Medical malpractice and legal liability

¶ … Malpractice Claims on Delivery and Quality of Patient Care

The purpose of this study is to explore the effects malpractice claims have on physician's ability to provide quality and effective patient care, regardless of the outcome of the case. Despite the medical miracles physicians are capable of delivering every year, some risk is always inherent when one uses any health care delivery system. In recent years the increased number and size of malpractice claims has capture the interest of public policy officials (Emanuele & Simmons, 2004).

Medical litigation is now according to many, "One of the largest components of the tort system" and "widely responsible for the high cost of health care" (Emanuele & Simmons, 2004). Among the research questions to be explored for this study include (1) what the effects of medical litigation are on the pool of qualified doctors, (2) whether increased claims result in decreased quality care and (3) how medical litigation affects patient access to premium and specialty services.

Hypothesis

Hypothesis 1: Increased medical malpractice claims reduce the pool of qualified doctors significantly and reduce the quality of care patients are receiving.

In addition the researcher will explore whether patient access to health care is limited because of increased medical malpractice claims.

Null Hypothesis: Increase medical malpractice claims do not reduce the pool of qualified doctors significantly and reduce the quality of care patient are receiving.

Morris, et. al (2003) point out that few studies or data exist that describe the interrelationships between malpractice claims and quality care. In addition few studies examine the actual payments made to plaintiffs in these cases. In recent years much attention has been paid to the impact malpractice has on the supply of qualified doctors available and patients access to health care (Bhat, 2001). This study will help fill the gap in research that currently exists by defining what relationship if any exists between malpractice claims and quality of care.

Literature Review

Some of the research suggests that the rising cost of malpractice insurance is to blame for physician's failure to offer more comprehensive medical services to patients (Frankel, 1994). This in and of itself may reduce the quality of health care offered patients in varying medical settings. No place is this more clear than in the field of obstetrics and gynecology (Bhat, 2001). The median payment for obstetrics related claims in the mid 1990s was $165,000 (Bhat, 74).

In some states malpractice premiums cost $100,000 or more for specialists (State Legislatures, 1993). Many doctors are performing more "defensive" techniques to prevent lawsuits, though this does not necessarily improve the quality of care patients receive (State Legislatures, 1993).

Some researchers have suggested that increased liability not only encourages physicians to practice defensive medicine, but also undermines many patients access to much needed medical services (Hyman & Silver, 2004).

Boulard (2002) cites many studies that clearly show the increasing costs of malpractice insurance affect specialist care. In 2002 alone more than 60 specialists at one critical care facility in Las Vegas left their jobs after another malpractice premium spike. The crisis results in closure of a 24-hour critical care center (Boulard, 2002). The crisis emphases the potential for not only reduced care but complete lack of access to care for hundreds of patients in similar situations. While legislatures are working on solutions to such problems, the issue is far from resolved. In some medical facilities, physician assistants and nurse practitioners are performing procedures doctor's once did, simply because the cost of medical malpractice is too high for doctors to perform procedures themselves (Bhat, 2001).