The medical malpractice system in the US and doctors’ fear of being sued really does add costs, according to a study. US doctors often say that fear of suing forces them to order unnecessary tests and procedures to protect themselves. But some top health economists, including some at the Congressional Budget Office, tend to play down such costs, saying that medical practice is not too affected by fear of liability. Researchers from Duke and MIT have now released what could be the most precise estimate of the costs of “defensive medicine”, at least for hospital care. They found that the likelihood of a lawsuit raised the intensity of health care that people got in hospital by the 5 percent. In addition, the study found that the patients who received extra care were no better off. The researchers examined the health care system for active-duty members of the military, who get access to a government system but are prevented from suing doctors and hospitals for malpractice. They then looked at what happened to the hospital care that these military staff received when a based closed, forcing them to use their benefits in civilian hospitals, where they could sue. The researchers found that spending on health care increased, particularly on extra diagnostic costs. Commenting on the study, Michelle Mello, a professor of law and health policy at Stanford, said that the report showed that physicians changed their behaviour in response to liability considerations, but not in a very calibrated manner. There are frequent proposals, both at federal and state level, to limit medical liability but there have been no serious attempts at eliminating medical malpractice rights altogether. Jonathan Gruber, a health economist at MIT and study author, said the estimates were best seen as a kind of ceiling for the effects of more realistic reforms. Any law limiting the cases where can patients can sue, or the amount of money they receive if successful, is likely to decrease medical use in the hospital by less than about 5 percent they measure in their study. Meanwhile Amitabh Chandra, a health economist at Harvard, said the best policies needed to reduce the burden on doctors while still generating “social value.” The study authors put forward a range of different types of changes that could be made, including one where physicians would be protected from liability if they adhered to common standards of care. The most popular state action has been capping monetary damages, but other approaches have yet to be tried.
The medical malpractice system in the US and doctors’ fear of being sued really does add costs, according to a study. US doctors often say that fear of suing forces them to order unnecessary tests and procedures to protect themselves. But some top health economists, including some at the Congressional Budget Office, tend to play down such costs, saying that medical practice is not too affected by fear of liability. Researchers from Duke and MIT have now released what could be the most precise estimate of the costs of “defensive medicine”, at least for hospital care. They found that the likelihood of a lawsuit raised the intensity of health care that people got in hospital by about 5 percent. In addition, the study found that the patients who received extra care were no better off. The researchers examined the health care system for active-duty members of the military, who get access to a government system but are prevented from suing doctors and hospitals for malpractice. They then looked at what happened to the hospital care that these military staff received when a based closed, forcing them to use their benefits in civilian hospitals, where they could sue. The researchers found that spending on health care increased, particularly on extra diagnostic costs. Commenting on the study, Michelle Mello, a professor of law and health policy at Stanford, said that the report showed that physicians changed their behaviour in response to liability considerations, but not in a very calibrated manner. There are frequent proposals, both at federal and state level, to limit medical liability but there have been no serious attempts at eliminating medical malpractice rights altogether. Jonathan Gruber, a health economist at MIT and study author, said the estimates were best seen as a kind of ceiling for the effects of more realistic reforms. Any law limiting the cases where can patients can sue, or the amount of money they receive if successful, is likely to decrease medical use in the hospital by less than the 5 percent they measure in their study. Meanwhile Amitabh Chandra, a health economist at Harvard, said the best policies needed to reduce the burden on doctors while still generating “social value.” The study authors put forward a range of different types of changes that could be made, including one where physicians would be protected from liability if they adhered to common standards of care. The most popular state action has been capping monetary damages, but other approaches have yet to be tried.