The Medical Malpractice Myth

[sgglaze]

Good read:

http://www.press.uchicago.edu/Misc/Chicago/036480.html

Excerpt:

In 2003 U.S. businesses paid $27 billion for auto liability insurance premiums, $57 billion for workers' compensation insurance premiums, and less than $5 billion for products liability insurance premiums. Doctors, hospitals, and other health professionals paid only about $11 billion in medical malpractice insurance premiums. This means that the real insurance money and the real claiming action for U.S. business does not lie in high-profile areas like products liability and medical malpractice. The real action lies in routine, below-the-radar areas like workers' compensation and automobile lawsuits. U.S. businesses paid less than half as much for products liability and medical malpractice insurance, combined, as they paid for auto insurance, alone, and only a quarter of what they paid for workers' compensation insurance.

Products liability and medical malpractice insurance look even less significant compared to what ordinary Americans paid for personal auto liability and no-fault auto insurance: $115.5 billion in 2003. That is more than U.S. business paid for auto, workers' compensation, products liability, and medical malpractice insurance combined. Adding all the premiums of all the different kinds of liability insurance together results in a big number—about $215 billion in 2003—but that number is hardly exploding, and the medical malpractice insurance share—$11 billion—looks pretty small by comparison. It looks even smaller next to the $1.5 trillion plus (that is more than 1,500 billion dollars) we spent on health care that year. Something that amounts to less than 1 percent of health-care costs simply cannot have the impact on health care that the medical malpractice myth would have us believe.

---

Members don't see this ad.

 

[maestro1625]

no spin in that article...

 

[Dookter]

It's true. Medical malpractice is an important part of expenses, but it is a relatively small part.

 

[deuist]

You throw around numbers as if to make doctors' complaints meaningless. How many are there? Now how many automobile drivers are there? More money gets pumped into car insurance because there are more drivers.

 

[sgglaze]

You throw around numbers as if to make doctors' complaints meaningless. How many are there? Now how many automobile drivers are there? More money gets pumped into car insurance because there are more drivers.

The article argues that medical malpractice litigation is not as detrimental to the economy as people tend to believe. The point he is making in the first paragraph is that auto liability insurance has a much higher cost for businesses than medical malpractice.

In the second paragraph he compares the cost of medical malpractice insurance to the entire cost of healthcare in the United States and we see it is a very small number, ~1%.

I really don't see where your comparison about the number of automobile drivers to the number of doctors fits in.

 

[badasshairday]

You throw around numbers as if to make doctors' complaints meaningless. How many are there? Now how many automobile drivers are there? More money gets pumped into car insurance because there are more drivers.

That is exactly what I was thinking right away.

 

[Dookter]

You throw around numbers as if to make doctors' complaints meaningless. How many are there? Now how many automobile drivers are there? More money gets pumped into car insurance because there are more drivers.

This article is not looking at the world in a doctor-centric way. It is looking at the healthcare system as a whole. It is pretty common for people to blame the problems of our healthcare system on lawyers or malpractice premiums or court settlements. If you simple remove all of the malpractice issues from the system, the healthcare system is still not in a good state. Yes, malpractice is a huge issue for doctors. However, economically, it is not causing the problems we have with healthcare.


EDIT: And I think something like this would make a great interview question....or at least if I interviewed people I might bring these issues up. It helps to see if people can look at the system as a whole, or if they have only considered healthcare in terms of physician salaries.

 

[colbgw02]

This article is not looking at the world in a doctor-centric way. It is looking at the healthcare system as a whole. It is pretty common for people to blame the problems of our healthcare system on lawyers or malpractice premiums or court settlements. If you simple remove all of the malpractice issues from the system, the healthcare system is still not in a good state. Yes, malpractice is a huge issue for doctors. However, economically, it is not causing the problems we have with healthcare.

That's an undersimplified view, IMHO. The better question is, and one that's difficult (if not impossible) to answer, how much money could be saved if physicians didn't feel compelled to practice "defensive" medicine? There's no way to quantify this, but I'm willing to guess that if released from the fear of litigation, the decrease in unnecessary and overblown work-ups combined with the drop in the overwhelming volume of paperwork would affect healthcare costs significantly.

 

[montessori2md]

Numbers are only useful if you know where they come from and have all of them, and are comparing apples to apples. Drivers insurance/auto insurance is a huge umbrella of different types of coverage, which also includes covering yourself and your car in case you harm them -as I understand it, MDs don't carry malpractice insurance in case they accidentally operate on themselves

The data mentioned does not include how many billions/trillions we spend on automobiles each year (to compare to health care), which (like health care costs) could be a widely variable number, depending on how you define them. Do health care costs include drugs? Over the counter drugs? Do auto expense include all repairs? Or just collision related expenses (ie, the sort auto insurance would cover)? What about gas, or purchase price of autos?

A better comparison would be corporate liability costs -the sort that say, trucking companies or airlines carry in the event that one of their vehicles or employees, while on the job, causes damage. One jet crash costs an airline a pile of cash, and I imagine their insurance rates reflect that. But, once again, you would have to be careful in the sort of data chosen to ensure that the comparison was useful at all.

To me, malpractice is interesting from a "how much of my bill is going to the insurance company?" perspective. Let's say every time I go to my MD, she pays $5 in liability insurance, and my overall bill is $100 for 15 minutes. That's 5% of all medical costs. In MHO, that's not too bad. But if I'm a medicare pt, and she gets $50, and still pays the $5 in insurance, then that's 10%, and that's a pretty substantial percentage for any business. It's certainly enough for any solid business manager to look at it and say, "how can we lower that?"

Not actually being an expert on malpractice, obviously all those numbers are made up, but from what I've seen on other threads, it's not terribly out of line, and probably on the conservative side. I know that it is possible to obtain insurance (at least in some specialties) on a sliding scale based on # of pts seen, as other threads have discussed this re: part time docs and how they pay the ins premiums.

 

[Dookter]

That's an undersimplified view, IMHO. The better question is, and one that's difficult (if not impossible) to answer, how much money could be saved if physicians didn't feel compelled to practice "defensive" medicine? There's no way to quantify this, but I'm willing to guess that if released from the fear of litigation, the decrease in unnecessary and overblown work-ups combined with the drop in the overwhelming volume of paperwork would affect healthcare costs significantly.

No, thinking that malpractice is the main problem with health care is a simplified view. Thinking outside that box is not the simplified view. Malpractice is just one part of the equation.

 

[trichomoniasis]

it's not so much the big picture that's the concern, but the individual specialty level (ie. OB/GYN being an easy target, neurosurgeons spending 100k+ a year, etc) that could potentially cause problems that may be localized for a bit but cause bigger problems down the road.

the point is that it is too easy to sue anyone for anything and even if you have no reasonable case it still costs everyone money.

 

[Dookter]

the point is that it is too easy to sue anyone for anything and even if you have no reasonable case it still costs everyone money.

Agreed. Defense bills from pointless lawsuits are a nightmare for docs. Go to http://www.williegary.com/ if you want to see a dude that flew into Durham on the Wings of Justice to sue doctors....

 

[trichomoniasis]

Agreed. Defense bills from pointless lawsuits are a nightmare for docs. Go to http://www.williegary.com/ if you want to see a dude that flew into Durham on the Wings of Justice to sue doctors....

he looks like the Montgomery Flea Market dude

 

[colbgw02]

No, thinking that malpractice is the main problem with health care is a simplified view.

Who even thinks this? I don't, and I certainly never said that I do.

 

[kdburton]

The article argues that medical malpractice litigation is not as detrimental to the economy as people tend to believe. The point he is making in the first paragraph is that auto liability insurance has a much higher cost for businesses than medical malpractice.

In the second paragraph he compares the cost of medical malpractice insurance to the entire cost of healthcare in the United States and we see it is a very small number, ~1%.

I really don't see where your comparison about the number of automobile drivers to the number of doctors fits in.

First of all insurance company revenue and payments are part of the economy, its not like all the money paid/received in malpractice suits and insurance claims go overseas or get locked up in a safe forever. Second of all the comparison to the number of drivers and the number of doctors does make sense. I pay like $200/year for auto insurance, but physicians pay a LOT more than that. The average payout for med malpractice claims is in the hundreds of thousands of dollars (car insurance payouts are obviously much less). Per capita in the physician population, their insurance premiums are a lot higher than the per capita car insurance premium (and many other insurance payments).

 

[Dookter]

Who even thinks this? I don't, and I certainly never said that I do.

Listen to anybody talk about healthcare and you'll hear all about malpractice.

 

[colbgw02]

Listen to anybody talk about healthcare and you'll hear all about malpractice.

Bringing up malpractice whenever healthcare is mentioned is a far cry from saying that malpractice is the number one problem in healthcare.

And even if people do talk all about malpractice when healthcare is the topic, what exactly does that mean? It means precisely squadoosh. Mention Vioxx, and I'm sure you'll hear about MIs. Nevermind that the number of people who died from Vioxx is miniscule as compared to the number of people who died or had adverse outcomes from UGIBs after taking Motrin for their arthritis. So let's not pretend that lay people's topic of conversation du jour is a real metric for anything.

Malpractice, IMO, is principally an issue because it:

1) discourages entry medicine in general and into certain specialties specifically, e.g. Ob/Gyn
2) encourages unnecessary and overly conservative patient work-ups

Even if economics isn't the chief motivating factor, that doesn't mean the issue shouldn't be corrected.

 

[8744]

The true cost of medical malpractice is in defensive medicine, unneccessary tests, and the inability of those in authority to use a little common sense. Not to mention the costly burden of excessive documentation which has to be experienced to believe.

Just you wait and see.

Also, if you don't think that the having to pay close to $200,000 a year for malpractice insurance like some OB-Gyns do in Florida has an effect on how they practice and who they treat well, you are buying what The Man is selling.

 

[dutchman]

Good read:

http://www.press.uchicago.edu/Misc/Chicago/036480.html

Excerpt:

In 2003 U.S. businesses paid $27 billion for auto liability insurance premiums, $57 billion for workers’ compensation insurance premiums, and less than $5 billion for products liability insurance premiums. Doctors, hospitals, and other health professionals paid only about $11 billion in medical malpractice insurance premiums. This means that the real insurance money and the real claiming action for U.S. business does not lie in high-profile areas like products liability and medical malpractice. The real action lies in routine, below-the-radar areas like workers’ compensation and automobile lawsuits. U.S. businesses paid less than half as much for products liability and medical malpractice insurance, combined, as they paid for auto insurance, alone, and only a quarter of what they paid for workers’ compensation insurance.

Products liability and medical malpractice insurance look even less significant compared to what ordinary Americans paid for personal auto liability and no-fault auto insurance: $115.5 billion in 2003. That is more than U.S. business paid for auto, workers’ compensation, products liability, and medical malpractice insurance combined. Adding all the premiums of all the different kinds of liability insurance together results in a big number—about $215 billion in 2003—but that number is hardly exploding, and the medical malpractice insurance share—$11 billion—looks pretty small by comparison. It looks even smaller next to the $1.5 trillion plus (that is more than 1,500 billion dollars) we spent on health care that year. Something that amounts to less than 1 percent of health-care costs simply cannot have the impact on health care that the medical malpractice myth would have us believe.

Bull****.

 

[Dookter]

Bringing up malpractice whenever healthcare is mentioned is a far cry from saying that malpractice is the number one problem in healthcare.

And even if people do talk all about malpractice when healthcare is the topic, what exactly does that mean? It means precisely squadoosh. Mention Vioxx, and I'm sure you'll hear about MIs. Nevermind that the number of people who died from Vioxx is miniscule as compared to the number of people who died or had adverse outcomes from UGIBs after taking Motrin for their arthritis. So let's not pretend that lay people's topic of conversation du jour is a real metric for anything.

Malpractice, IMO, is principally an issue because it:

1) discourages entry medicine in general and into certain specialties specifically, e.g. Ob/Gyn
2) encourages unnecessary and overly conservative patient work-ups

Even if economics isn't the chief motivating factor, that doesn't mean the issue shouldn't be corrected.

First of all, people do say that malpractice is the #1 problem in healthcare. I did not say that anyone here said that. But it does come up.

I agree that the lay people's thoughts on healthcare might be a little skewed. But since these same lay people are the ones with the most votes, their opinions matter. And yes, medical malpractice is a huge issue, especially when looking at it from the point of view of the doctors. However, the article posted [and the reality of the situation] is that the economics of health care [and health care problems] extend far beyond medical malpractice. That is the only point. Are malpractice issues very important? Yes. Should they be rectified? Absolutely. I don't see anyone saying we shouldn't work for positive change. However, I think we also have to embrace the reality of the sitation and realize that is one little piece of the pie.

Also, I agree that the comparison between different types of insurance in the oringinal article is useless.

 

[colbgw02]

However, I think we also have to embrace the reality of the sitation and realize that is one little piece of the pie.

Agreed.

 

[F12]

Good read:

http://www.press.uchicago.edu/Misc/Chicago/036480.html

Excerpt:

In 2003 U.S. businesses paid $27 billion for auto liability insurance premiums, $57 billion for workers' compensation insurance premiums, and less than $5 billion for products liability insurance premiums. Doctors, hospitals, and other health professionals paid only about $11 billion in medical malpractice insurance premiums. This means that the real insurance money and the real claiming action for U.S. business does not lie in high-profile areas like products liability and medical malpractice. The real action lies in routine, below-the-radar areas like workers' compensation and automobile lawsuits. U.S. businesses paid less than half as much for products liability and medical malpractice insurance, combined, as they paid for auto insurance, alone, and only a quarter of what they paid for workers' compensation insurance.

Products liability and medical malpractice insurance look even less significant compared to what ordinary Americans paid for personal auto liability and no-fault auto insurance: $115.5 billion in 2003. That is more than U.S. business paid for auto, workers' compensation, products liability, and medical malpractice insurance combined. Adding all the premiums of all the different kinds of liability insurance together results in a big number—about $215 billion in 2003—but that number is hardly exploding, and the medical malpractice insurance share—$11 billion—looks pretty small by comparison. It looks even smaller next to the $1.5 trillion plus (that is more than 1,500 billion dollars) we spent on health care that year. Something that amounts to less than 1 percent of health-care costs simply cannot have the impact on health care that the medical malpractice myth would have us believe.

This article does not provide enough information to make a valid argument.

The fist paragraph makes completely invalid comparisons across industries and insurance types. You have to compare apples with apples for anything to make sense. But, this isn't even like comparing apples with oranges - it's like comparing apples with motor oil. Auto insurance, product liability insurance, and health care have completely different cost structures. Without delving a little deeper and revealing which entities within each industries actually flit the bill, the numbers are meaningless.

The second paragraph is just as bad. The auto industry in the US is MASSIVE, as cars constitute most of our transportation infrastructure. Not a valid comparison by any means.

The fact that Insurance bills paid by entire industries are comparable in magnitude to those paid by a few hundred thousand physicians is in itself evidence that malpractice suits may be a major problem in the US health care system.

 

[badasshairday]

Why do OB/Gyn's have to pay so much for malpractice insurance? Why do they have so many cases?

 

[colbgw02]

Why do OB/Gyn's have to pay so much for malpractice insurance? Why do they have so many cases?

Well, and this is in no way exhaustive, the health of a child is near and dear to all parents. In fact, it's the proverbial 3rd rail of medicine. So much so, that parents are often willing to blame others when things don't go as planned.

It also helps that some states allow an Ob/Gyn to be held liable for any sort of deficit up until the child turns 18 years old.

 

[JacobSilge]

I'll agree that there are some people who (wrongly) believe that malpractice is the biggest issue facing health care. However, I think the reason that it gets so much face time in the media is because it is the one (of many) issue increasing the cost of health care that many feel can be relatively easily solved by tort reform/loser-pays/whatever chosen method. Comparably simple solutions to other pressing issues like increased demand due to an aging population and strains on medicare/medicaid just don't exist.

 

[deleted103644]

First of all, people do say that malpractice is the #1 problem in healthcare. I did not say that anyone here said that. But it does come up.

I think you're a bit mistaken. People don't think that malpractice is the #1 problem in healthcare. People thinking about careers in medicine however often consider it the #1 reason they're hesitant to become doctors. This is not a problem for healthcare per se, but it does have effects on the quantity and quality of the supply of new US MDs - which one might reasonably claim has an effect on the quality of healthcare in the US. I know quite a few smart and talented people who have decided to pursue dentistry instead for this (and other) reasons. Fortunately, I'm a masochist and will pursue a career in medicine hell or high water.

 

[EndSong]

Ye Gods... That article was awful. It barely made sense. How does the total american spending on car insurance being greater than the costs of medical malpractice mean anything, except that as a country, we spend more on insuring cars than we do on insuring doctors. And there are probably lots of reasons why one is more than the other, but to construct the argument that malpractice IS or IS NOT a big problem in health care is unrelated entirely to the facts presented.

Why stop at comparing the cost of medical malpractice insurance with car insurance, when we can compare the costs of medical malpractice and the costs of the department of defense? I'm sure medical malpractice looks even smaller when we look at the cost of "keeping our country safe." But then again, Medical Malpractice insurance does often exceed postage insurance, so it is also very, very expensive and thus is the biggest problem in health care.

A correct argument is looking at all the problems in health care and weighing how badly they damage health care and then determining which is most detrimental.

 

[Law2Doc]

The better question is, and one that's difficult (if not impossible) to answer, how much money could be saved if physicians didn't feel compelled to practice "defensive" medicine? There's no way to quantify this, but I'm willing to guess that if released from the fear of litigation, the decrease in unnecessary and overblown work-ups combined with the drop in the overwhelming volume of paperwork would affect healthcare costs significantly.

Well, in general, the American people and most physicians have no objection to legitimately negligently injured people getting their due -- it tends to be the "frivolous" and "excessive" lawsuits that get stuck in peoples' craw. Which is why politicians talk of tort "reform" not medmal abolishment. But recent studies have suggested that so called frivolous suits are really a small ripple in the pond. Since you would still have to carry insurance and do things to avoid nonfrivolous negligence you would still have to practice some degree of defensive medicine, even with a bit of clean-up in medmal. Probably would not lead to all that much in the way of savings - certainly wouldn't lessen the complaining in the industry. And the bulk of paperwork will continue even with some medmal reform because even if you inhibit the so called frivolous suits, you are going to need documentation to demonstrate that negligence/gross negligence/recklessness has not occurred. This is a cost that will continue to climb until everything gets computerized.

In fact ALL professions need to carry malpractice insurance and can get sued for screw ups. I was covered by significant malpractice insurance when I practiced law (the size of the policy was based on the size of deals the firm was engaged in, ie the amount of damage I could do). That (negligence law) is a basic tenet of American jurisprudence and won't likely ever change. Doctors are not singled out, but tend to get hit harder because of the damage they can cause when they screw up (esp OB/GYNs because an injured baby has a lifetime of expenses and disability). But the justice system is designed to protect the injured victim, not the doctor, so you have to look at it from that frame of reference.

While I agree the above article oversimplifies costs, I think those who suggest getting rid of medmal, defensive medicine, etc. probably undersimplify even worse -- medmal is a necessary evil because doctors will make mistakes and in the US those negligently damaged victims get to be "made whole". You can tweak it to get rid of the unreasonable awards and frivolous cases but those are less common than you would think reading this board, and really aren't big ticket expense items (except to the doctors in those cases). The reality is that everyone on here will make a mistake or two as a physician, and when they do, their insurance policy will protect them.

 

[postbacker]

How is this issue handled in other countries, particularly the "socialized" med countries?

 

[trichomoniasis]

Why do OB/Gyn's have to pay so much for malpractice insurance? Why do they have so many cases?

because if you hiccup while you're delivering a baby you'll give it the palsy.

 

[Kikaku21]

Good read:

http://www.press.uchicago.edu/Misc/Chicago/036480.html

Excerpt:

In 2003 U.S. businesses paid $27 billion for auto liability insurance premiums, $57 billion for workers’ compensation insurance premiums, and less than $5 billion for products liability insurance premiums. Doctors, hospitals, and other health professionals paid only about $11 billion in medical malpractice insurance premiums. This means that the real insurance money and the real claiming action for U.S. business does not lie in high-profile areas like products liability and medical malpractice. The real action lies in routine, below-the-radar areas like workers’ compensation and automobile lawsuits. U.S. businesses paid less than half as much for products liability and medical malpractice insurance, combined, as they paid for auto insurance, alone, and only a quarter of what they paid for workers’ compensation insurance.

Products liability and medical malpractice insurance look even less significant compared to what ordinary Americans paid for personal auto liability and no-fault auto insurance: $115.5 billion in 2003. That is more than U.S. business paid for auto, workers’ compensation, products liability, and medical malpractice insurance combined. Adding all the premiums of all the different kinds of liability insurance together results in a big number—about $215 billion in 2003—but that number is hardly exploding, and the medical malpractice insurance share—$11 billion—looks pretty small by comparison. It looks even smaller next to the $1.5 trillion plus (that is more than 1,500 billion dollars) we spent on health care that year. Something that amounts to less than 1 percent of health-care costs simply cannot have the impact on health care that the medical malpractice myth would have us believe.

Couple of things:

1. As others have said, there is a problem with denominators here. Auto insurance covers way more American drivers than Malpractice insurance covers doctors. This is like comparing Germany's GDP with America's on a non-per capita basis. Its not apples to oranges.

2. Even at the "broad total effect on the economy level" that posters have mentioned, we miss the essence of the problem. The economy is based on individual preference. If doctors get charged to much in malpractice insurance and it affects where they practice, if they practice, and how they practice, the consumer loses. This is the problem we face.

3. This doesn't address other problems with malpractice insurance. The effect on doctor's clinical judgement that fear imposes. The fact that people who actually are damaged are not getting anything because the lawyer deems the case unwinnable, or that the award would not be "worthy" of pursuit. Moral of healthcare workers.

Malpractice is a problem. It needs to be addressed.

 

[Mortal_Lessons]

However, I think we also have to embrace the reality of the sitation and realize that [medical malpractice] is one little piece of the pie.

That's just not true. On paper, sure--medical malpractice premiums make up something like 1 % (or whatever number you quoted above), but like everyone else has mentioned, this 1 % is a lot to doctors. And before you argue against my doctor-centric view, let's take a moment and see who these doctors treat. The lay people. So if the doctors treating the lay people have to practice defensive medicine, order many superfluous tests, and occasionally even retire before they'd ideally like to b/c of the high cost of malpractice premiums, then the healthcare problem (specifically from the malpractice root) is magnified more than its paper-looking cost. In summary, you're right about how on paper, medical malpractice premiums are only a small slice of the pie, but to ignore its true costs which may not be clearly and explicitly captured in a nice, succinct manner, is to underestimate its importance.

 

[Dookter]

That's just not true. On paper, sure--medical malpractice premiums make up something like 1 % (or whatever number you quoted above), but like everyone else has mentioned, this 1 % is a lot to doctors. And before you argue against my doctor-centric view, let's take a moment and see who these doctors treat. The lay people. So if the doctors treating the lay people have to practice defensive medicine, order many superfluous tests, and occasionally even retire before they'd ideally like to b/c of the high cost of malpractice premiums, then the healthcare problem (specifically from the malpractice root) is magnified more than its paper-looking cost. In summary, you're right about how on paper, medical malpractice premiums are only a small slice of the pie, but to ignore its true costs which may not be clearly and explicitly captured in a nice, succinct manner, is to underestimate its importance.

You guys are just proving the point over and over again. Malpractice issues are overblown. Someone so much as mentions the fact that malpractice actually is one little part of healthcare expenses, and people go nuts. Sure, it is significant. Sure, it leads to other expenses. Sure, it causes a lot of pain for doctors [especially in certain fields]. And I never suggested we underestimate its importance or ignore it. I am just saying we need to not overestimate its importance...it'll just distract us from all the other issues out there.

EDIT: And if you look at what you quoted me as saying---it IS true. Malpractice is one little piece of the pie. Sure, it's a piece....but it's one piece of many.

 

[patrickd223]

You do realize that there are alot more people driving cars, buying coffee from McDonalds, and shopping in department stores than people getting operations and seeing doctors right? 11 billion might seem like a little bit comparatively but if you match it to the # of people in business with the # of doctors in medicine... The true facts will come out.

 

[Law2Doc]

and occasionally even retire before they'd ideally like to b/c of the high cost of malpractice premiums,

Actually because of the hit to income that medmal insurance causes, far more doctors are actually retiring later than they'd ideally want to because they haven't saved a big enough retirement nut.

See Dooker's point above. If you are looking at this issue from the standpoint of doctors, you are kind of missing the boat.

 

[Mortal_Lessons]

EDIT: And if you look at what you quoted me as saying---it IS true. Malpractice is one little piece of the pie. Sure, it's a piece....but it's one piece of many.

I think it's a bigger piece than you're making it out to be. Just b/c a pie has many slices doesn't mean that one slice can't be relatively larger than the others. The article's comparisons of malpractice premiums to other types of premiums, which on paper is substantially less, is nothing but a smokescreen and an attempt to compare apples and oranges. I think we need to find a healthy balance of how much to emphasize medical malpractice-- and being no expert in the field, I don't know how we could do that, but I'm wary of experts who have other hidden agendas.

 

[Mortal_Lessons]

Actually because of the hit to income that medmal insurance causes, far more doctors are actually retiring later than they'd ideally want to because they haven't saved a big enough retirement nut.

See Dooker's point above. If you are looking at this issue from the standpoint of doctors, you are kind of missing the boat.

To your point about retirement: Straight from the first line of a recent Neurosurgery journal article. And as you may know, neurosurgeons carry some of the highest medical malpractice premiums:

"PROFESSIONAL liability concerns coupled with ever-increasing
insurance premiums constitute one of the
primary reasons neurosurgeons cite for their retirement
from practice at an earlier stage than they might
otherwise have wished."

Um, so I think I'm straight on about that point. Can you provide evidence to that contrary? I can send you the article if you like, as it is an interesting read in its own right.

 

[Law2Doc]

I think it's a bigger piece than you're making it out to be. Just b/c a pie has many slices doesn't mean that one slice can't be relatively larger than the others. The article's comparisons of malpractice premiums to other types of premiums, which on paper is substantially less, is nothing but a smokescreen and an attempt to compare apples and oranges. I think we need to find a healthy balance of how much to emphasize medical malpractice-- and being no expert in the field, I don't know how we could do that, but I'm wary of experts who have other hidden agendas.

The article is definitely comparing apples to oranges, but medmal is really a grape by size compared to other healthcare issues.

 

[Law2Doc]

To your point about retirement: Straight from the first line of a recent Neurosurgery journal article. And as you may know, neurosurgeons carry some of the highest medical malpractice premiums:

"PROFESSIONAL liability concerns coupled with ever-increasing
insurance premiums constitute one of the
primary reasons neurosurgeons cite for their retirement
from practice at an earlier stage than they might
otherwise have wished."

Um, so I think I'm straight on about that point. Can you provide evidence to that contrary? I can send you the article if you like, as it is an interesting read in its own right.

Not buying it. That doctors are opposed to medmal in various journal articles is not exactly news. But that doctors aren't retiring as early as they used to is pretty common knowledge.

 

[Mortal_Lessons]

Not buying it. That doctors are opposed to medmal in various journal articles is not exactly news. But that doctors aren't retiring as early as they used to is pretty common knowledge.

Wait, you didn't address the quote above. The journal article may be about medmal, but that specific quote is about early retirement b/c of medmal. Just b/c doctors aren't retiring as early as they used to doesn't mean there's a casual relation between that and medmal. In fact, the quote above shows otherwise. Lol..

 

[Law2Doc]

Wait, you didn't address the quote above. The journal article may be about medmal, but that specific quote is about early retirement b/c of medmal. Just b/c doctors aren't retiring as early as they used to doesn't mean there's a casual relation between that and medmal. In fact, the quote above shows otherwise. Lol..

I think we are going to need to agree to disagree on this one. If folks are retiring later and later these days then saying that medmal is driving them out early rings a bit hollow don't you think?

 

[JacobSilge]

Law2Doc and Mortal_Lessons, I think you guys are both right! In the specialties where malpractice costs are the highest (such as Neurosurgery or OB) some physicians will end up retiring early since making a practice profitable is much harder with the malpractice burden. However, for the majority of physicians malpractice isn't that much of an issue and it only decreases compensation, leading to more years worked to save for retirement.

 

[Mortal_Lessons]

Law2Doc and Mortal_Lessons, I think you guys are both right! In the specialties where malpractice costs are the highest (such as Neurosurgery or OB) some physicians will end up retiring early since making a practice profitable is much harder with the malpractice burden. However, for the majority of physicians malpractice isn't that much of an issue and it only decreases compensation, leading to more years worked to save for retirement.

 

[deuist]

For the people who claim that malpractice isn't so bad, how many doctors have you heard of that leave states for less hostile areas? Now how many drivers do you know of that leave a state in search of cheaper car insurance? Physicians aren't going to pack up and leave a practice because malpractice is a mere nuisance. The premiums must be sufficiently high to warrant such a move.

 

[Dookter]

For the people who claim that malpractice isn't so bad, how many doctors have you heard of that leave states for less hostile areas? Now how many drivers do you know of that leave a state in search of cheaper car insurance? Physicians aren't going to pack up and leave a practice because malpractice is a mere nuisance. The premiums must be sufficiently high to warrant such a move.

Wow, you guys are really having trouble grasping this. The part of the article talking about auto insurance, etc., is absolutely useless. And the point of the article is NOT from the point of view of doctors. It is looking at the healthcare system. Malpractice is an issue, absolutely. It is NOT the reason the healthcare system is so screwed up. It is a fraction of all the money spent in the system. No wonder they ask about healthcare issues in interviews. It seems like a lot of people here would stare with a blank look at say, "But but but but but, doctor's salaries....doctor's salaries...doctor's leaving practice...doctor's salaries....blah blah blah...."

 

[ElisaBailey]

aren't there fewer doctors than there are drivers, so each doctor takes up a larger bulk...?

 

[deuist]

Wow, you guys are really having trouble grasping this. The part of the article talking about auto insurance, etc., is absolutely useless. And the point of the article is NOT from the point of view of doctors. It is looking at the healthcare system. Malpractice is an issue, absolutely. It is NOT the reason the healthcare system is so screwed up. It is a fraction of all the money spent in the system. No wonder they ask about healthcare issues in interviews. It seems like a lot of people here would stare with a blank look at say, "But but but but but, doctor's salaries....doctor's salaries...doctor's leaving practice...doctor's salaries....blah blah blah...."

I don't see why you're being so condescending. The title of this article is about malpractice insurance. While there are other problems with medicine, I'm speaking to the most common issue that has been brought up on this thread.

 

[Mortal_Lessons]

[Malpractice] is NOT the reason the healthcare system is so screwed up. It is a fraction of all the money spent in the system. No wonder they ask about healthcare issues in interviews. It seems like a lot of people here would stare with a blank look at say, "But but but but but, doctor's salaries....doctor's salaries...doctor's leaving practice...doctor's salaries....blah blah blah...."

Why don't you comment a bit on why the healthcare system is so screwed up. Your attitude seems to warrant it.

 

[sgglaze]

Good read:

http://www.press.uchicago.edu/Misc/Chicago/036480.html

Excerpt:

In 2003 U.S. businesses paid $27 billion for auto liability insurance premiums, $57 billion for workers' compensation insurance premiums, and less than $5 billion for products liability insurance premiums. Doctors, hospitals, and other health professionals paid only about $11 billion in medical malpractice insurance premiums. This means that the real insurance money and the real claiming action for U.S. business does not lie in high-profile areas like products liability and medical malpractice. The real action lies in routine, below-the-radar areas like workers' compensation and automobile lawsuits. U.S. businesses paid less than half as much for products liability and medical malpractice insurance, combined, as they paid for auto insurance, alone, and only a quarter of what they paid for workers' compensation insurance.

I have to clear this up because it's been bugging me. The vast majority of you have interpreted this paragraph to be saying that Autoinsurance costs more than malpractice insurance, therefore malpractice isn't that big of a problem. You've then criticized this position as comparing apples to oranges and that it doesn't take into account the amount of doctors compared to the amount of drivers.

Feel free to correct me if I'm wrong, but that is not the point of that paragraph. He's making a claim about public perception of insurance claims. He's saying that, while most people think the real claiming action and lawsuits in insurance are in areas like malpractice and liability (which are often very highly publicized and would therefore distort public perception), most insurance money actually goes towards workman's comp and automobile lawsuits.

Ok, just had to get that out of the way because a lot of people are making a big deal about an apples oranges comparison which really isn't there in the first place. Also there is a link to the whole article, which has more to say than those 2 paragraphs.

 

[maestro1625]

liability issues and insurance costs aren't the main culprit for the massive costs of US healthcare, yet those issues are a major problem for certain individual doctors. (what else would drive a succesful OBGYN to move to Iowa?)

good enough for everyone?

/and why isn't this obvious?