Texas’ enhanced physician workforce has resulted in the opportunity for 2 million more patient visits per year than likely would have occurred without reform.
1992 to 2010 from two hospital databases and published the results in the April 2011 issue of the Journal of the American College of Surgeons.
“Malpractice Risk and Cost Are Significantly Reduced after
Tort Reform” shows Texas had far fewer surgical liability law- suits after tort reform — 40 per 100,000 operations before versus 8 per 100,000 operations afterward.
The data used in the study gave the authors a snapshot of medical liability suit prevalence and associated costs from 1992 to 2010, when surgeons performed 98,513 procedures. Patients filed 25 lawsuits during the pre-reform timeframe (1992–2003). Overall litigation cost for these cases was $7.15 million, including $5.56 million in liability payments and $1.6 million in legal fees. The health science center’s annual cost of all medical liability claims during the pre-reform period to- taled nearly $600,000. In contrast, after tort reform (2004–10), patients filed only
three surgery-related lawsuits, with legal costs totaling just $500 per year. Additionally, medical lawsuit filings in Harris and Dallas counties are down since 2003. According to the Dallas County District Clerk’s Office, there were 1,108 medical liability law- suits there in 2003. The same year, Harris County had 1,203 cases. Last year, there were only 85 medical liability lawsuits in Dallas County and 234 in Harris County. Data from the counties show that through May this year, there were 36 law- suits in Dallas County and 98 in Harris County.
TMA supports national tort reform An American Medical Association report on physicians’ expe- riences with medical liability claims published last year says that an average of 95 medical liability claims had been filed for every 100 physicians surveyed from 2007 through 2008. The report reveals nearly 61 percent of physicians 55 and older were sued, and there is wide variance in the impact of liability claims among specialties.
16 TEXAS MEDICINE September 2011
For instance, the number of claims per 100 physicians is more than five times greater for general surgeons and obstetricians and gynecologists than for pediatricians and psychia- trists. Before they reach age 40, more than 50 percent of obstetricians and gynecologists have been sued. The report also shows 90 percent of gen- eral surgeons 55 and older have been sued.
The AMA report finds the num- ber of medical liability claims does not indicate the frequency of medi- cal error, as the physician prevails 90 percent of the time in cases that go to trial. While 65 percent of claims are dropped or dismissed, they aren’t without expense. Average defense costs per claim range from a low of
more than $22,000 among claims dropped or dismissed to a high of more than $100,000 for cases that go to trial. This leads to increased costs for physicians and patients, AMA says.
In an effort to rein in costs, TMA supports expanding Texas- style tort reform nationally. “Tort reform at the national level would allow hospitals and clinics to direct more money toward patient care and away from defending frivolous lawsuits,” Dr. Malone said. Earlier this year, then-TMA President Susan Rudd Bailey,
MD, wrote House Judiciary Committee Chair Lamar Smith (R- Texas) to encourage passage of the Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011, filed by Representatives Smith, Phil Gingrey, MD (R-Ga.), and David Scott (D-Ga.). In addition to a $250,000 cap on noneconomic damages, the bill requires medical liability suits to be filed within three years of the injury in most cases. The HEALTH Act maximizes patients’ awards by allowing courts to ensure that an unjust portion of the patient’s recovery isn’t misdirected to an attorney and allows patients to recover the full cost of economic damages, such as medical bills and lost income. TMA’s letter is in addition to a letter of endorsement that AMA and 100 other physicians and medical organizations sent to the bill’s sponsors. At press time, the bill had cleared the House Energy and Commerce Committee and was pending further action. In addition, TMA backs legislation to improve patients’ ac- cess to physicians by ending unnecessary lawsuits. U.S. Rep. Michael C. Burgess, MD (R-Texas), filed House Resolution 896, known as the Medical Justice Act, earlier this year. The bill regulates civil actions for an injury or death resulting from health care by, among other provisions, limiting the noneco- nomic damages that an individual could recover. Medical litigation and soaring liability insurance premiums contribute significantly to the rising cost of health care, Rep-
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