We were wondering whether to start a game of "Medical Negligence Truth or Dare" but decided "Medical Negligence True or False" might be a little safer. (Although as you'll see, in health care safety isn't always Job One.) Anyway, let's give it a try.
TRUE OR FALSE?
1. After a state caps damages for the purpose of decreasing unnecessary tests and procedures (i.e., reducing "defensive medicine"), common tests like cardiac stress and imaging tests do, in fact, decrease.
False. Instead, such tests appear to increase, as does Medicare Part B lab and radiology spending. Researchers say,“If the policy goal is to limit healthcare spending, damage caps are simply the wrong tool.… [A] core message from our findings is that writ large, the ‘adopt damage caps, reduce spending’ story lacks empirical support. Instead, measures to reduce overtreatment will need to be carefully targeted to particular areas of concern.”
2. Medical societies are making healthcare unsafe by focusing attention on “tort reform” instead of reducing errors.
True. According to researchers, after “the American Society of Anesthesiologists (ASA) studied closed claims data in 1985 to examine ‘the types of injuries that occur and their frequency,’ anesthesia procedures were changed ‘that protected millions of patients from harm.’ However, ‘other professional societies were slow to follow the ASA’s lead. Instead of devoting resources to the study of root causes, they sought to reduce their members’ exposure to liability claims by lobbying for damages caps and other restrictions on lawsuits. These efforts benefited their members, but likely harmed patients by reducing the pressure the liability system exerted on providers to improve patient safety.”
3. Actual payouts to malpractice victims are usually capped at doctors' insurance policy limits - even if juries award more.
True. Data show that even when injuries and negligence are significant and a jury verdict is appropriately large, actual payouts to patients rarely exceed the health care provider’s insurance policy limits. In other words, there are no "jackpots" here.
4. More than 250 doctors who recently surrendered a medical license in one state were able to practice in another state.
True. This is according to a 2018 investigation by the Milwaukee Journal Sentinel, USA Today and MedPage Today.
5. Medical boards frequently consult the National Practitioner Data Bank (NPDB), which exists to ensure that past physician negligence, such as prescription drug abuse, unsafe surgeries, or sexual relations with patients, are known before allowing a doctor to practice.
False. Last year, "30 state medical boards in the U.S. backgrounded a physician using the database fewer than 100 times, according to numbers from the Health Resources and Service Administration. Thirteen boards didn’t even check it once.”
6. When hospitals settle malpractice cases involving one of their doctors, they use tactics to avoid reporting the doctor’s actions to the NPDB.
True. One tactic is called the “corporate shield.” According to researchers, “The shield is employed when ‘the medical corporation for which the doctor works is named in the suit, and the doctor is either not originally named or is released specifically for the purpose of avoiding a report to the NPDB.’ Although the extent to which this tactic reduces the number of payments that are reportable to the NPDB is not known, some authors believe that one-half of otherwise reportable adverse events are deflected by this means.”
7. Doctors are correct: malpractice settlements are poor indicators of past negligence and poor predictors of future claims.
False. Indeed the exact opposite is true. According to researchers, malpractice settlements are “good indicators of past negligence because both the likelihood and the size of payments correlate with the strength of the evidence of medical malpractice. They are good predictors because the number of past settlements correlates with the likelihood that more payments will be made.” Also here.
8. The U.S. medical malpractice insurance industry is losing money as a result of underwriting losses (i.e., too many claim payouts).
False. The net income for these insurers increased to more than $1.1 billion from $764 million in 2016.
9. A wrong or delayed diagnosis causes, on average, one patient death per day in a U.S. hospital.
False. On average, someone dies in U.S. hospitals due to wrong or delayed diagnosis every nine minutes.
10. Unsafe medical workplace conditions are a bigger patient safety problem than physician burnout.
False. Physician burnout, which 55 percent of doctors report, is at least equally responsible for medical errors as unsafe medical workplace conditions, if not more so. And “health care facilities where doctor burnout was seen as a common problem saw their medical error risk rate triple, even if the overall workplace environment was otherwise thought to be very safe.…” See here, here, here, here.)
BONUS QUESTION
(Just cause there's lots to say about the following.)
By the end of the decade, there is expected to be a shortage of between 42,600 and 121,300 physicians, including OB-GYNs, because doctors cannot afford their medical malpractice insurance premiums.
False. Yes, there will be such shortages but for reasons that have nothing to do with malpractice. Rather, this is due to the “growing, aging population” and “physician-retirement decisions.” For example, data from the Centers for Medicare & Medicaid Services demonstrate that “the growing shortage in obstetricians and gynecologists (OB-GYN) [is] due to a maturing workforce and coming retirement wave.” Others note, "Changes in physician-retirement decisions could have the greatest impact on supply, and over one-third of all currently active physicians will be 65 or older within the next decade.” According to a survey from the Doctors Company, “Over half of physician respondents plan to retire within the next five years,” a 54 percent increase from 2012 results. Why? Doctors are considering retirement as they feel the pressure of declining reimbursements, increased administrative burden, and industry consolidation.” Even in Texas, which stripped away patients’ rights in 2003 ostensibly to address the problem of physician supply, there’s a major physician shortage because medical school enrollment and resident positions are insufficient to meet the projected demand of a growing population.
Hope you did well cause your life may depend on it (not to scare anyone). You can find all this and more in the Center for Justice & Democracy's new Briefing Book - Medical Malpractice: By The Numbers, December 2018 Update.
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