William H. Harridge lecture: the medical malpractice crisis in surgery

Abstract

a l he first thing that we see from this medical liability crisis s access. Access us already becoming a problem. A year go, there were no neurosurgeons in the northern part of est Virginia. They all quit. People had to be transported ignificant distances to be treated. By beyond access, what bout the cost of this, the liability cost? Medical liability is stimated to reach $126 billion, that is 2,000 increases since 975. It is an incredible increase. It increases more quickly han the overall medical costs, and that is one of the probems. From 1975 to 2000, medical costs increased enough to ake the people in the community scream, “Look, we are aying 449% more for health care,” especially people at eneral Motors and similar places who have to pay for this ealth care. But the medical liability costs went up 1,600%. Overall, the liability costs have increased 4 times faster han the rate of inflation, twice the rate of medical care nflation. Well, that leads to something you all may not want to alk about, but it is something you do, something I even do, nd that is defensive medicine. We are seeing more and ore people who are being referred to emergency departents instead of being seen in outpatient settings, where it s cheaper, easier to do. The safety-net hospitals in centers uch as mine, which are academic centers, were flooded ith patients that could be treated elsewhere, but they do not ant to take the responsibility for it. It is hard to get mergency room doctors and it is very difficult because obody wants to take care of uninsured patients. So once we reat them in the Ochsner emergency room, we cannot find n outside doctor near their homes to take care of them. You know how this goes, basically just performing tests hat are unnecessary. Half the physicians in America believe hat this liability makes them unable to talk about what appened. Along with this, I wanted to share with you a ouple of things here. The Cesarean-section rate in the nited States now is higher than in any other developed ountry in the world. Yet we have had no improvement in ur birth rate statistics. The rate of false mammograms in he United States is 2 times higher than it is in other eveloped countries, again, with no improvement in the ancer detection rate. People just over read them.