Are There Two Sides to the Malpractice Story?

Medical tort reform has likely never been more debated than during our recent national efforts to rein in the skyrocketing cost of health care. Malpractice lawsuits have long been the bane of physicians, and many politicians and the public at large have not been unsympathetic to their complaints.

Although I have seen few credible accounts that deny that malpractice constitutes a considerable cost to the health care system, I have seen research that suggests that malpractice gets a bit of a bad rep. An article in a recent issue of Health Affairs brings this discussion out into the open. Researchers found “high levels of malpractice concern among both generalists and specialists in states where objective measures of malpractice risk were low.” The authors also reported “relatively modest differences in physicians’ concerns across states with and without common tort reforms,” suggesting that “many policies aimed at controlling malpractice costs may have a limited effect on physicians’ malpractice concerns.”

So, while the cost of malpractice is high, it is also perhaps not entirely the point of contention, which muddies the malpractice vilification waters a bit. And, as has recently been pointed out in an article published in the Wall Street Journal, maybe malpractice deserves to be viewed in a more positive light.

That’s right. Malpractice does do some good things for the medical profession.

According to the article, the majority of malpractice lawsuits are over diagnostic errors, which, as we all know, are going to happen (medicine is described in the article, not inaccurately, as an “odds game”). Through malpractice lawsuits, the healthcare system learns where doctors can go wrong. Individual physicians make changes to their practice and prescribing habits due to malpractice results. The article even points out that several institutions are studying lawsuits to identify lessons that can be learned.

Would we pay as much attention to diagnostic errors if malpractice wasn’t such a palpable force? I would like to think so, but I don’t know. Conventional wisdom tells me that the issues that bite us in the wallet that tend to get attention.