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The Medical Malpractice Myth
Forget tort reform. The Democrats have a better diagnosis.
By Ezra Klein The Movie That Makes a How Do You Get Rural African
Better Case for Sarah Palin AIDS Patients To Trust
Posted Tuesday, July 11, 2006, at 6:20 AM ET Than She Ever Did Western Medicine?
The Republican answer to runaway health-care spending is
to cap jury awards in medical malpractice suits. For the
fifth time in four years, Senate Majority Leader Bill Frist
tried and failed to cap awards at $250,000 during his self-
proclaimed "Health Care Week" in May. But this time, the
The Five Most Interesting The Trip: The Finest Michael
Democrats put a better idea on the table. Things You'll Ever Read Caine-Impression Showdown
About the Porn Industry in History
Sens. Hillary Clinton and Barack
Obama also want to save on Like 122
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S e ns. B i l l F ri st and H i l l ary
C l i nt on health care. But rather than PRINT
capping jury awards, they hope Is Rosie Huntington-Whiteley really the
DISCUSS
to cut the number of medical malpractice cases by reducing medical hottest swimsuit model in the world?
E-MAIL (StyleBistro)
errors, as they explain in an article in the New England Journal of
Medicine. In other words, to the Republicans, suits and payouts are RSS Los Angeles Lakers' Mike Brown: First
the ill. To the Democrats, the problem is a slew of medical injuries meeting with Kobe Bryant 'went very well'
RECOMMEND... (ESPN)
of which the suits are a symptom. The latest evidence shows the
Democrats' diagnosis to be right.
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RELATED IN SLATE The best attempt to
(MarketWatch.com)
synthesize the academic literature on medical
malpractice is Tom Baker's The Medical Malpractice 5 Financial Mistakes People Make
David Dobbs presents the Swedish fix to (TheStreet.com)
medical malpractice. Michael Kinsley Myth, published last November. Baker, a law
attacks the American Medical professor at the University of Connecticut who
[what's this]
Association's approach to tort reform. studies insurance, argues that the hype about
Atul Gawande argues that when medical
medical malpractice suits is "urban legend mixed
errors happen, doctors are to blame,
not "the system." with the occasional true story, supported by Slate.com on Facebook
selective references to academic studies." After all, Like 146,144
including legal fees, insurance costs, and payouts, the cost of the suits comes to less than one-
half of 1 percent of health-care spending. If anything, there are fewer lawsuits than would be Bush tax cuts 10th anniversary: They've been
expected, and far more injuries than we usually imagine. a failure in every conceivable way.
7,912 people shared this.
NBA Finals 2011: LeBron James' Michael
As proof, Baker marshals an overwhelming array of research. The most impressive and Jordan problem.
comprehensive study is by the Harvard Medical Practice released in 1990. The Harvard 696 people shared this.
researchers took a huge sample of 31,000 medical records, dating from the mid-1980s, and
Florida's crazy new law preventing doctors
had them evaluated by practicing doctors and nurses, the professionals most likely to be from asking patients about their guns.
sympathetic to the demands of the doctor's office and operating room. The records went 2,194 people shared this.
through multiple rounds of evaluation, and a finding of negligence was made only if two Brow Beat : The Return of Rollerblades?
doctors, working independently, separately reached that conclusion. Even with this 1,160 people shared this.
conservative methodology, the study found that doctors were injuring one out of every 25 View My Network on Slate »
Why a Sarah Palin presidential campaign is
patients—and that only 4 percent of these injured patients sued. hopeless.
MOST
917 people shared this. MOST
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The Harvard study stands for a large body of literature. On their own, however, the results Ken Burns' Civil War: How the documentary
changed the way we think about the war.
don't disprove the Republicans' thesis that many medical malpractice suits are frivolous. Maybe 1. Thanks a Lot, Ken Burns
1,890 people shared this.
badly injured patients don't sue, while the reflexively litigious clog up the legal system, making Because of you, my Civil War lecture is always packed—
with students raised on your sentimental, romantic, deeply
Anthony Weiner scandal: In defense of the
tort reform a viable solution. But a new study, released in May, demolishes that possibility. Dr. misleading portrait of the conflict.
crotch shot.
David Studdert led a team of eight researchers from Harvard School of Public Health, Brigham By James M. Lundberg |this. 7, 2011
289 people shared June
and Women's Hospital, and the Harvard Risk Management Foundation* who examined 1,452
2. Happy 10 th Birthday, Bush Tax Cuts! to wear
Appropriate work attire: What is OK
medical malpractice lawsuits. They found that more than 90 percent of the claims showed You'veto theaoffice in the summer?
been failure in every conceivable way.
evidence of medical injury, which means they weren't frivolous. In 60 percent of these cases, By Annie Lowreyshared this.
311 people | June 8, 2011
the injury resulted from physician wrongdoing. In a quarter of the claims, the patient died. 3. The Longform.org Guide to the Pornextract
Fired (and resigned) journalists Industry
literary revenge on their former bosses.
From the inspiration for Boogie Nights to the twisted psyche
2,336 people shared this.
of a professional porn reviewer, five great reads about the

2. business of smut.
When baseless medical malpractice suits were brought, the study further found, the courts By Max Linsky | June 10, 2011
efficiently threw them out. Only six of the cases in which the researchers couldn't detect injury 4. Lunch With David Mamet
received even token compensation. Of those in which an injury resulted from treatment, but The dramatist says he's "crazy" about Sarah Palin.
By John Gapper | June 11, 2011
evidence of error was uncertain, 145 out of 515 received compensation. Indeed, a bigger
problem was that 236* cases were thrown out of court despite evidence of injury and error to 5. Airless
patients by physicians. The other approximately 1,050 cases, in the research team's opinion, LeBron James' Michael Jordan problem.
By Josh Levin | June 10, 2011
were decided correctly, with damage awards going to the injured and dismissal foiling the
frivolous suits.*
TODAY'S TODAY'S TODAY'S TODAY'S
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Nor is there evidence to show that the level of jury awards has shot up. A recent RAND study
looked at the growth in malpractice awards between 1960 and 1999. "Our results are Spring rolls eternal.
striking," the research team concluded. "Not only do we show that real average awards have
grown by less than real income over the 40 years in our sample, we also find that essentially
all of this growth can be explained by changes in observable case characteristics and claimed
economic losses."
Which brings us back to the Republicans' and Democrats' divergent approaches. The Obama-
Clinton legislation fits well with Studdert's and RAND's findings. It also builds on successful
efforts by the nation's anesthesiologists and a few hospitals to reduce their medical malpractice
payouts.
Anesthesiologists used to get hit with the most malpractice lawsuits and some of the highest
insurance premiums. Then in the late 1980s, the American Society of Anesthesiologists
launched a project to analyze every claim ever brought against its members and develop new
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ways to reduce medical error. By 2002, the specialty had one of the highest safety ratings in
the profession, and its average insurance premium plummeted to its 1985 level, bucking Sign up for Slate's daily newsletter.
nationwide trends. Similarly, feeling embattled by a high rate of malpractice claims, the
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University of Michigan Medical System in 2002 analyzed all adverse claims and used the data
to restructure procedures to guard against error. Since instituting the program, the number of
suits has dropped by half, and the university's annual spending on malpractice litigation is MORE MEDICAL EXAMINER COLUMNS
down two-thirds. And at the Lexington, Ky., Veterans Affairs Medical Center, a program of early
disclosure and settlement of malpractice claims lowered average settlement costs to $15,000,
We Eat Crap. It Makes Us Sick.
compared with $83,000 for other VA hospitals.
Our inability to talk about it is driving the hysteria
around Europe's E. coli outbreak.
Clinton and Obama would offer federal grants and support to unroll such programs nationwide. Kent Sepkowitz | June 6, 2011
And they want to create a national database to track incidents of malpractice and fund Man Milk
research into standards, procedures, and technologies that would prevent future injuries. So, My curious quest to breast-feed.
what say you, Bill Frist? Is it time for another Health Care Week? Michael Thomsen | May 25, 2011
Curses
Correction, July 11, 2006: The original paragraph misstated the relevant numbers in the Are there really more accidents on Friday the 13th ?
Studdert malpractice study. (Return to the corrected paragraph.) Atul Gawande | May 13, 2011
Search for more Medical Examiner articles
Correction, July 17, 2006: The original sentence incorrectly stated the institutional Subscribe to the Medical Examiner RSS feed
affiliations of the researchers. (Return to the corrected paragraph.)
View our complete Medical Examiner archive
The original sentence incorrectly stated the number of cases thrown out of court despite
evidence of injury and physician error. (Return to the corrected paragraph.)
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Ezra Klein is a writing fellow at The American Prospect.
Photgraph of Sens. Bill Frist and Hillary Clinton by Joshua Roberts/Getty Images.
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Jonathan Michael Lloyd
The above is all well and good, but what of the costs *within* the healthcare system due to
a perception of risk due to lawsuits? I speak of the multiple lab tests that may not be
necessary for a diagnosis or treatment option, and which add up to billions of dollars
across this great land of ours.
Friday, February 05, 2010, 15:43:49 – Flag – Reply
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