In a continuation of the tort reform theme, Health Affairs recently featured a study finding that physicians’ fear of malpractice does not appear to be correlated with their actual risk of being sued. Senior study author David Katz, MD, associate professor of medicine with University of Iowa Health Care, said:

"We found that both generalist and specialist physicians fear being sued for malpractice even in states where their risk of being sued is relatively low. One likely explanation is that physicians' concerns about malpractice are driven more by their perception that the malpractice tort process is unfair and arbitrary and less by their actual risk of getting sued.” [emphasis mine]

The study found that, in general, physicians’ concerns about malpractice were not reduced by malpractice reforms implemented in some states. They write: “States that had established caps on total damages or abolished joint-and-several liability were associated with modestly lower levels of physician malpractice concern.” Two reforms – split recovery and patient compensation funds – were actually associated with higher levels of concerns among physicians. Additionally, collateral-source rule and periodic payments reforms were not significantly associated with any change.

I think this brings up some interesting points.  If malpractice reform can’t reduce the fear of being sued, what can? Despite the article’s somewhat negative outlook (the authors conclude that the only way we can reduce costs through malpractice reform is to tie malpractice reform to bundled payments), I do think tort reform can go a long way in helping defensive medicine. The ACC has a couple of things in the works to help members reduce risk. For one, the ACC is working on tort reform legislation. Secondly, we have a new Risk Management Institute that uses both educational tools and other ways to reduce risks of suits and costs of coverage for our members.

What do you think can help to reduce defensive medicine costs?

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