Legal Intrusions on Physician Independence

Abstract

It has become fashionable for physicians to blame the reduction in professional autonomy that many are experiencing on lawyers and the legal system [32, 33, 34, 44]. A primary cause of their concern has been significant growth in the cost of medical malpractice insurance premiums, a development that many term a crisis.1 There are statistics to support the claim of crisis. A recent survey by the American Medical Association (AMA), for example, revealed that the average number of malpractice claims filed annually per 100 physicians increased from 3.3 to 8 in the period from 1978 to 1983 ([32], p. 15). The General Accounting Office (GAO) reports that malpractice insurance costs for physicians doubled between 1983 and 1985, from $1.7 billion to 3.4 billion [43]. There are other statistics, however, that suggest the talk of crisis is exaggerated. The GAO reports that the malpractice insurance premiums paid by the average physician remain “small” in contrast to such other costs as payroll and medical supplies, amounting to about nine percent of the average doctor’s total expenses [43].