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AMA Fight for Medical Liability Reforms Continues

56501897By Rebecca J. Patchin, M.D.

Every day across America physicians are forced to consider the broken medical liability system when making important medical decisions. Physicians are compelled to order unnecessary tests to avoid lawsuits, yet many still wind up in court fighting a meritless case. This expensive, ineffective cycle has to stop for the sake of both physicians and patients, and the AMA is working to make that happen.

Medical liability reforms will ensure adequate access to health care, as well as reduce health-care spending. Not only are physicians forced to put aside patient care to defend themselves in court against meritless lawsuits, but they are also forced to pay sky-high medical liability premiums. Patients who have been harmed by negligence should be fairly compensated, and we need reforms that provide patients with their day in court without driving up health-care costs and reducing access to care for all. Unfortunately, the current liability system has evolved into a “lawsuit lottery,” where a few patients and lawyers receive astronomical awards, and put access to care at risk for everyone else.

Defensive medicine is an unfortunate outgrowth of our country’s broken liability system and one reason for the out-of-control health-care costs in America. A 2003 Health and Human Services (HHS) report estimated the cost of defensive medicine to be between $70 and $126 billion per year. Physicians need to be able to practice without the constant pressure of lawsuit threats. The Obama administration has signaled they are open to medical liability reform, and the AMA will continue to keep this issue on the table.

The AMA ideal is medical liability reforms patterned on proven reforms working in California and Texas. With a $250,000 cap on non-economic damages, these states’ reform laws have shown to be fair to patients and effective at stabilizing medical liability insurance rates. Unfortunately, this proven reform has yet to be enacted on the national level, so we must think of innovative ways to address the challenges of our current liability system and the political realities of the day. Alternative dispute resolution and health courts are two concepts that show promise.

Alternative dispute resolution mechanisms make it possible to resolve medical liability claims fairly and in a more timely and cost-effective manner. Appropriate alternative dispute resolution methods should be able to identify meritless claims and dispose of them, decrease the proportion of cases being litigated, increase the portion of settlement payment received by the patient and identify suitable guidelines for payment of damages.

Health courts would provide a forum where medical liability actions could be heard by judges specially trained in medical liability matters and who hear only medical liability cases. The AMA developed and adopted health court principles in 2007. Within these courts, physicians can be confident that cases will be heard by judges that can knowledgeably assess the unique conditions of medical liability cases.

Several states have amended the statutory qualifications for those who may serve as medical expert witnesses at trial. Such amendments have created additional standards that experts must meet in order to ensure the testimony juries receive is presented by an individual with particularized expertise in the matter in question.

Health-care reform is a top priority in America, and medical liability reform should be part of the package, especially if we truly want to reduce the growth in health-care spending. The AMA is committed to enacting and defending strong medical liability reform laws on the state and national levels so that physicians can focus on what’s most important – patient care.

Rebecca J. Patchin, M.D. is Board Chair-elect, American Medical Association 


  1. Dr. Mike Amsden

    With 30+ years in the “pit ” as an ER doctor, without a doubt the single biggest help to control costs is tort reform. I felt compelled to defend against the lawyer saying “the doctor knew or should have known ….” insert any lab or xray result… here. I have been sued and to court for missing something which I ordered the test for and the patient himself refused to get the test. This did not help me feel like taking risks. Besides how many of us see a patient for a shoulder ache and order a cat scan of the chest to rule out Pancost’s tumor at the first visit. There is not enough money in the world to pay for “perfection” in medicine. There must be step wise diagnositc paths which account for costs and “the vagaries of human disease”. I recall looking for TB in a patient for 4 weeks before it was found. Mandate insurance companies take all. Do not let them cherry pick for healthy people from birth. My ER has to see all comers regardless of finances or state of health. Take care not to incintivise results too much or doctors will dismiss patients with bad genetics or difficult health problems because that patient costs too much in “results” pay. I have seen this already. Doctors refuse to take a difficult case because they feared poor results would harm their record or land them in court. This will never be a simple as going through a pre-flight check list in an airliner, something to which I have seen medicine compared.

  2. This medical liability reform in the USA is essential for the health growth and sustainability of private healthcare initiative in the USA and also elswhere.The USA is the the prime example of how healthcare can be efficiently and effectively operated as a private sector initiative for social services. The success of US healthcare services is a testimony of success in private healthcare services the world can emulate.This is important to balance the strong demand for public healthcare initiatives to ensure social justice.


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