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Rahul K. Parikh, M.D. is a brave man. In an article he has penned for the online magazine Salon, Dr. Parikh takes on his colleagues, peers and the American Medical Association and challenges the idea that medical malpractice lawsuit reform, or tort reform, must be part of a national health care plan to bring down the cost of health care.

In addressing the myths of tort reform propounded by doctors and insurance companies, Dr. Parikh states that:

Their refrain is familiar to anybody following the healthcare reform debate. The only problem is that it’s not true. There’s nothing "sure or quick" about changing medical liability laws that will improve healthcare or its costs. Defensive medicine adds very little to healthcare’s price tag, and rising malpractice premiums have had very little impact on access to care.

Throughout the article, Dr. Parikh challenges the notion that there has been a so-called "explosion" of medical liability lawsuits, that defensive medicine is driving the cost of health care up, and that lawsuits are driving doctors out of business.

In citing a Harvard study, Dr. Parikh explains that

In 2006, researchers from Harvard published a study in the New England Journal of Medicine that was designed to avoid the limits, and the biases, of prior research. What they found kills the notion of frivolous lawsuits. It suggests that most people who sue are suing for good reason.

As for defensive medicine,

Yet more recent analyses show that the effect of defensive medicine on overall costs is, at best, marginal. The most visible of them came from the nonpartisan Congressional Budget Office. In a 2004 report, it reviewed studies suggesting tort reform did reduce healthcare costs, including the Kessler and McClellan study. However, when the CBO applied the methods used in that study to a broader set of ailments, it found no evidence that restrictions on tort liability reduced medical spending. It also found no difference in per capita healthcare spending between states with and without limits on malpractice awards. More recently, the Kessler-McClellan study received another blow when two new authors reassessed their original work. Unlike the original study, this one looked at the effects of tort reforms over a longer time period. Just like the CBO review, it concluded that "Direct reforms (caps on damages, abolition of punitive damages, eliminating mandatory prejudgment interest, and collateral source offset) did not significantly reduce payments for Medicare-covered services."

Dr. Parikh seems to hit the nail on the head in his final paragraph:

Tort reformers neglect the fact that malpractice reform won’t save one extra life. To make that difference, insurers, doctors and their lobbyists like the AMA need to find ways to improve patient safety. So for those who push tort reform as a panacea for a sick healthcare system, working to prevent injuries is a much more noble pursuit than writing up baseless arguments for the back pages of a newspaper.

I’m a lawyer. If you want to discount my blogs about tort reform, I can understand that. But take a moment and read Dr. Parikh’s article. Perhaps you will find the honest views of a doctor more persuasive. Regardless of profession, we should all agree that patient safety should be the number one driving factor in any health care reform efforts. Dr. Parikh explains that tort reform is not a way to bring about better patient safety.


  1. Gravatar for Jeremy Engdahl-Johnson
    Jeremy Engdahl-Johnson

    Today's medical professional liability system is too adversarial and too expensive. There are alternatives. More at

  2. Gravatar for Mike Bryant

    Ah Jeremy, the on repeated comment that we see on almost every health care post post. I've gone there a couple of times now and still see all of the contradictions. Thanks for posting the Dr's article Christoper, he really does explain reality Very well. I saw this question today: How many med mal cases do we see where the person wishes they would have done some defensive medicine.

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