Malpractice and medical litigation

Abstract

Patient-doctor relationship has become complex and medical litigation appears to be a “modern” feature of such a relation. Indeed at the time of this editorial, a search in Google using the terms “medical litigation” generates 2,270,000 results! The cost of medical litigation has steadily increased at almost 12% annually since 1975 in the USA and most likely with similar rates in all Western countries. Malpractice has both direct and indirect costs which have been calculated in 2003 by the US Department of Health and Human Services to account for 2% (direct costs of medical malpractice) of the nation's health-care spending and for 5–9% of overall expenses when the costs of defensive medical practices are taken into consideration. The adverse impact of defensive medicine include not only unnecessary costs which, however, limit the access to care for certain patients or over and under treatment of the most severe illnesses but also delayed adoption of medical advancements. Actually, the threat of a law suit may discourage the physician and, in particular, the surgeon to use new pharmaceutical and medical devices to avoid the possible accusation of “learning” on the patient. Even though we might incline to consider medical litigation a relatively new phenomenon, supposedly unknown in the past when the doctor-patient relationship was essentially a fiduciary relation, the possibility for a physician to be charged with malpractice was not probably so rare. Competence and eventually experts' support in tribunal constituted, like today, the most effective defensive tools as it may be deduced when reading the comments and the suggestions made by Galen in his preferred book: АΝАΤΟΜΙΚΑΙ ΙΓΧEΙΡΗΣEΙΣ (Anatomicae administrationes) (Fig. 1):