Concerns about reducing the rate of growth of health expenditures have reignited interest in medical liability reforms and their potential to save money by reducing the practice of defensive medicine. It is not easy to estimate the costs of the medical liability system, however. This article identifies the various components of liability system costs, generates national estimates for each compo...

BACKGROUND Interpersonal aspects of care, such as the communication behaviors of physicians, are often cited as central to patients' decisions to initiate malpractice litigation. Relatively little is known, however, about the impact of the communication behaviors of surgeons. In the current study, we investigated the relationship between judgments of surgeons' voice tone and their malpractice c...

Allen Kachalia, Niteesh K. Choudh y, and David M. Studdert M edical science brings innovations in patient care at an astounding pace today new chemotherapeutic agents, coated stents, and minimally invasive surgery are just few recent examples. For physicians, though, the specter of malpractice liability can overshadow the marvel of practicing in this era. Many physicians are working in a volati...

BACKGROUND The frequency of head computed tomography (CT) imaging for mild head trauma patients has raised safety and cost concerns. Validated clinical decision rules exist in the published literature and on-line sources to guide medical image ordering but are often not used by emergency department (ED) clinicians. Using simulation, we explored whether the presentation of a clinical decision ru...

Medical malpractice liability reform is often promoted as a means to increase the labor supply of health care providers and improve access to medical care. Theory suggests, however, that if physicians differ in their malpractice risk, then reforms will tend to attract those physicians with the highest risk. In principle, any association between reforms and overall malpractice risk could be attr...

In 1990, J. Robert Prichard released his report (1) to the Conference of Deputy Ministers on “Liability and Compensation in Health Care.” He concluded that from 1975 to 1990 there had been significant growth in the frequency and severity of malpractice claims, insurance premiums and the cost of malpractice litigation. Despite this growth, only about ten percent of persons suffering avoidable he...

The empirical literature on defensive medicine includes studies utilizing date at the state or county level. In comparison to the rest of the literature, these jurisdictional studies typically find the least evidence that rising malpractice liability costs induce cost-increasing or quality-reducing practices by physicians. A key assumption in these studies is that changes in malpractice pressur...

SOME “RED FLAGS” are obvious in suggesting a problematic client. Others are the product of data about legal malpractice claims, in terms of their frequency and severity. Lawyers who have been sued for legal malpractice often report that they had a “bad feeling” about the client or the case from the start, but they felt they needed the work, they couldn’t say “no,” or they felt compelled to help...