WASHINGTON -- May 24 -- As the District of Columbia Council begins to tackle the issue of medical malpractice, the most recent data on physician malpractice payments in the District show no connection between recently rising insurance rates for local doctors and lawsuits by patients, a new study by Public Citizen finds. The report also shows that the number of OB/GYNs has increased in recent years while the number of births by women of child-bearing age has steadily declined.
Despite complaints by some District doctors and politicians about a medical liability “crisis,” the study found that the total value of medical malpractice payments to victims made on behalf of District doctors has declined 52.5 percent from 1991 to 2004 when adjusted for medical inflation, which has averaged 4.7 percent a year. The decline was 64 percent from 2001 to 2004 – the peak years of the “crisis,” according to proponents seeking to limit patients’ legal rights.
“The call for curtailing the rights of District patients injured by inept or negligent medical care to seek relief in the courts is altogether misguided,” said Frank Clemente, director of Public Citizen’s Congress Watch. “Yes, insurance companies have been hiking their rates on local doctors, but lawsuits filed by injured District patients are plainly not the cause.”
Medical malpractice and physician oversight have recently become a major issue in the District. This week, the D.C. Council’s Committee on Health held a hearing on the quality of oversight provided by the District’s Board of Medicine. Also on Wednesday, a task force appointed by Councilmember David Catania begins work on malpractice and insurance issues. Meanwhile, an Alabama firm is proposing to take over the District’s leading malpractice insurer, NCRIC Group Inc., with a decision currently pending before the District’s insurance commissioner.
To read the full Public Citizen report, District of Columbia Medical Malpractice Payout Trends 1991 ─ 2004: Evidence Shows Lawsuits Haven’t Caused Doctors’ Insurance Woes, click here.
The report is based on the most recent information from the federal government’s National Practitioner Data Bank (NPDB). The NPDB reports on malpractice payments made on behalf of doctors by malpractice payers, such as insurance companies, state-run insurance funds and self-insured health care providers. Those making malpractice payments are required to report them to the NPDB under federal law. The NPDB also contains information on disciplinary actions taken against doctors and provides a repository of data that those employing doctors can query for background checks.
In analyzing records from the NPDB, Public Citizen found that:
- The number of malpractice payments paid on behalf of District doctors each year has declined 14.5 percent over the past 14 years (1991 to 2004), dropping from 55 to 47. Moreover, the total number of payments has dropped 35.6 percent from 2001 to 2004, from 73 to 47, when warnings about the “crisis” began.
- The median value of District doctors’ malpractice payments to individuals or their families, adjusted for inflation, has likewise fallen over the long- and short-term, by 22.9 percent from the $175,000 level in 1991 and by 31.6 percent since a peak of $197,300 in 1998.
- The number of malpractice payments of $1 million or more, adjusted for inflation, has fallen from a high of seven in both 1998 and 2001 to zero in 2004.
- Rather than providing windfalls to patients with minor injuries, malpractice payments overwhelmingly benefit those most seriously injured. In the District, 79 percent of payments for 2004 involved major or significant permanent injuries, or death. Measured by total damages paid out, the most serious cases accounted for an even greater share of the total: 91 percent, or $14.1 million, compared to only 9 percent, or $1.4 million, for minor injuries.
- Obstetricians complain they have been hurt the most, but the proportion of all District doctor medical malpractice payouts made by OBs declined 43.7 percent from 1991 to 2004, from 35.7 percent of all payouts in 1991 to 20.1 percent in 2004. The total number of payouts by OBs grew modestly from 14.5 percent of all payments in 1991 to 17 percent in 2004.
- The number of OBs in the District has grown from 216 in 1995 to 226 in 2003 – a 4.6 percent increase. Meanwhile, the number of births per 1,000 women of child-bearing age has declined 18.5 percent from 1995 to 2002, the latest year for which data is available. As the fertility rate declines so does the marketplace for obstetricians.
- As Public Citizen has found to be true nationally, a small number of doctors account for the lion’s share of all malpractice payments and many of them have gone undisciplined by the D.C. Board of Medicine and other state medical boards. Just 4.3 percent of D.C. doctors, each of whom has had two or more malpractice payouts, were responsible for 47.3 percent of all payments from 1990 to 2004. Moreover, only 15.8 percent of doctors with five or more malpractice payouts have been disciplined by the D.C. Board of Medicine or other state medical boards.
“The real crisis for D.C. residents remains inadequate safeguards for patient safety and incompetent treatment by a very small number of physicians,” Clemente said.
For more information on medical malpractice, click here.