Effects of a Malpractice Crisis on Specialist Supply and Patient Access to Care

Authors

Michelle M. Mello
David M. Studdert
Catherine M. DesRoches
Jordon Peugh
Kinga Zapert
Troyen A. Brennan
William M. Sage, Texas A&M University School of LawFollow

Document Type

Article

Publication Date

11-2005

Journal Title

Annals of Surgery

ISSN

0003-4932

DOI

10.1097/01.sla.0000182957.54783.9a

Abstract

Objective:

To investigate specialist physicians' practice decisions in response to liability concerns and their perceptions of the impact of the malpractice environment on patient access to care.

Summary Background Data:

A perennial concern during “malpractice crises” is that liability costs will drive physicians in high-risk specialties out of practice, creating specialist shortages and access-to-care problems.

Methods:

Mail survey of 824 Pennsylvania physicians in general surgery, neurosurgery, orthopedic surgery, obstetrics/gynecology, emergency medicine, and radiology eliciting information on practice decisions made in response to rising liability costs.

Results:

Strong majorities of specialists reported increases over the last 3 years in patients' driving distances (58%) and waiting times (83%) for specialist care or surgery, waiting times for emergency department care (82%), and the number of patients forced to switch physicians (89%). Professional liability costs and managed care were both considered important contributing factors. Small proportions of specialists reported that they would definitely retire (7%) or relocate their practice out of state (4%) within the next 2 years; another third (32% and 29%, respectively) said they would likely do so. Forty-two percent of specialists have reduced or eliminated high-risk aspects of their practice, and 50% are likely to do so over the next 2 years.

Conclusions:

Our data suggest that claims of a “physician exodus” from Pennsylvania due to rising liability costs are overstated, but the malpractice situation is having demonstrable effects on the supply of specialist physicians in affected areas and their scope of practice, which likely impinges upon patients' access to care.

First Page

621

Last Page

628

Num Pages

8

Volume Number

242

Issue Number

5

Publisher

Wolters Kluwer Health

Recommended Citation

Michelle M. Mello, David M. Studdert, Catherine M. DesRoches, Jordon Peugh, Kinga Zapert, Troyen A. Brennan & William M. Sage, Effects of a Malpractice Crisis on Specialist Supply and Patient Access to Care, 242 Annals Surgery 621 (2005).
Available at: https://scholarship.law.tamu.edu/facscholar/1726