April 2, 2003
New Study Debunks Claims of an Impending Medical Malpractice Insurance "Crisis" in Rhode Island
Real Malpractice Crisis Involves "Repeat Offender" Doctors; Overall Insurance Premiums, Malpractice Payments to Injured Patients Have Decreased, Study Finds
WASHINGTON, D.C. – Contrary to the alarmist rhetoric spread by the state’s medical and business lobbies, the temporary malpractice insurance spikes experienced by doctors in many states are not on the horizon in Rhode Island, according to a report issued today by Public Citizen, a national consumer advocacy organization. The report concludes that instead, the most significant, long-term medical malpractice "crisis" in Rhode Island is the unreliable quality of care being delivered to state residents by a relatively small proportion of the state’s doctors.
The annual amount of medical malpractice insurance premiums that Rhode Island doctors pay has decreased since 1992 when inflation is taken into account, the study found. Also, the amount of malpractice payouts Rhode Island insurers make annually to patients who have suffered from doctor errors has decreased since 1992 when inflation is considered. Moreover, there has been a significant decrease in the number of malpractice payouts made in the state to patients, while the number of physicians in Rhode Island increased by 11 percent from 2,623 in 1999 to 2,915 in 2002.
Public Citizen released the report as the issue gains attention nationally and in Rhode Island, where lawmakers are considering legislation that would make it harder for injured patients to seek compensation for their injuries. Nationally, the U.S. Senate may soon consider a measure that would cap awards for pain and suffering damages in medical malpractice cases at $250,000. U.S. Sens. Jack Reed (D) and Lincoln Chafee (R), both representing Rhode Island, will play a key role in determining the fate of that legislation in Congress.
"Capping damages will only hurt those who have been most severely injured by health provider negligence," said Public Citizen President Joan Claybrook. "Congress and state legislatures should enact measures to stop insurance company price spikes, not penalize patients who have already suffered from negligence."
Repeat offender doctors are responsible for more than half of malpractice costs in Rhode Island, the study found. Between September 1990 and September 2002, 4.8 percent of Rhode Island’s doctors were responsible for 52.7 percent of all malpractice payments to patients, according to information obtained from the federal government’s National Practitioner Data Bank. This small number of doctors made two or more malpractice payments worth a total of $104.7 million. Further, just 1.6 percent of the doctors made three or more payments to patients, representing 26 percent of all payments.
Less than one-third of doctors who made four or more malpractice payments to patients have been disciplined by the state medical board. Rhode Island is one of the nation’s less stringent states in disciplining doctors, ranking 35th among all states and the District of Columbia in 2002, according to Public Citizen’s annual ranking of state medical boards. The state has yet to fully implement a 1997 law mandating public disclosure of profiles of individual physicians. Although some profiles are available online, they omit two crucial categories: malpractice information and criminal convictions. The system is scheduled for an update this summer, but the profiles still will not contain data on doctors’ malpractice payouts.
According to Public Citizen’s report, The Facts About Medical Malpractice in Rhode Island (click here to view):
- Medical errors cause 164 to 365 preventable deaths in Rhode Island each year. These errors cost residents, families and communities $63 million to $108 million annually in lost wages, lost productivity and increased health care costs. In contrast, medical malpractice insurance costs Rhode Island’s doctors less than $22 million annually.
- Rhode Island’s doctors paid $21.6 million in premiums for malpractice insurance in 2001, compared to $19.5 million in 1996, an increase of 11 percent. Adjusting for medical inflation, which was 19.8 percent during the same period, and the growing number of physicians in the state, this represents a significant decline in actual dollars.
- According to the National Practitioner Data Bank, the number of medical malpractice payments to patients by Rhode Island doctors declined 21 percent, from 73 in 1997 to 58 in 2001.
- Annual malpractice payments to patients by Rhode Island insurers have decreased when inflation is considered. The amount of malpractice payments made to Rhode Island patients was $22.8 million in 2001, a $1.7 million or 8 percent increase over $21.1 million in 1992, equaling 0.9 percent a year. However, during this same period, costs for medical care increased 47 percent nationwide, an average of 5.2 percent a year.
"Long-term solutions to reducing malpractice insurance costs lie in reducing medical errors," said Frank Clemente, director of Public Citizen’s Congress Watch. "Data show that the legal system is not the problem. There are too many medical errors and too much medical negligence, a lot of which could be prevented with stronger disciplining of the relatively few repeat offender doctors."
In addition to effective doctor discipline, the study suggests that states require hospitals and other health care providers to institute meaningful risk prevention programs. Hospitals should implement measures to curb errors, such as using computers to order and track prescriptions (these can cut errors by 55 percent), requiring proper hand-washing to reduce infections, addressing the nursing shortage and reducing the long hours of medical residents. Also, insurance risk should be spread, reducing the number of classifications of doctor specialties. Risk pools for some are too small and thus overly influenced by a few losses and the concentration in a few specialties of doctors handling the highest risk patients.