April 25, 2003

In Washington State, Medical Malpractice Lawsuits and Costs Have Not Increased; Limiting Citizen Access to Courts Is Wrong Cure

"Repeat Offender" Doctors Threaten Patient Care, New Report Shows

SEATTLE – No increases in the total number of medical malpractice lawsuits and payouts to injured patients in the state of Washington, or in the size of payouts, exist to justify restricting patients’ rights in court, a report released today by the national consumer advocacy organization Public Citizen concludes. In fact, the number of payouts decreased between 1993 and 2001, and the monetary size of payouts per doctor has dropped dramatically since 1997, when adjusted for inflation.

Physicians’ groups, hospitals and their political allies are pushing state lawmakers to impose a $350,000 cap on the amount juries can award patients injured by medical malpractice for non-economic damages – that is the pain and suffering caused by serious injuries resulting in paralysis, brain damage and disfigurement. They claim there has been an explosion in medical malpractice litigation. But data from government and private sources refute this claim, and a cap would do nothing to improve patient care or relieve doctors of high premium rates.

"The facts show that the legal system is not causing a malpractice insurance problem. A rise in rates may be caused by the economics of the insurance industry, but the number of lawsuits or the amount of damages awarded to injured patients are not to blame," Public Citizen President Joan Claybrook said. "Rather than asking state lawmakers to take away citizens’ legal rights, doctors should be demanding that the medical board do a better job of weeding out their dangerous colleagues."

Each year, Public Citizen ranks the performance of state medical boards based on their rate of serious disciplinary actions per 1,000 doctors. In 2002, the Washington State Medical Quality Assurance Commission took serious actions against only 36 of its 16,154 doctors, for a rate of 2.23 actions per 1,000 physicians – making Washington 41st among all 50 states and the District of Columbia. That is less than one-fifth the rate of discipline in Wyoming, the top-ranked state. In six of the past seven years, Washington has been ranked 36th or worse.

Claybrook released the report, Medical Misdiagnosis in Washington: Challenging the Medical Malpractice Claims of the Doctors’ Lobby, today at a press conference in Seattle. According to the report (click here to view):

• Malpractice insurance premiums paid by Washington health care providers decreased by 1.4 percent from 1991 to 2001, even while overall costs of medical care increased by 58 percent nationally, according to government data. The recent spike in premiums that incited doctors’ demands for caps is tied to poor investment returns in the insurance industry, not lawsuits. Washington’s premiums represent the median in the nation, with half the states having higher average premiums and half having lower average premiums. Also, the state’s malpractice insurance market remains competitive compared with markets elsewhere.
  
• The number of medical malpractice payouts to injured patients per year has declined. According to the federal National Practitioner Data Bank (NPDB), there were 225 payouts in Washington in 2001, which is 16 fewer than in 1993 and just below the average over the past nine years. The number of lawsuits filed also has remained steady – there were only 3 percent more lawsuits filed in 2002 compared to 1994, an increase of only one-fifth the rate of Washington’s population.
  
• Caps on non-economic damages have not benefited doctors or patients in California. A comparison of the rates charged by the largest insurers in Washington and California shows that the malpractice insurance rates for doctors are about the same, indicating that a cap on damages does not lower doctors’ malpractice rates. Moreover, Washington patients benefit from not having a cap, as the average award for an injured patient is 54 percent higher in Washington than in California.
  
• The cost of medical negligence and errors to Washington’s patients and consumers is considerable. Based on findings by the Institute of Medicine, Public Citizen estimates that there are 920 to 2,048 deaths in the state each year due to preventable medical errors, costing residents, families and communities $355 million to $606 million. The total cost of malpractice insurance to Washington health care providers, by comparison, is only $109.9 million per year.
  
• Despite the large amount of malpractice that occurs, health care providers are not being faced with dramatic numbers of lawsuits. Nationwide, as many as 98,000 people are killed each year by preventable errors in hospitals, but only one in eight injured patients or families sue.
  
• "Repeat offender" doctors are responsible for a large portion of malpractice payouts to injured patients in Washington. NPDB data show that 3.5 percent of the state’s doctors, all of whom have made two or more payouts, have been responsible for 42.6 percent of all payouts since September 1990. Just 31 doctors, who have made five or more payouts, account for 7 percent of all payouts in the state since 1990.
  
• Malpractice insurance premiums are an insignificant expense when compared to overall health care expenditures in the state. In 1998, those premiums accounted for only 0.54 percent of the $19.3 billion in total health care spending.
  
• No evidence supports the Washington State Medical Association’s claims that doctors will abandon their practices because of malpractice premiums. The state’s doctor population is increasing at a faster rate than its overall population, and there are now 3,720 more doctors practicing in Washington than there were in 1993.
  

"Damage caps hurt those who have been most severely injured by health care provider negligence. They discriminate against those with lower earning potential and they take away everyone’s legal rights," Claybrook said. "State lawmakers must not cave to the demands of the special interests when no evidence supports their claims."

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