Liability Caps And Patient Risk

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Extraordinary cases of alleged medical malpractice have made the headlines as of late, and it’s brought tort reform once again back into the discussion sphere. The circumstances behind the surge in interest around reform are unfortunate, but it is a timely conversation. Three studies have recently been released which, while revealing different truths about tort reform, all point to what many of us inherently already know – it doesn’t work.

Does Reform Attract Doctors?

The first study released, conducted by the Northwestern University School of Law, looked at whether or not physicians are drawn to states that have liability caps in place. The study, entitled Does Medical Malpractice Reform Increase Physician Supply? Evidence from the Third Reform Wave, shows that, in fact, the only sector of high risk doctors who seem to move to states with caps in place are plastic surgeons. Numbers from all other physician groups, including that of rural doctors, fluctuate at a normal rate.

Researchers studied the nine states that placed liability caps on non-economic damages between 2002 and 2005. The information is sure to surprise supporters of tort reform who have been saying for years that once these types of reforms take effect, states see a beneficial influx of physicians.

Do Healthcare Costs Decrease?

The second study, also from the Northwestern University School of Law, takes a look at defensive medicine. Much research has been done to determine the effects of tort reform on healthcare costs, with mixed results. The researchers at Northwestern University found that, once tort reform passes, there is a split in direction of costs. For services covered under Medicare part B, which covers hospital visits, there was no significant impact. However, there was a 4 to 5 percent increase in costs under Medicare Part A, which covers physician visits.

For this study, entitled Do Doctors Practice Defensive Medicine, Revisited, researchers looked at the same nine states they used for the first study. Just as with the first study, this one suggests that the information used by pro-tort reform groups is erroneous, at best.

Does Patient Care Suffer?

In the final of the three studies, which was overseen by the Department of Economics at Northwestern University, researchers studied the records of patients who had received medical care in five states that had adopted caps on damages deemed non-economic. In the five state study, entitled The Deterrent Effect of Tort Law: Evidence from Medical Malpractice Reform, researchers discovered that the safety level of patient’s typically drops once caps are in effect.

Patient Safety Indicators (PSIs), which are the “standard measures of often preventable adverse reactions” were studied. Infections, birth and surgical errors, as well as in hospital injuries are all examples of PSIs. The study’s authors discovered a phenomena when reviewing the data. Once caps were passed, most PSIs rose while, simultaneously, medical care standards grew lax over time.

In this trifecta of studies from Northwestern University, we see that tort reform does not lead to better care, in fact it lowers the quality of care provided to patients. We also find that physician visit costs increase under tort reform, and doctors aren’t flocking to states that pass reform laws. In short, these three studies prove once again what we already know – tort reform equals bad medicine.

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