I’ve never been sued for malpractice in thirty years of practicing medicine, most of it in one of the highest risk specialties for getting sued — pediatric critical care. I’d like to think this is because I’ve practiced good medicine, but I know that’s not the reason. Mainly, I’ve just been lucky, and my luck could change in a moment. I have highly competent, even stellar colleagues who’ve been sued multiple times, mainly because they’ve been unlucky.
As a tort, a personal injury matter, malpractice is intended to do two things. First, it is a way to compensate patients who have been injured by physicians’ avoidable mistakes. And we do need to have some way to accomplish that. Unfortunately, what data we have about malpractice litigation suggests it’s a poor way to do it; most of the truly injured go uncompensated and some who are not reap huge windfall settlements in the lottery that is malpractice litigation.
Our malpractice system has a second purpose. Malpractice litigation, or the threat of it, is also supposed to police the medical profession by keeping us on our toes. Unfortunately, it does a poor job at that, too. It turns out that medical skill has nothing to do with a doctor’s chances of getting sued; truly bad doctors get away with truly bad things and our best doctors get sued.
What do I think about this? I think we must have a way for patients who have been harmed to seek compensation for their injury, and we must have a way to protect the public from incompetent doctors. Our current system does neither of these. It also injects a large but unknown expense into the healthcare system when doctors order tests and consultations their patients don’t need.
If you would like to read more about this very volatile issue it’s best to look at several viewpoints. To get you started, here is the position of the American Medical Association, here is a typical media polemic that questions the AMA motives, and here is the point of view from a left-leaning think tank. Finally, here is one suggested solution, one which aims to make the entire process more even-handed to both doctors and patients; I recommend it to you.