News
& trends
April 2007 | Volume 43, Issue 4
Public Citizen report debunks med-mal myths
Alba Lucero Villa, Associate Editor
Medical malpractice payments to injured patients have
been declining, despite the rising number of preventable
medical errors, according to a recent report by Public
Citizen.
The Washington, D.C.-based consumer advocacy
organization analyzed malpractice payments reported in
the National Practitioner Data Bank (NPDB) between 1990,
the year the data bank was established, and 2005. It
concluded that patient safety—not medical negligence
litigation—is the real crisis. Contrary to widespread
myths about skyrocketing payments to plaintiffs, the
report found:
- The number of malpractice payments declined by
15.4 percent in the time period studied.
- The average annual payment decreased by 8
percent in that period and never exceeded $1 million
after inflation adjustments.
- In 2005 alone, the sum of judgments for more
than $1 million comprised less than 3 percent of the
total value of malpractice payments.
The report suggested that malpractice payments are
neither unpredictable nor irrational, as tort “reform”
advocates claim, but instead correspond to severity of
injury. More than 82 percent of the total sum of
payments compensated patients who suffered the most
severe injuries, and plaintiffs whose cases involved a
“minor permanent injury” received 55 percent less than
those who had a “significant permanent injury.”
“Rather than providing irrational awards to
undeserving plaintiffs, the current medical liability
system is rational in its outcomes,” the report
concluded. The highest payments have gone to the
families of people who died as a result of medical
malpractice. In 2005, more than 64 percent of payments
involved death or major injuries, while less than 2
percent were for an “insignificant injury.”
In response to the report, the American Medical
Association (AMA) issued a statement questioning the
reliability of data obtained from the NPDB—which is
maintained by the Department of Health and Human
Services—citing a 2000 study by the Government
Accountability Office that found discrepancies in the
database.
“What the AMA doesn’t tell people is that the data is
actually revised every quarter,” said Seth Oldmixon, a
legislative assistant at Public Citizen’s Congress Watch
group and the author of the report.
Other groups, such as the Physician Insurers
Association, joined the AMA in criticizing the report’s
methodology, particularly its use of the medical care
services index instead of the consumer price index to
measure inflation.
“If you really want to determine a just compensation,
you have to adjust for inflation based on the unusually
high rate of inflation that medical services fall
under,” Oldmixon countered.
The critiques are “a red herring to distract from the
real problem that there is a lack of serious attention
to patient safety and physician oversight,” he said.
“There is a virtual epidemic of medical errors plaguing
the country.”
The Public Citizen report echoed findings from a 2006
Harvard School of Public Heath study that reviewed 1,452
closed malpractice claims from five liability insurers
and determined that 80 percent involved injuries
resulting in “significant or major disability or death.”
The Harvard study concluded that “portraits of a
malpractice system that is stricken with frivolous
litigation are overblown,” and “the malpractice system
performs reasonably well in its function of separating
claims without merit from those with merit and
compensating the latter.”
The study also noted that while 63 percent of
injuries were the result of a medical error, one in six
of those claims did not result in compensation.
In addition to recommending improvements in patient
safety and health-care provider training, Public
Citizen’s report stressed the importance of disciplining
repeat offenders. Only 33 percent of doctors who made 10
or more malpractice payments were disciplined by their
state medical board, and some doctors with up to 31
med-mal payments have never been subjected to any
disciplinary action, according to the report.
Currently, attorneys and patients have no way of
knowing who these doctors are, as the NPDB Public Use
File conceals practitioners’ personal information. The
report urged Congress to lift the veil of secrecy,
especially considering the small percentage of doctors
responsible for the majority of the malpractice
committed.
While 82 percent of doctors had not made a medical
malpractice payment since 1990, 5.9 percent of the
others accounted for 57.8 percent of all malpractice
payments since 1991, according to the data.
“The report pokes a hole in the myth that it’s
lawsuits that are driving malpractice insurance premiums
through the roof,” said Jeffrey Roy, a Boston-based
attorney who handles medical malpractice cases. “It
validates a lot of what we have been saying for a number
of years—that there is a great medical malpractice hoax.
“When I visit or speak with any group, I talk about
these types of studies,” Roy said. “There’s still a
level of skepticism out there [about medical malpractice
claims]. People have been trained and brainwashed over
the past couple of years. As more data like this comes
out, we are going to be able to turn that page.”
The full text of the report, The Great Medical
Malpractice Hoax, is available online at
www.citizen.org/documents/NPDB%20Report_Final.pdf.
