The Big Lie about the Big Lie of Medical Malpractice Payouts

On May 1, Johns Hopkins Medicine published a study with a provocative title: “Catastrophic Medical Malpractice Payouts in the United States.” The word “catastrophic,” for the purposes of this article are those medical malpractice lawsuit payouts totaling $1 million or greater. The study’s abstract explains that researchers studied “all paid malpractice claims nationwide using the National Practitioner Data Bank over a seven-year period (2004-2010)” in order to determine “the specific characteristic and overall cost burden of these payouts.” They chose 2004 as a start date because that year was the first time data regarding age, sex and severity of patients’ injuries began being recorded. The abstract also reports, “Factors most associated with catastrophic payouts were a patient age [of] less than one year; quadriplegia, brain damage, or lifelong care; and anesthesia [errors].”

The leader of the study was Marty Makary, an associate professor of surgery and health policy at the Johns Hopkins University School of Medicine. In the journal’s press release he explains,  “The notion that frivolous claims are routinely resulting in $100 million payouts is not true.” Makary continues, “The real problem is that far too many tests and procedures are being performed in the name of defensive medicine, as physicians fear they could be sued if they don’t order them. That costs upwards of $60 billion a year. It is not the payouts that are bankrupting the system–it’s the fear of them.”

The study established that in this seven-year span 77,621 claims were paid, of which 7.9 percent were considered catastrophic (6,130 in total). The total dollar amount of the payouts was $27 billion, and catastrophic payouts made up 36.2 percent of this figure (or $9.8 billion). This means that catastrophic payouts total about $1.4 billion per year, which, as ScienceDaily points out, is “far less than 1 percent of national medical expenditure in the United States.”

The researchers found that 34.2 percent of catastrophic payouts were related to diagnosis, while almost 22 percent were obstetrics-related and nearly 18 percent came about from surgical errors. Also worth noting is that “37 percent of catastrophic payouts involved a physician with a previous claim in the database.”

As the health care system moves forward and tries to lower costs, Makary suggests that the focus “should be on doctor protections aimed at reducing defensive medicine rather than the creation of [medical] malpractice caps  [in personal injury cases].” He argues that additional research is required in order to establish what may prevent the kinds of errors that end up in catastrophic personal injury payouts, but that the most important step is to reduce the medical industry’s overuse of unnecessary diagnostic tests and procedures.