NEJM Article Debunks Defensive Medicine Myths and the Effects of Tort Reform

It has long been a position of those who wish to promulgate tort reform that underlying malpractice claims cause physicians to practice defensive medicine. Defensive medicine essentially means that doctors are ordering extra tests, taking extra precautions, and are being overly protective of their practices so as to over-treat patients. Tort reform laws are statutes passed to limit the remedies of patients who have been injured as a result of medical negligence. The theory behind defensive medicine is that it exposes patients to additional risks and increases the cost of medicine. The lawyers who represent medical malpractice victims have long believed that such an argument for tort reform is simply bunk and the main purpose of tort reform is to increase the profits of insurance companies.

On October 16, 2014, the New England Journal of Medicine, a preeminent peer review publication, issued the article, The Effect of Malpractice Reform in Emergency Department Care.

The purpose of the article was to study whether or not legal reforms would reduce wasteful spending in the Emergency Room where the emergency room physicians practice in an information poor, resource rich environment. Pro-insurance company tort reformers theorize that tort reform would reduce alleged defensive practices.

The article studied three (3) states: Texas, Georgia and South Carolina, to determine whether or not such tort reform reduced testing and/or purported wasteful spending. The study examined emergency department visits from 1997 through 2011. A comparison was made of patient-level outcomes, both before and after legislation in reformed states and in control states. In 3 of the 9 states, no policy attributable reduction and intensity care was detected. There were no reduction rates of CT or MRI utilization or hospital admissions.

The writers concluded that the tort reform had very little effect on the intensity of practice and the rate of any purported defensive medicine. In the view of patient advocates, this study further debunks the pro-insurance company tort reforms that increase corporate profits.

If you or a family member has been the subject of malpractice or poor treatment in the emergency room, contact the lawyers at Carmody & Ging at 412-281-2929.