Professional Liability
The MMS continues to advocate for reforms of the professional liability system, which does not serve patients adequately, and does not effectively promote either accountability or patient safety.
Overview
- Massachusetts professional liability premiums are in the top quarter of all U.S. states. The highest malpractice premiums are paid by obstetrician/gynecologists, whose typical annual premium in 2008 was $96,000.
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Roadmap for Transforming Medical Liability and Improving Patient Safety in Massachusetts
Conference discussing the possibilities of medical liability reform utilizing the "Disclosure, Apology and Offer" model for addressing adverse medical events, and unveiling a draft roadmap for implementing such a model in Massachusetts. Includes presenters' slides, and videos of their presentations. Produced in March 2011; co-sponsored by the MMS and the Beth Israel Deaconess Medical Center.
Background and Reference Materials
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The Impact of Defensive Medicine in Massachusetts
Original research by the MMS documenting the prevelance of defensive medicine practices in Massachusetts. (.pdf, 19 pages)
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Health Care at the Crossroads - Strategies for Improving the Medical Liability System and Preventing Patient Injury
White paper published in 2005 by the Joint Commission on Accreditation of Healthcare Organizations, proposing a new approach to address the "fundamental dissonance between the medical liability system and the patient safety movement." (.pdf, 52 pages)
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A Better Approach to Medical Malpractice Claims? The University of Michigan Experience
This article compares the traditional approach to claims with what is being done at the University of Michigan. The case example illustrates how an honest, principle-driven approach to claims is better for all those involved. (Journal of Health & life Sciences Law, Jan. 2009)
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Apology in Medical Practice: An Emerging Clinical Skill
Dr. Aaron Lazare writes, "An effective apology is one of the most profound healing processes between individuals, groups, or nations." (JAMA, Sept. 20, 2006 - subscription or purchase required for full text)
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Liability Claims and Costs Before and After Implementation of a Medical Error Disclosure Program
The University of Michigan Health System has fully disclosed medical errors and offered compensation to patients since 2001. This study found a decrease in new legal claims, number of lawsuits per month, time to claim resolution, and costs. (Annals of Internal Medicine, Aug. 17, 2010)
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Making Patient Safety the Centerpiece of Medical Liability Reform
Hillary Rodham Clinton adn Barack Obama describe legislation they filed as U.S. senators to implement pilot programs for disclosure and compensation.
(NEJM, May 25, 2006)
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Guilty, Afraid, and Alone - Struggling with Medical Error
How can patients, families, and clinicians in cases of adverse events approach closure and forgiveness? Honest and direct communication may be the best antidote.
(NEJM, Oct. 25, 2007)
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Malpractice Reform - Opportunities for Leadership by Health Care Institutions and Liability Insurers
The authors discuss the potential value of emerging models of disclosure of medical injuries and early resolution of medical liability cases.
(NEJM, April 15, 2010)
MMS Stance
- The professional liability system is toxic to patient safety, promotes a culture of secrecy, undermines the patient-physician relationship, and does not promote accountability.
- A fundamental transformation of the system is needed. We need to encourage full disclosure of adverse events, root-cause analysis, early compensation for patient injuries, alternative dispute resolution and mediation. Court should be the last resort.
- Traditional tort reform measures, such as capping non-economic damages, eliminating joint and several liability and more, are proven effective in moderating malpractice insurance premium increases.
MMS Achievements
- The MMS successfully sought legislation to reduce the pre-judgment interest rate to the Treasury Bill plus four points, as opposed to the previous 12 percent flat rate.
- The MMS has submitted legislation that would prohibit physicians' genuine expressions of regret to patients and their families inadmissible in court.
- The MMS continues to seek state legislation to improve the professional liability climate in Massachusetts.
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