"Juries are able to see this some of the time, but not all," Chandra said, adding that "hassle costs," such as anxiety and court time, add to physicians' burden in facing unwarranted suits. "I now understand why doctors are so upset with the malpractice system. They're worn down."
Chandra and his colleagues, who came from Massachusetts General Hospital, the University of Southern California and the RAND Corp., analyzed claims spanning 1991 to 2005 from a major malpractice insurer operating in all 50 states and the District of Columbia. Data reflected more than 230,000 physician-years of coverage involving nearly 41,000 doctors.
Chandra and Bhattacharya disagreed whether the specter of malpractice suits caused doctors to practice so-called defensive medicine, prompting them to order more tests or procedures for patients out of fear of potential claims.
"On one hand, there's no question doctors are being sued extremely often," Chandra said. "It's also clear to me that defensive medicine is not as big a factor as doctors claim."
Bhattacharya, however, contended that defensive medicine contributes to the larger problem of excessive medical costs.
"You can tell yourself it's good medicine, but on the other hand, we're facing the problem of very high health care expenses," he said. "While I don't believe it's a major contributor to high health care costs, I do believe it is a contributor."
Chandra asserted that establishing "no-fault funds" to compensate patients and families in unavoidable situations, such as birth injuries, would be one of the ways to fix the dysfunctional malpractice system. Laws that establish caps or limits on the maximum amount patients can recover in malpractice suits are popular among doctors, he said, but aren't necessarily a sound idea.
"Damage caps don'
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