Doctors have long claimed that rising medical malpractice premiums have impacted their practices. Some have explained the ordering tests that are seen as unnecessary and expensive is a way for doctors to practice “defensive medicine” and shield themselves from potential malpractice claims. But a new study finds that may not be true.
The study was conducted by the RAND Corporation, which is a nonprofit research organization. They looked at three states that had enacted malpractice reform legislation that makes it harder for patients to sue doctors. Those states are Georgia, South Carolina and Texas.
Changes in Medical Malpractice
A common claim made in emergency room-related malpractice cases is a failure by the doctor to diagnose a life-threatening condition. The doctor misses a heart attack or acute appendicitis and sends the patient home. Or physicians can fail to triage patients adequately and injury or illness worsens while waiting for care. Results in these cases can cause permanent damage or death.
About ten years ago, Georgia (2005), South Carolina (2005) and Texas (2003) changed their legal standard for bringing a medical malpractice claim from ordinary negligence to the higher standard of gross negligence. To show ordinary negligence, the patient bringing the suit would have to show the doctor failed to exercise reasonable care. The higher gross negligence standard requires patients to prove their doctors consciously disregarded the need to use reasonable care and knew their actions would likely cause serious injury.
The study looked at a sample from nearly four million Medicare patients who made visits to 1,166 hospital emergency rooms. They looked at the three reform states and at neighboring states to use for control data. The period covered 1997 through 2011. They compared patient outcomes, before and after legislation, controlling for patient and hospital characteristics and temporal trends.
- The data showed that emergency room doctors in those three states continued to admit patients and order imaging tests at the same rate as they did before the law changed.
- There was no reduction in average emergency room charges in two of the states – Texas and South Carolina. Georgia did show a 3.6 percent lower rate in emergency room charges.
The study was published in the New England Journal of Medicine. The lead author suggested that if we want to reduce health care costs and waste, malpractice reform is not the answer.