In a new study released by the Center for Studying Health System Change (HSC), researchers believe that traditional malpractice reforms enacted by states, such as caps on damages that we have in Texas, do not actually change how physicians practice. In the August edition, it was noted that Medicare patients receive more diagnostic tests and emergency department referrals when treated by physicians who worry more about medical malpractice liability, regardless of whether the state in which they practice has adopted so-called medical malpractice tort reform.
The study was funded by the National Institute for Health Care Reform and analyzed office-based physicians’ concerns about malpractice liability compared to their actual tests ordered and referrals made. The researchers found that doctors who were more concerned about medical malpractice liability ordered more services for patients than those who were less worried about liability issues. Then an analysis was done based on the amount of liability tort reform legislation that had been enacted in a state. The conclusion was that there was no correlation between the amount of reforms enacted by a state and a reduced amount of medical services. In fact, in a few cases there were states with a higher level of understood malpractice risk that actually had a lower level of care ordered.
In an article from the Insurance Journal, there was an interview with Dr. Emily Carrier. “Traditional malpractice liability reforms don’t appear to resolve the concerns that drive physicians to practice defensive medicine,” said Emily R. Carrier, M.D., an HSC senior researcher and coauthor of the study with James D. Reschovsky, Ph.D., an HSC senior fellow; David Katz, M.D., an associate professor at the University of Iowa; and Michelle M. Mello, Ph.D., J.D., a professor at the Harvard School of Public Health.
“Dealing with defensive medicine, which not only increases costs but subjects patients to unnecessary care, may require reassuring physicians that medical injuries can be resolved in less adversarial and stressful ways while still protecting patients, Carrier said.