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Facts and Figures about Medical Liability Reform - National
Loss of Access to Care:
4 in 10 malpractice cases are GROUNDLESS. See www.mercurynews.com/mld/mercurynews/living/health/14547495.htm
21 states are considered to be "in crisis" by the AMA. Only six are considered to be "currently OK:" including California, Colorado, New Mexico, Wisconsin, Indiana and Louisiana. (AMA, 2006)
One in seven Obstetricians no longer delivers babies. (ACOG, Medical Liability Survey, July 19, 2004)
Nearly half of America's counties lack an ob-gyn: Of 3,143 counties in the nation, 1,541 do not have a practicing ob-gyn to deliver needed care (AMA Master file, 2004, Area Resource Files of the Bureau of Health Professionals )
75% of neurosurgeons no longer operate on children. (Alliance of Specialty Medicine, Feb. 17, 2005) Each year, medical liability suits are filed against 50% of neurosurgeons. (Archives of Internal Medicine, June 14, 2004)
55% of orthopedic surgeons avoid certain high risk procedures, including 39% who no longer perform spine surgery. (Alliance of Specialty Medicine, Feb. 17, 2005)
Each year, 25% of the nation's ER physicians are sued. As a result, some trauma centers must transfer complex cases, are "downgraded" or are forced to close. (American College of Emergency Physicians)
30% of anesthesiologists responding to a 2005 survey conducted by physician recruiting firm LocumTenens.com said they would not choose medicine if they could decide their career paths all over again. The 2005 figure represents increases of 25% since 1997 and 6% since 2003. American Medical Association data indicate the number of residents entering anesthesiology practice between 1990 and 2002 declined by 15%. Of the roughly 30,000 practicing U.S. anesthesiologists, approximately 12% are residents. Approximately 60% are age 45 or older, while more than a quarter are age 55 or older. .(Source: 2005 survey conducted by physician recruiting firm Locumtenens.com)
Tort costs:
U.S. tort costs reached a record $260 billion in 2004, or approximately $886 per person, surpassing the previous record set in 2003 by $16 billion. Medical malpractice tort costs totaled $28.7 billion in 2004, up from $26.5 billion in 2003. Since 1975, medical malpractice costs have increased at an annual rate of 11.7% versus 9% for all other tort costs. (Tillinghast-Towers Perrin, 2006). http://www.insurancejournal.com/news/national/2006/03/13/66411.htm That's a cumulative increase of 2,374%. ((Donna's math - you might want to check this....))
From 1975--2003 the cost of medical malpractice lawsuits has risen more than 2,000% to $26.5 billion, according to Tillinghast, an actuarial consultancy. (Source: The Economist, December 2005) ((So, it looks like my math was pretty accurate...))
Medical malpractice liability alone constitutes more than 10 percent of the U.S. tort tax, which by 2003 represented more than $3,300 for the average family of four, according to Tillinghast-Towers Perrin. (Source: Litigation Raising Health Care Costs, Study Says, The Heartland Institute, January 1, 2006)
Medical malpractice tort costs rose 12% a year between 1975 and 2003, or four times the rise in overall medical outlays. Medical malpractice liability costs in 2003 were $26 billion a year, 2,000% above the 1975 level (Surce: James Copland, head of the Manhattan Institute’s Center for Legal Policy, Harvard Club panel, February 2006, in the New York Sun, Feb. 24, 2006)
The profitability of medical-liability insurers has been on the decline and was lower than that of other property/casualty insurers. Between 1996 and 2003, the combined ratio of medical-liability insurers increased from 106.6 to 136.9, meaning that for every $1 insurers received in premiums in 2003, they paid out about $1.37 in claims and expenses. In contrast, the 2003 combined ratio of all property/casualty insurers was 100.1. (Source: A.M. Best Co.'s 2004 Best's Aggregates & Averages, presented in Best's Review September 2005 Issue, Doctors' Orders)
Facts about suits:
There are currently 125,000 medical liability lawsuits in the system. (AMA Analysis)
75% of medical liability claims are closed with no payment to the plaintiff, yet cost about $19,000 per physician in defense costs. Of the cases which go to trial, physicians are found to be not negligent 83% of the time, yet defense costs average $94,000 per physician. Only 1% of cases result in trial victories for plaintiffs. (Physician Insurers Association of America - PIAA - 2005)
Jury awards for medical-malpractice claims rose fractionally, while awards for all personal-injury liabilities fell significantly. Overall compensatory jury-award median for personal-injury cases fell 30% in 2002. The compensatory jury-award median for Medical malpractice cases, however, after steadily climbing more than 100% from 1996 to 2000, leveled off, but did not fall. The percentage of $1 million or more medical-malpractice verdicts remained the same from 1999 through 2002 at 52%. (Source: Jury Verdict Research, Current Award Trends in Personal Injury - 43rd Edition, April 2004)
Inefficient system:
Approximately 60 cents on each dollar expended on the system is absorbed by administrative costs, with legal fees being the primary component of this expense. ("Costs and Compensation Paid in Tort Litigation," testimony to Congressional Subcommittee, RAND Institute for Civil Justice)
US Tort system returns less than 50 cents on the dollar to the people it is designed to help and returns only 22 cents to compensate for actual economic loss. (Tillinghast-Towers Perrin, US Tort Costs: 2003 Update)
Incidences of silicosis have fallen since protections were put in place in the 1970s. A few years ago, the lawyers signed up tens of thousands of "victims" for class-action lawsuits — picking up along the way some plaintiffs who had also filed claims as victims of asbestos, including 20,000 suits against U.S. Silica filed in a short period that began in November 2002. In a 250-page ruling, Judge Janis Jack of the Federal District Court in Corpus Christi, Texas, bluntly said the 10,000 claims of silicosis before her were part of a "scheme" that was "manufactured for money." Since then, more than half of those 10,000 claims have been pitched out of court or voluntarily pulled by trial lawyers — a tacit admission, we'd say, that the claims were bogus to begin with. (Source: Investors Business Daily, "Lawyers on Trial," 2006)
Hospitals:
45% of hospitals report that the professional liability crisis has resulted in the loss of physicians and/or reduced coverage in emergency departments. (American Hospital Association Professional Liability Insurance Survey - 2003)
59% of U.S. hospitals were recruiting anesthesiologists, and most of those (57%) had been doing so for more than six months. Almost half of respondents had had to limit either the number of operating rooms (OR’s) in service or some OR operating hours. (Source: national survey of hospital administrators commissioned by the American Society of Anesthesiologists (ASA) in 2002)
Reforms Work:
Medical liability premiums in California, where MICRA laws have been in effect for 30 years, increased only 282% between 1976 and 2003. In the rest of the nation, premiums grew by 920%. (National Association of Insurance Commissioners data)
Direct reforms, including caps on non-economic damages, reduced the likelihood that a physician will be sued by 2.1%. In direct reform states, premiums declined by 8.4% within the first three years. (Stanford Researchers, Effects of Malpractice Pressure and Liability Reforms on Physicians' Perceptions of Medical Care, 1997)
By the year 2000, States with damage caps averaged 12% more physicians per capita than states without damage caps. (Agency for Healthcare Research and Quality, 2003 study)
Insurers' loss ratios in states capping awards were 11.7% lower than in states without caps; premiums in states with a cap on awards were 17.1% lower than in states without caps. (Thorpe, Emory University, The Medical Malpractice "Crisis:' Recent Trends and the Impact of State Tort Reforms, Health Affairs, Jan. 21, 2004)
Americans Support Reforms:
74% of Americans support a federal law to limit the amount a jury can award to compensate for pain and suffering in a medical liability lawsuit. (Newhouse-Frederick, January, 2005, Harris Interactive, March 2005)
82% of Americans favor Imposing limits on attorneys' fees and 73% favor requiring sanctions against attorneys who file frivolous lawsuits. (Source: Insurance Research Council, "IRC Study Finds Strong Support for Wide Variety of Civil Justice Reform Measures." Click here to learn more. )
Two-thirds (66%) of adults think that malpractice claims are brought against doctors when there has been no malpractice "very often" (26%) or "somewhat often" (40%). (Source: Harris Interactive, "National Survey Shows That More Than Half of Adult Americans Support Medical Malpractice Reform." Click here to learn more.)
Defensive Medicine:
70% of physicians practice defensive medicine because they fear lawsuits. ("Fear of Litigation Study - the Impact on Medicine:, Common Good, April 11, 2002)
$70-$126 billion per year could be saved on defensive medicine. (Addressing the New Health Care Crisis," US Dept. of Health and Human Services, March, 2003)
Neurosurgeons:
According to the The average yearly premium for a neurosurgeon's malpractice insurance in 2000 was $44,367. In 2004, it was $81,749, an 84 percent increase. The highest premiums nearly doubled from $200,000 to almost $400,000 in the same time period. (Source: American Association of Neurological Surgeons.)
$228,396 ~ The average malpractice insurance premium paid by neurosurgeons in St. Clair County, Illinois in 2004. That's five times more than their colleagues in Wisconsin. (The Economist, 2005)
Obstetrician/gynecologists:
The average ob/gyn has 2.64 claims filed against him or her during their career nationwide. In Pennsylvania, the number increases to 3.56. Nationally, 76.3% of ob/gyns have had claims filed against them; 41.5 have had three or more. In PA, 86.3% have had at least one claim filed, while 57.4% have had three or more. During the survey period from Jan. 1999 through Dec. 2002, nationally, 49% have had a claim opened or closed, while 21% have two or more. In PA, 61.3% have had at least one claim opened or closed, while 19.9% have had two or more. Nationally, the mean number of years to close a claim is 4 years; in PA, it's 4.7 years. (Source: 2003 ACOG survey on Professional Liability)
As a result of the high number of lawsuits affecting ob/gyns and the high cost of medical liability insurance, many ob/gyns have made significant changes in their practices. Asked how they have changed practices purely due to liability issues, over 2,000 respondents responded this way: Nationally, 22% have decreased the number of high-risk OB patients, 14.8% have stopped performing VBACs, and 14% have stopped practicing obstetrics completely. In PA, 13.7% have decreased high-risk patients, 10% have stopped performing VBACs and 15% have stopped practicing obstetrics completely. (Source: 2003 ACOG survey on Professional Liability)
There have been even more notable changes SINCE January 2001. Nationwide, 3% have retired from practice, 3.8% have relocated out of the state in which they lived and 3.2% have relocated within their state. In Pennsylvania, 3.7% have retired, 6.2% have relocated out of PA, and 5% have relocated within the state. Since January 2001, nationwide, 25.2% of ob/gyns have decreased the amount of high-risk OB care and 9.2% have stopped practicing obstetrics. In PA, 20% have decreased high-risk care and 12.5% have stopped delivering babies. (Source: 2003 ACOG survey on Professional Liability)
In a larger survey area including Pennsylvania, Delaware, and New Jersey (District III of ACOG), the numbers are even more staggering: 25.5% decreased high-risk care while 17.9% have stopped providing OB care - almost double the national average of 9.2%. Ob/gyns have also decreased gynecological surgical procedures in this area, by 22.8%, which is higher than the national average of 14.8%. To further illustrate the difficulties in these states, 41.2% had four or more claims filed against them during their careers, higher than the national average of 28.6%. In District III, among physicians who've stopped doing obstetrical care (17.9%), the average age at which they do this is 48 years old, typically considered to be the prime of a physician's career. (Source: 2003 ACOG survey on Professional Liability)
The average age of ob/gyn physicians nationally is 48 years old. Nationwide, 72% of trained ob/gyn physicians do both obstetrics and gynecology. In Pennsylvania, only 50.6% do both. (Source: 2003 ACOG survey on Professional Liability)
Nearly two thirds of ob/gyns (65.4%) have made one or more changes to their practice as a result of the risk of professional liability claims or litigation. (Source: 2003 ACOG survey on Professional Liability)
In 2004, Florida's average malpractice premium was $195,000, compared to about $17,000 in Oklahoma, one of the lowest-premium states. Dade County in Florida, which includes the city of Miami, had an average malpractice premium of $277,000 in 2004. (Source: Forbes.com, "Insurance Costs Could Trigger Ob/Gyn Shortage," 7-02-2005, June issue of Obstetrics & Gynecology.)
This year, the medical school graduating class at SUNY Upstate was 125. Of these, only six decided to go into OB-GYN residencies and of those six, only two remained in New York. (Source: Oswego County Business Magazine, "The Cost of Delivering Babies," December05/January06)
A survey of 226 medical students at a New York state university found that while "almost 63% of the students had considered an ob/gyn specialty," only 5% "actually planned to do it." (Source: Ob.Gyn.News, "Liability Woes Threaten Career Choice, Satisfaction," June 1, 2004)
In 2003, U.S. graduates filled just over two-thirds of available ob-gyn slots--the lowest percentage ever--while graduates of foreign medical schools filled 23 percent and 9 percent of slots went unfilled." (Source: Dr. Charles Lockwood, chair of Obstetrics and Gynecology at Yale-New Haven Hospital, Women's eNews, "Fewer Ob-Gyns Leave Women Less Access to Care," June 4, 2004)
Many major organizations, including the Centers for Disease Control and Prevention, the March of Dimes Birth Defects Foundation and the National Institute on Child Health and Development endorsed review conducted by over 100 independent researchers which found that only 10% of cerebral palsy results from lack of oxygen during labor. The rest is caused by disorders that develop far earlier in pregnancy and cannot be blamed on physician error during birth. Even though the data has been accepted in the field since the 1980's, personal injury lawyers have remained immune to the research. And that, according to the Times, is one of the main reasons why 43% of the cost of delivering a baby goes to cover the obstetrician's malpractice insurance - and why so many doctors are leaving the field. (Source: STATS at George Mason University http://www.stats.org/record.jsp?type=logentry&ID=94)
Mammograms Threatened:
Radiologists across the country are faced with the prospect of litigation and the high cost of malpractice insurance, and are now refusing to read mammograms. Radiology residents are passing over specializing in breast imaging, and over 700 mammography centers across the United States have closed their doors in the last few years (Source: "The Death of Mammography: How Our Best Defense against Breast Cancer Is Being Driven to Extinction")
A survey of 45 U.S. mammography facilities in three states found that 44 percent did not have enough radiologists on staff to meet the demand for mammography services. Women had to wait between 1 and 4 weeks for diagnostic mammography, designed to investigate a possible problem. For regular screening mammograms, women waited up to 8 weeks for an appointment. (SOURCE: Radiology, May 2005.)
Since 1985 over $304 million has been paid on behalf of physicians nationwide on claims related to cancer of the female breast. (Source: Physician Insurers Association of America, March 08, 2006)
A study examining malpractice claims involving 25 companies found radiologists accounted for 33 percent of all claims and the most common allegation against radiologists was "mammogram misread." (2002 Physicians Insurers Association of America breast cancer study.)
There are four breast-imaging fellowship programs with six available seats in Florida. All are vacant. A medical malpractice task force also cited a recent survey of 211 radiology residents that showed 63 percent of students wouldn't accept a fellowship in breast imaging. (Source: Dr. Ada Patricia Romilly, task force member and administrative leader for breast imaging for the H. Lee Moffitt Cancer Center in Tampa, St. Petersburg Times, "Report: Lawsuits limit cancer tests," December 18, 2004)
29% of radiologists responding to a 2005 survey said they would not choose medicine if they could decide their career paths all over again. The 2005 figure represents an increase of 24% since 1997. The number of residents entering radiology practice between 1990 and 2002 declined by 1%. (Source: AMA Data). Meanwhile, locum tenens industry sources indicate demand increased by 16% in a much shorter time frame from 1997 to 2001. (Source: 2005 survey conducted by physician recruiting firm Locumtenens.com)
Political:
In 2003, the American Trial Lawyers Association was the third most generous political action committee in the country, controlling $2.8 million. 89% of that cash went to Democrats, making ATLA the largest political action committee contributor to the Democrats. All told, the litigation industry has contributed a staggering $470 million to federal campaigns since 1990. Excessive litigation continues to grow, undermining American competitiveness in the global economy. Total tort costs exceed $200 billion annually, more than 2% of America's gross domestic product - a significantly higher percentage than in any other developed nation. The RAND Institute found that less than half of awarded dollars actually get to plaintiffs, with the rest absorbed by administrative costs and lawyers' fees. (Source: MONE, New York Sun - In Whose Interest? March 13, 2006)
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