Public Citizen Recommends Addressing Patient Safety, Preventing Medical Errors and Improving Physician Oversight to Save Lives and Cut Costs
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Despite claims by business and medical lobbying interests and the Bush administration, there is no medical malpractice lawsuit crisis in America, according to analysis released today by Public Citizen. The new report, “The Great Medical Malpractice Hoax,� dispels oft-repeated myths of dwindling doctors and spiraling insurance premiums used to support limits on the ability of injured patients to seek redress in the courts.
The real problems are a lack of attention to patient safety, the high incidence of preventable medical error and the lack of accountability for a small set of doctors who account for a majority of medical malpractice payments, the report reveals. The report also presents several recommendations for Congress, state governments and hospitals to reduce health care costs and save lives.
“Over the past few years, the Republican-led Congress has repeatedly attempted to curtail the legal rights of medical malpractice victims by capping damage awards and imposing other limits on access to the courts by consumers,� said Public Citizen President Joan Claybrook. “This report shows that lawmakers were misguided; in fact, Congress should work to reduce medical errors.�
Public Citizen reviewed publicly available information from 1990 to 2005 from the federal government’s National Practitioner Data Bank (NPDB), which contains data on malpractice payments made on behalf of doctors as well as disciplinary actions taken against them by state medical boards or hospitals. According to the analysis, the total number of malpractice payments paid on behalf of doctors, with judgments and settlements, declined 15.4 percent between 1991 and 2005, and the number of payments per 100,000 people in the country declined more than 10 percent. In addition, the average payment for a medical malpractice verdict, adjusted for inflation, dropped eight percent in the same period.
The numbers show that patients do not win large jury awards for less serious claims but that payments usually correspond to the severity of injury. In 2005, less than three percent of all payments were for million-dollar verdicts and more than 64 percent of payments involved death or significant injury – while less than one-third of one percent were for “insignificant injury.�
“Despite assertions by the medical and business lobbies that physicians are leaving practice because of burdensome malpractice lawsuits, the number of doctors is increasing faster than the population,� said Laura MacCleery, director of Public Citizen’s Congress Watch group. “In recent years, medical malpractice insurers have been reaping huge profits, not paying out excessive jury awards. The false claims of a malpractice lawsuit crisis are really about putting profits ahead of patients. They distract from real health care reform designed to improve patient safety, enhance efficiency and cut costs.�
Public Citizen’s analysis indicates that to limit preventable patient deaths and injury and rising health care costs, reforms should reduce medical errors and tighten lax doctor discipline and oversight.
To improve patient safety and prevent errors, Congress should establish a national mandatory adverse event reporting system so that hospitals share information that can help them correct faulty systems and practices. To combat medication errors, hospitals should invest in computer physician order entry systems. This would avoid mistakes associated with illegible handwriting and automatically check for errors or bad drug interactions. Despite a 2006 study by the Institute of Medicine concluding that medication error is one of the most common preventable mistakes and costs as much as $3.5 billion annually, fewer than five percent of hospitals have implemented such a system. Hospitals and medical practices should also limit physicians’ workweeks to reduce fatigue-induced error.
Improving physician oversight is vital to addressing the small percentage of repeat offenders who continue to practice despite being responsible for a majority of malpractice claims in America. The report documents that just 5.9 percent of doctors have been responsible for 57.8 percent of the number of malpractice payments from 1991 to 2005, with each of these doctors making at least two payments. The vast majority of doctors – 82 percent – have never had a medical malpractice payment since the NPDB was created in 1990. State medical boards, which are largely responsible for doctor discipline, should be given greater funding and staffing, and be required to provide stricter oversight to prevent dangerous doctors from practicing in their own or other states.
Greater disclosure of offenders would also provide consumers with the information necessary to make informed decisions about their health care. Congress should lift the veil of secrecy on the national database by allowing the public access to the names of doctors – which are now kept secret – and state legislatures should require state medical boards to improve their Web sites to provide better quality and accessibility of information about doctor discipline.
Source: Public Citizen
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