a year, or 2.4% of healthcare spending, far lower than the American Medical Association's estimate of between $70 billion and $126 billion.