Several of our recent posts have been focused on the debate over “tort reform,” specifically as it applies to medical malpractice lawsuits. The common argument made by tort reform proponents was that doctors were ordering expensive and unnecessary tests because they feared being sued for medical malpractice if they missed something or made a mistake. The practice is referred to as “defensive medicine.”
Unfortunately, this is a myth that persists despite significant evidence to the contrary. And the media may be largely perpetuating this misinformation (though probably unintentionally). Two contrary articles put out within the last year suggest that certain news outlets report stories with little regard for the broader context.
In late March, the website “Health,” which is a division of TIME Inc, reported on the results of a survey of emergency room physicians. The survey found that “nearly all emergency room doctors surveyed order pricey MRIs or CT scans their patients may not need, mainly because they fear malpractice lawsuits.”
That article may not seem unusual in and of itself. But on the Health website, there is another article published in October of last year that completely contradicts the one from last month. This contradiction is especially egregious because both articles were written by the same author.
The article from October points to research (not just a survey) showing that “malpractice reform may not keep physicians from ordering unnecessary and expensive tests.” The study looked at healthcare costs in three states that had enacted the most severe medical malpractice reform laws. In a comparison of pre-reform and post-reform costs, one of the three states saw a very small drop in costs. In the other two states, emergency room costs actually went up.
In the article published late last month, the author makes no mention of or reference to his previous article, which would have provided some important balance. Is journalism like this why the myths about tort reform persist despite evidence to the contrary?
Policy experts with in-depth knowledge of the healthcare industry have argued that doctors order expensive and potentially unnecessary tests for two primary reasons. The first is a desire to be thorough, which is laudable (save for the costs patients incur). The other reason has to do with how doctors and hospitals make money. The “fee for service” model does not reward efficiency. Rather, it incentivizes performing as many services as possible.
The debate about healthcare reform and malpractice laws is a large and complex one. To facilitate better understanding, however, the media has a responsibility to provide at least some basic context when reporting on these issues.
Source: Health, “Malpractice Fears Spurring Most ER Docs to Order Unnecessary Tests,” Dennis Thompson, March 24, 2015