Past malpractice claims help doctors avoid future mistakes

"By analyzing the breakdowns in care that led to missed, delayed or incorrect diagnoses, insurers and health-care providers are developing programs to avert mistakes. ... Diagnostic errors are the leading cause of malpractice suits, accounting for as many as 40 percent of cases and costing insurers an average of $300,000 per case to settle, studies of resolved claims show. Peter Pronovost, a patient-safety researcher at Johns Hopkins University, estimates that diagnostic errors kill 40,000 to 80,000 hospitalized patients annually." But "[o]ne concern is that using claims data to educate doctors will lead to more 'defensive medicine,' in which doctors order more tests and procedures than needed to protect themselves against malpractice suits." Kaiser Permanente is also using the data "for educational purposes" and "[t]he Veterans Health Administration is developing programs to help doctors more closely follow up on abnormal lab results" (Landro, 9/27).

Meanwhile, The Seattle Times interviewed Amitabh Chandra, "a professor of public policy at Harvard University's John F. Kennedy School of Government, [who] was among the experts recently analyzing the costs of defensive medicine for the September issue of Health Affairs." Chandra says the drivers for medical care costs "are not end-of-life care. Driving up these costs are techniques about which there is very little understanding. Like orthopedic services replacing knees and hips. Titanium or ceramic? There is little knowledge of which is best and these are techniques we can use in everybody, regardless of age. are not end-of-life care. We have no idea if we are doing more of it than we need to. There is little knowledge of what is the optimal rate of MRIs in a population, for example. Everything is the current system is sensitized for the patient to ask for more and for the system to do more for the patient. The doctor says, if I didn't do the MRI bad things might happen to the patient. And so on. We are ultimately paying for all of this in the form of higher taxes" (Haas, 9/27).