Healthcare Management

9554Discussion Post response
The Affordable Care Act (ACA) was a groundbreaking health reform document that has helped many Americans gain the opportunity to have proper health insurance. However, one item of interest that was not included in this reform bill was that they did not have anything that reformed the liability issues around medical malpractice. I think two medical liability reform items have the most negligible impact on the healthcare system: pretrial screening panels and limiting attorney fees on individual cases.

The pretrial screening panels are “expert panels review malpractice cases at an early stage and provide opinions about whether claims have sufficient merit to proceed.” (Kachalia & Mello, 2011) This panel cannot limit the case from moving forward, but their viewpoint is admissible in a trial. This reform aims to reduce the number of unfounded cases that continue to trial and reduce the attorneys’ opportunity to litigate bad cases that cost money and tie up the system. One significant advantage to the healthcare system is that this reform will reduce the amount of defensive medicine practiced in the United States.

Defensive medicine has two legs, positive and negative. Positive defensive medicine is when a physician orders a test that is not indicated or required but would protect them from litigation. In a recent survey, they found “that 93 percent of specialists believe that they altered their clinical practice due to malpractice concerns, and 43 percent ordered clinically unnecessary imaging to protect themselves from lawsuits.” (Metzler & Meara, 2017) Negative defensive medicine is described as when a physician does not order a test for fear of litigation or moves out of that specific state where litigation rates are higher. A recent estimate of what defensive medicine costs annually is $56 billion.

Limiting attorneys’ fees can be expressed in two ways. First, they can determine the maximum value awarded at trial or a percentage of the award maximum. This would reduce the opportunity for attorneys to chase low-value, unmerited cases. Positively states that have these reforms would keep their physicians and maintain the continuity of care that they depend on daily.

References:

Kachalia, Allen,M.D., J.D., & Mello, Michelle M,J.D., PhD. (2011). New

Directions in Medical Liability Reform. The New England Journal of

Medicine, 364(16), 1564-72. http://dx.doi.org/10.1056/NEJMhpr1012821

Metzler, I., & Meara, J. (2017, March 21). Medical liability reform: Evidence for legislative and alternative approaches. The Bulletin. Retrieved March 2, 2022, from https://bulletin.facs.org/2012/01/medical-liability/