Malpractice reform doesn't stop physicians from practicing defensive medicine

Medical malpractice reform has been supported by many experts who argue it lowers healthcare costs by reducing the amount of defensive medicine practiced by physicians, but according to a recent RAND Corporation study, that argument may not be based in fact.

For the study, researchers examined the behavior of emergency physicians in Georgia, Texas and South Carolina, which all raised the standard to gross negligence for proving malpractice in the emergency department about 10 years ago. The higher gross negligence standard requires plaintiffs to prove physicians consciously disregarded the need to use reasonable care and knew their actions were likely to cause serious injury to patients.

The study specifically examined whether physicians in the three states ordered an advanced imaging study, whether the patient was hospitalized after the emergency visit and the total charges for the visit. Physicians have identified advanced imaging and hospitalization as common defensive medicine practices.

The researchers found medical malpractice reform laws had no effect on physicians' use of advanced imaging or on the rate of hospitalization following emergency visits in the three states.

The study also found malpractice reform caused no reduction in charges in Texas and South Carolina. In Georgia, average emergency department charges had dropped 3.6 percent since 2005, when malpractice reform was adopted in the state.

"Our findings suggest that malpractice reform may have less effect on costs than has been projected by conventional wisdom," said Daniel A. Waxman, MD, the study's lead author and a researcher at RAND. "Physicians say they order unnecessary tests strictly out of fear of being sued, but our results suggest the story is more complicated."

Researchers examined 3.8 million Medicare patient records from 1,166 hospital EDs from 1997 to 2011 for the study.

The results of the study were published in the Oct. 16 edition of the New England Journal of Medicine.

More articles on medical malpractice:

Are the savings from tort reform a myth? 
The new physician employment model and malpractice insurance: What you don't know could cost you
Man sues physician for listing homosexuality as 'chronic condition' in his medical record 

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