AMA Fight for Medical Liability Reforms Continues

By 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