Jeff Segal, MD, JD, FACS
I doubt that lately, few subjects have been studied, discussed or argued as much as the effects that frivolous lawsuits have on the nation’s healthcare system. This summer, three more studies looked at this problem from various vantage points.
First, Jackson Healthcare investigated whether physicians working under contract with the federal government practice less defensive medicine than their private sector peers. As a reminder, as if anyone really needed one, defensive medicine describes ordering medically unnecessary tests, treatments or consultations to avoid malpractice lawsuits. The results? Only 43 percent of physicians working under government contract, where the Federal Tort Claims Act offers protection against personal financial liability, stated they practiced defensive medicine. Contrast that to an earlier Jackson Healthcare study where 92 percent of private sector physicians admitted that they practiced defensive medicine. (We wonder about the other 8%.) Of those surveyed who worked in both private and government, 62 percent reported practicing more defensive medicine in their private sector work than they did under government contract.
Jackson Healthcare Chairman and CEO Rick Jackson stated “the Federal Tort Claims Act offers government-contracted physicians protection against personal financial liability, whereas private sector physicians work under the constant shadow of lawsuit lottery suits.”
Next, Jackson Healthcare examined physicians in countries with more reasonable tort environments. Survey Pacific interviewed 200 randomly selected physicians from four countries (New Zealand, Canada, Sweden and the United Kingdom). Their findings? None surveyed reported practicing defensively.
Again, Rick Jackson, “The root driver of defensive medicine, and its inflation of our overall healthcare costs, is the fact that physicians in the (US) private sector are the only physicians in the world who are personally financially liable.”
Finally, a study out of Texas explored the efficacy of the state’s tort reform measures. The study, published in the Journal of the American College of Surgeons, found a nearly 80% decrease in surgical liability lawsuits at the University of Texas Health Science Center at San Antonio since tort reform was enacted in 2003. The study “confirmed our hypothesis that (tort reform) was important, but the magnitude of the decrease was quite striking,” said Dr. Basil Pruitt, Jr., co-author of the project.
Opponents of tort reform will undoubtedly find fault with these findings. But study after study after study come to the same conclusion; defensive medicine, and the burdensome costs associated with the practice, is driven by the fear of meritless malpractice lawsuits. Until some measure of real tort reform is enacted, we will keep stating the facts, and fighting the fight.