Malpractice: Right Diagnosis; Wrong Solution

June 20, 2013
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Zeke Emanuel and his colleagues at CAP are taking on the malpractice system. Give them credit for recognizing the problem:

Zeke Emanuel and his colleagues at CAP are taking on the malpractice system. Give them credit for recognizing the problem:

More than 75 percent of physicians — and virtually all physicians in high-risk specialties such as obstetrics and gynecology and neurosurgery — face a medical-malpractice claim over the course of their career. While litigation costs are higher for claims that result in awards, litigation costs for claims that do not result in awards are still significant, averaging $17,130. Moreover, physicians spend an average of 11 percent of their careers with an unresolved malpractice claim, and claims that did not result in payments account for more than 70 percent of this time…

In the most recent peer-reviewed study, orthopedic surgeons recorded in real time whether imaging was required for clinical care or ordered for defensive reasons and found that physicians ordered 19.1 percent of imaging tests and 38.5 percent of MRIs for defensive reasons.

So what do they want to do about it? Let doctors off the hook if they practice cookbook medicine:

To reduce the costs of defensive medicine, the Center for American Progress proposes a “safe harbor” in medical-malpractice litigation to protect physicians if they:

  • Document adherence to evidence-based clinical-practice guidelines
  • Use qualified health information-technology systems
  • Use clinical decision-support systems that incorporate guidelines to assist physicians with patient diagnoses and treatment options.

The biggest problem with these people is that they only talk to each other. At the NCPA we solved this problem a decade ago.