Legal Intern, Manhattan Institute's Center for Legal Policy
Proponents of extensive medical malpractice liability often suggest that such liability deters doctors from practicing bad medicine. The argument goes as follows: The greater the chance doctors will be held responsible for their negligent actions, the more careful they will be when treating patients.
A new paper by Michael Frakes of Cornell Law School, however, demonstrates the weakness of the relationship between medical malpractice liability and health care quality. The paper analyzes data from 1979 to 2005 and contrasts various medical liability regimes and health quality measurements. Frakes uses "avoidable hospitalizations" and "inpatient mortality rates" as metrics for the quality of health care. Then, he "investigate[s] the malpractice-quality link by exploring the impact of legal reforms, such as damage caps, that arguably blunt the impact of the liability system without effectively changing its structure."
The results of the study suggest a statistically insignificant link between more extensive medical malpractice liability and better quality health care:
The results of this empirical exercise generally cast doubt upon the role that current medical liability rules play in inducing the provision of quality medical care. For instance, the estimated relationship between avoidable hospitalization rates and malpractice pressure, as identified by the adoption of non-economic damage caps and related tort reforms, is both statistically insignificant and small in magnitude, with a 95% confidence interval that is relatively tightly bound around zero. At one end of this interval, the lack of a non-economic damages cap (which is indicative of higher malpractice pressure) is associated with only a 4% decrease in avoidable hospitalizations. That is, at the most, the evidence implies an arguably modest degree of deterrence (with respect to outpatient care). I derive similar findings in exploring the impact of liability pressure on inpatient mortality rates for select conditions.
To be sure, those pushing for greater medical malpractice liability advance other reasons for supporting such a regime apart from better quality care (e.g., the trial bar frequently argues extensive medical malpractice liability is fairer to patients who suffer from negligent care since they can recover greater damages). But, at the very least, this new study has cast doubt upon the notion that exposing doctors to greater liability results in patients receiving better care.