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"Reforms" don't reduce doctors' fears of malpractice claims

Despite the documentation of nearly 90,000 preventable deaths that occur in U.S. hospitals annually, many politicians and lobbyists suggest that "reforming" malpractice laws (to eliminate claims) is necessary to reduce health care costs.  Estimates of the savings that would result from making malpractice claims more difficult to pursue range from 1 to 3 percent of our bloated health care expense, and the "reformer" lobbyists argue that reforms will discourage doctors from incurring unnecessary tests and procedures that are a result of malpractice anxiety. A new study  published by  Dr. David Katz and the University of Iowa confirms that this rationale for "reforms" is not justified.

The Iowa researchers compared physician attitudes in states that were extensively "reformed" with physician attitudes in states where no significant "reforms" have been initiated.  They found that physician attitudes about malpractice--and their likelihood of undertaking "defensive medicine" (i.e., ordering tests that are necessary only to protect them from suit)--were not affected by legal changes limiting patients' rights.  Even where significant reforms have curtailed patients' rights and protected physicians very thoroughly, the doctors remain unduly worried about a malpractice tort process that they consider unfair and arbitrary [and thus unlikely to avoid practicing defensive medicine].

This is certainly not a surprise, given that:

1.  On average, doctors are smart and detail-oriented, inclined to control their environment wherever possible:  the "tort" process is the only aspect of a physician's practice where the physician may not have the final word.

2.  Doctors get their information about malpractice and the "unjust and arbitrary" legal system primarily from a single source:  the insurers who are billing them to protect them from this "threat." 

3.  The public discourse about malpractice is primarily driven by insurers and the politicians and lobbyists who rely upon insurer contributions and support.  The values of compensating legitimate victims and of discouraging negligence are lost on insurers who profit by maximizing premiums while minimizing payouts. 

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