Skip to main content
PMC home page
British Medical Journal (Clinical Research Ed.) logoLink to British Medical Journal (Clinical Research Ed.)
. 1987 Jun 13;294(6586):1529–1532. doi: 10.1136/bmj.294.6586.1529

Medical malpractice in perspective. I--The American experience.

L Quam, R Dingwall, P Fenn
PMCID: PMC1246679  PMID: 3111624

Abstract

Concern over the possibility of an American style medical malpractice "crisis" in the United Kingdom has recently been voiced by members of both medical and legal professions. The validity of such fears is examined by reviewing the conditions that have given rise to the current American difficulties. It is argued that the rise in malpractice insurance premiums and associated restrictions in availability should be seen against the background of underwriting problems specific to medical liability in conjunction with a general decline in reinsurance cover. The evidence in relation to the clinical and resource implications of malpractice is analysed. In particular, arguments that increased litigation has influenced the practice of "defensive" medicine and the choice of specialty are critically examined. Medical malpractice claims and insurance are only part of a professional environment which is undergoing dramatic social and economic changes, many of which seem more plausible candidates to be treated as important influences on the nature and organisation of health care in the United States.

Full text

PDF
1531

Images in this article

1532p1532-a
on p.1532

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adams E. K., Zuckerman S. Variation in the growth and incidence of medical malpractice claims. J Health Polit Policy Law. 1984 Fall;9(3):475–488. doi: 10.1215/03616878-9-3-475. [DOI] [PubMed] [Google Scholar]
  2. Bovbjerg R. R., Havighurst C. C. Medical malpractice: an update for noncombatants. Bus Health. 1985 Sep;2(9):38–42. [PubMed] [Google Scholar]
  3. Couch N. P., Tilney N. L., Rayner A. A., Moore F. D. The high cost of low-frequency events: the anatomy and economics of surgical mishaps. N Engl J Med. 1981 Mar 12;304(11):634–637. doi: 10.1056/NEJM198103123041103. [DOI] [PubMed] [Google Scholar]
  4. Freeborn D. K., Baer D., Greenlick M. R., Bailey J. W. Determinants of medical care utilization: physicians' use of laboratory services. Am J Public Health. 1972 Jun;62(6):846–853. doi: 10.2105/ajph.62.6.846. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Ginzberg E. The destabilization of health care. N Engl J Med. 1986 Sep 18;315(12):757–761. doi: 10.1056/NEJM198609183151210. [DOI] [PubMed] [Google Scholar]
  6. Greenspan N. T. A descriptive analysis of medical malpractice insurance premiums, 1974-1977. Health Care Financ Rev. 1979 Fall;1(2):65–71. [PMC free article] [PubMed] [Google Scholar]
  7. Hein H. A. The status and future of small maternity services in Iowa. JAMA. 1986 Apr 11;255(14):1899–1903. [PubMed] [Google Scholar]
  8. Holzer J. F. Analysis of anesthetic mishaps. Current concepts in risk management. Int Anesthesiol Clin. 1984 Summer;22(2):91–116. doi: 10.1097/00004311-198408000-00009. [DOI] [PubMed] [Google Scholar]
  9. Iglehart J. K. Early experience with prospective payment of hospitals. N Engl J Med. 1986 May 29;314(22):1460–1464. doi: 10.1056/NEJM198605293142228. [DOI] [PubMed] [Google Scholar]
  10. Iglehart J. K. The professional liability crisis. The 1986 Duke Private Sector Conference. N Engl J Med. 1986 Oct 23;315(17):1105–1108. doi: 10.1056/NEJM198610233151732. [DOI] [PubMed] [Google Scholar]
  11. Localio A. R. Variations on $962,258: the misuse of data on medical malpractice. Law Med Health Care. 1985 Jun;13(3):126–127. doi: 10.1111/j.1748-720x.1985.tb00901.x. [DOI] [PubMed] [Google Scholar]
  12. Mixson W. T. The spring of hope. Obstet Gynecol. 1986 Feb;67(2):153–156. doi: 10.1097/00006250-198602000-00001. [DOI] [PubMed] [Google Scholar]
  13. Owens A. Doctors' earnings: the year of the big surprise. Med Econ. 1985 Sep 9;62(18):195–215. [PubMed] [Google Scholar]
  15. Schwartz W. B., Komesar N. K. Doctors, damages and deterrence. An economic view of medical malpractice. N Engl J Med. 1978 Jun 8;298(23):1282–1289. doi: 10.1056/NEJM197806082982304. [DOI] [PubMed] [Google Scholar]
  16. Smith R. When things go wrong. Br Med J (Clin Res Ed) 1986 Aug 23;293(6545):461–462. doi: 10.1136/bmj.293.6545.461. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Somers H. M. The malpractice controversy and the quality of patient care. Milbank Mem Fund Q Health Soc. 1977 Spring;55(2):193–232. [PubMed] [Google Scholar]
  18. Tancredi L. R., Barondess J. A. The problem of defensive medicine. Science. 1978 May 26;200(4344):879–882. doi: 10.1126/science.644329. [DOI] [PubMed] [Google Scholar]

Articles from British Medical Journal (Clinical research ed.) are provided here courtesy of BMJ Publishing Group

RESOURCES