'An unstable situation': Nuclear verdicts are resetting what malpractice cases are worth

Nuclear verdicts are resetting what malpractice cases are worth

The average of the 50 largest medical malpractice judgments in the United States has climbed from just over $30 million to more than $56 million per case in the past two to three years. Beyond that, what Richard Anderson, M.D., FACP, chairman and CEO of The Doctors Company and TDC Group, calls "thermonuclear" verdicts — those exceeding $100 million — are now a regular occurrence. Medical Economics sat down with Anderson and asked him about the trend.

Anderson pointed to several forces converging at once. Wealth concentration has dulled the public's sense of what large sums mean, he said.

"It used to be that $100,000 seemed like a lot of money. Then millions seemed like a lot, then billions. Now we are comfortable talking about trillions, even though virtually none of us can comprehend what a trillion anything is." Younger juries, he added, carry less institutional trust and different expectations of fairness than previous generations.

There's also a cultural dimension that cuts across age groups: the belief that any adverse outcome has a responsible party who owes compensation. "If you do not sue, you are 'leaving money on the table,'" Anderson said. "That is a very dangerous attitude."

The consequences extend well beyond the individual verdict. When a $50 million judgment is returned in a given venue, it resets the baseline for what similar cases are expected to be worth, shaping settlement negotiations and plaintiff expectations even in cases with different facts. "The effect, like a wave, goes throughout the entire health care system," Anderson said. And because the government now funds more than 55% of U.S. health care, he argues the financial harm is increasingly circular: large malpractice indemnities paid by public dollars are ultimately paid by taxpayers.