MAY/JUNE 2006 ANNALS OF FAMILY MEDICINE TIP SHEET

EVIDENCE FOR LEGISLATIVE REFORM OF THE U.S. MEDICAL LIABILITY SYSTEM
Significant reductions in malpractice payments could be realized if total or no economic damage caps were operating nationally and hard noneconomic damage and total damage caps could yield lower premiums according to an analysis of national medical liability payment data. Analyzing data from the National Practitioner Data Bank reported from 1999 through 2001, Guirguis-Blake and colleagues investigate the relationship between 10 specific state tort statutory reforms and malpractice payments and premiums. Of the 44,913 claims analyzed, total and noneconomic damage caps were significantly associated with lower dollar amounts per payment, payment per practicing physician and payment per person in the population. The average amount per payment was 22 percent less for those states with noneconomic caps than it was for those states without noneconomic caps. In addition, they find an association between total caps and lower insurance premiums and a suggestion that hard noneconomic damage caps are also associated with lower insurance premiums.

The authors suggest that if tied to a comprehensive plan for reform, the money saved could be used to implement alternative approaches to patient compensation or to achieve other system reforms benefiting patients, employers, physicians and hospitals.
The U.S. Medical Liability System: Evidence for Legislative Reform
By Janelle Guirguis-Blake, M.D., et al

DECLINE IN VAGINAL BIRTH AFTER CESAREAN DELIVERY
In 1999, the American College of Obstetricians and Gynecologists (ACOG) adopted more restrictive guidelines for vaginal birth after cesarean delivery (VBAC) requiring a physician to be immediately avai
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Contact: Kristin Robinson
kristinr@aafp.org
913-906-6000 x5221
American Academy of Family Physicians
30-May-2006