By Kevin Whitelaw
The debate over steep medical malpractice awards has long centered on claims that they are driving up the cost of health care, but it turns out that the prospect of big payouts is actually causing doctors to reduce their workload.
On average, doctors end up working 1.7 hours less per week when their expected medical liability risk increases by just 10 percent, according to a new study published in the latest issue of the Journal of Law & Economics.
"This is roughly equivalent to one in 35 physicians leaving the workforce entirely, or about 21,800 physicians," write economists Eric Helland, of Claremont McKenna College, and Mark Showalter, an economics professor at Brigham Young University.
The study offers an interesting new take on the debate over capping medical malpractice awards, which tends to be a rather abstract tussle over estimates of how much an overhaul of the tort system could lower medical costs.
The economists examined data gathered from insurers about medical liability risks in each state, broken out by medical specialty, as well as survey data from doctors about their workload and income.
They found that when the liability risk changes -- for example, the maximum allowable jury award in a malpractice case goes up or down -- doctors alter their workload.
The effect is particularly pronounced for doctors over the age of 55 and those who have their own practice, which could mean that they are extra sensitive to the risk of large damage awards.
The findings suggest that doctors could be seeing fewer patients each week in order to minimize their odds of a lawsuit.
Of course, that might not necessarily be a bad thing. Although it could reduce the availability of doctors, particularly with certain specialties, it also could mean that doctors are simply being more careful in treating their patients.
But Helland and Showalter point out that the nationwide effect of changes to liability risk could add up enough to affect patients' access to health care.
At the same time, the researchers are not endorsing a Republican proposal for a nationwide cap on malpractice awards.
"If the cost of providing medical care varies by state, why should we have a national, one-size-fits-all approach?" Showalter says in a press release. "The same cap would have very different effects in Kansas than in New York."