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Tort reform still represents the pain of an ailing system


Group Editor Daniel Verdon says tort reform is just one part of a complex problem encompassing providers, payers, physicians, and the justice system.

They are just two words, and yet to many physicians tort reform symbolizes much pain associated with an ailing judicial and healthcare system.

While the aim of tort reform is to put a ceiling on damages, muzzle greedy trial attorneys and keep spiraling healthcare costs and malpractice insurance premiums in check, it’s just one piece of an increasingly complex problem that ultimately involve the legal system, health of patients, clinical decision making, medical ethics, payers, income, boards, licensure, clinical guidelines, evidence-based medicine, and ultimately, fear.

And while all the arguments surrounding tort reform have been decades in the making, the rhetoric and hyperbole surrounding the issue this time seem to be a little different. It will be driven by the real need for the system to contain spiraling healthcare costs overall–not necessarily from huge malpractice, negligence, non-economic damages, or baseless lawsuits – but from a concerted effort to address the practice and costs associated with defensive medicine.

And that is exactly why Medical Economics opted to tackle this complicated topic. It’s so much more than tort reform. Our coverage explores the dichotomy of the issue, looks at national data and offers physician opinions on the potential impact of tort reform. It also explores why excesses in the judicial system have ultimately trained physicians to err on the side of caution.

This issue picks at key policy problems, and it examines physician fear about getting sued. It’s looks at the realities of a malpractice or negligence lawsuit, the long-term impact to reputation and career. Malpractice happens; so do medical mistakes; so do negative outcomes when you are dealing with a complex biological system. It is about life; it’s about healing; it’s about the quality of life, and it’s about death. It’s about second-guessing your treatment decisions. It’s about what a physician feels is right for the patient at the time a test is ordered, drug prescribed, c-section recommended or other procedure undertaken. It’s about the cost of a physician’s reputation, licensure, and career. It’s about the decade lost to defending a malpractice lawsuit. It’s about ordering tests to make certain your clinical hunch is accurate before embarking on a treatment regimen.

While it’s important to understand data from the Congressional Budget Office that estimates caps on damages would only reduce healthcare spending by .5%, it is just as important to unmask and address why physicians feel compelled to practice defensive medicine in the first place.

In our coverage, Michael Niziol, MD, may have said it best. “As I tell my new practitioners, no one can fault you for ordering a test. But they can fault you for not ordering the test.”

While there has been progress in some states in place caps on non-economic damages, all the issues surrounding the practice of defensive medicine will take on even greater importance in the next few years as the scrutiny and focus intensifies on cost containment, adhering to guidelines and using evidence to justify your medical decisions.

So, how should the system change? E-mail me your comments for inclusion in an upcoming issue: medec@advanstar.com.

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