Dr. Marty Makary, an associate professor of surgery and health policy at the Johns Hopkins University School of Medicine, and colleagues found in their review that U.S. malpractice payouts of more than $1 million added up to roughly $1.4 billion a year -- making up far less than 1 percent of national medical expenditures in the United States. The cost of U.S. healthcare was $2.6 trillion in 2010.
"The notion that frivolous claims are routinely resulting in $100 million payouts is not true," Makary, the study leader, said in a statement. "The real problem is that far too many tests and procedures are being performed in the name of defensive medicine, as physicians fear they could be sued if they don't order them. That costs upwards of $60 billion a year. It is not the payouts that are bankrupting the system -- it's the fear of them."
Catastrophic claims, or payouts more than $1 million, were more likely to occur when a patient who is killed or injured is under the age of 1; develops quadriplegia, brain damage or the need for lifelong care as a result of the malpractice; or when the claim results from a problem related to anesthesia, the review found. More than 77,000 claims were paid, and catastrophic claims made up 7.9 percent.
Makary and colleagues reviewed nationwide medical malpractice claims using the National Practitioner Data Bank, an electronic repository of all malpractice settlements or judgments since 1986. They looked at 2004-10 data.
Makary said the data suggested the focus of legal reform efforts should be on doctor protections aimed at reducing defensive medicine rather than the creation of malpractice caps.
The findings were published online in the Journal for Healthcare Quality.