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April 6, 2004

Malpractice "Crisis" Not Reducing Access to Trauma Care

AMA Horror Stories Don’t Pan Out; Trauma Care Plentiful in AMA’s "Crisis" States and Lacking in Two-Thirds of States They Call "OK"

WASHINGTON, D.C. – A recent survey found a plentitude of trauma care facilities in states the American Medical Association (AMA) says are experiencing a malpractice "crisis" – highlighting the misleading nature of the AMA’s scare tactics.

Meanwhile, a Public Citizen spot-check of AMA claims that trauma care providers were leaving certain states found them to be false, prompting a written warning to Senate Republican leaders not to repeat the stories during this week’s malpractice floor debate.

"The AMA’s campaign against malpractice victims has been built on a big lie—that lawsuits are threatening access to care," said Joan Claybrook, president of Public Citizen. "But when you look at the hard statistics or scratch the surface of the phony anecdotes, you find no relationship between malpractice suits in a state and the number of doctors there."

A study published last year in the Journal of the American Medical Association identified 10 states with the highest concentration of trauma centers. But five of those were states where the AMA claimed patients were threatened with lack of access to health care due to rising malpractice insurance premiums – i.e., that there were not enough doctors. Meanwhile, four of the six states that the AMA said are "currently OK" were found to have fewer than the recommended number of trauma centers, despite harsh caps on damages to victims of medical malpractice.

The JAMA study, published March 26, 2003, found that Illinois, Wyoming, Connecticut, Missouri and New York, each of which AMA lobbyists have claimed face a malpractice "crisis," ranked among the top 10 in trauma centers per 1 million population.

The article also listed four states with strict damage caps – Indiana, Louisiana, New Mexico and Wisconsin – among states that do not have one trauma center per million residents, considered the minimum acceptable number for accessible trauma care. Those four states, along with California and Colorado, are described by AMA lobbyists as "currently OK" in terms of access to care. Of the six states the AMA holds up as examples of having accessible care, only one, Colorado, is in the top 10 in concentration of trauma centers. (Click here to view a fact sheet.)

In addition, Public Citizen fact-checked claims made by the AMA at an October 1, 2003, House Government Reform Committee hearing about trauma care providers abandoning Pennsylvania and Washington state, both of which the AMA had designated as "crisis" states and which had not enacted limitations on lawsuits. Public Citizen telephoned the offices of several specialists and found that nine instances where the AMA claimed providers had left were false. This echoes findings of a General Accounting Office study last summer that also found AMA claims to be unsubstantiated or exaggerated.

In a letter to U.S. Sens. Bill Frist (R-Tenn.) and John Ensign (R-Nev.), whose bill would restrict obstetrical and trauma care patients from bringing lawsuits, Claybrook warned Republicans not to use the discredited anecdotes and urged that the Senate’s time be spent on initiatives that would truly increase access to care.

"The chronic problems of our health care system – too many uninsured, declining reimbursements, lack of doctors in rural and inner-city areas, and the defection of surgeons to doctor-owned specialty hospitals – must be addressed," Claybrook said. "We suggest that the Senate’s valuable floor time would be better spent confronting these systemic problems rather than trying to score political points with anti-lawyer rhetoric."

Click here to view a Public Citizen study showing no relationship between a state’s medical malpractice laws and the number of doctors practicing there.

Click here to view the letter.


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