Sorting fact, fiction is only way to fix malpractice woes

News reports of recent efforts to reduce malpractice insurance costs have missed what is needed: genuine reform of the medical justice system.

A good way to start is by jettisoning some commonly held misperceptions about the current malpractice system. Call them the "Myths of Malpractice." Here's what is really going on:

Myth No. 1: The medical malpractice crisis is someone else's problem, not mine.

Premiums paid for malpractice insurance directly affect everyone's access to needed care and the cost of this care. Some excellent doctors are leaving practice in the face of unaffordable insurance premiums. Others are cutting back on the services they offer. To the limited extent allowed, doctors and hospitals pass increased malpractice insurance expenses on to patients and their health insurers.

If we don't fix the problems with the malpractice system, you may lose your doctor. You certainly will pay more for your care.

Myth No. 2: We need to preserve the current legal system to guarantee a fair hearing and provide compensation for patients harmed by the health-care system.

The medical justice system today is mostly random; it has become essentially a lottery. Hardly anyone seems to know this, although the facts are on the public record. A 1991 New England Journal of Medicine study found that nine out of 10 victims of disability-causing malpractice go uncompensated. That's right — overwhelmingly, people harmed through medical mishaps are not compensated.

And a recent study by Harvard University researchers found that 80 percent of malpractice claims were filed against doctors who had made no error whatever. For instance, recent articles in scientific journals have documented that many, if not most, cases of birth-related cerebral palsy — cases in which juries tend to be highly sympathetic to plaintiffs — are not the result of malpractice by obstetricians. Juries often deliver sizable awards against providers who commit no errors for what are unfavorable, but random, outcomes of nature.

Myth No. 3: The malpractice system is necessary to punish and remove incompetent health-care providers.

Unfortunately, the system that rarely provides just compensation for patients also perversely protects doctors who should be removed from practice by enabling them to sue other physicians who might step forward to question their competence. This undoubtedly has a chilling effect on whistle-blowing, and those who regulate doctors are often reluctant to suspend or revoke licenses without expert medical testimony.