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An Important Step on Medical Malpractice Reform

Ezekiel Emanuel discusses the move towards real medical malpractice reform from the Agency for Healthcare Research and Quality.

Many people perceive that the current medical malpractice system is ineffective and unfair to both physicians and patients.  On one hand, the Institute of Medicine has estimated that between 44,000 and 98,000 Americans die each year because of preventable medical errors.  Too many patients experience significant challenges with health care quality and patient safety, and many injured patients are not well served by the current medical liability system.  Many doctors believe that the current system encourages frivolous lawsuits that tarnish reputations and contributes to the escalating cost of health care.

As reviews by both the Robert Wood Johnson Foundation and Agency for Healthcare Research and Quality (AHRQ) have revealed, we lack a solid evidence base for determining which practices will provide fair and prompt compensation to patients, reduce preventable injuries, improve the quality of care, and reduce liability premiums.

The 20 grants awarded today by the Agency for Healthcare Research and Quality (AHRQ) are an important step in the right direction.  They will fund programs that aim to reduce avoidable injuries. For instance, one program in Massachusetts aims to reduce errors in primary care physician offices, particularly concerning medications and referrals.  Another in Minnesota targets patient safety around childbirth by instituting best practices at 16 hospitals statewide and determining if there is a correlation between fewer complications in childbirth and malpractice suits targeted at obstetricians.  A third, in Oregon, will develop and work to implement a “safe harbor” system in which physicians who prove they adhered to evidence based guidelines are protected from frivolous lawsuits.

Many of these grants will rigorously test so-called “disclosure and early offer” interventions, which was the keystone of a 2005 medical malpractice bill proposed by then-Senators Obama and Clinton. These interventions inform injured patients and families promptly and make efforts to provide prompt and fair compensation.

The grants were praised by J. James Rohack, M.D., the President of the American Medical Association who said “The AMA is pleased that federal medical liability reform demonstration projects are quickly moving forward, with $25 million in grants to state programs announced today.”

The HHS Patient Safety and Medical Liability initiative program represents the largest investment in malpractice reform by the Federal government in at least 20 years.  It will give states and health systems the information they need to improve their malpractice systems, making them more fair and efficient for both patients and doctors. 

Ezekiel J. Emanuel, M.D., Ph.D., is Special Advisor for Health Policy with the Office of Management and Budget