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A Measure of Malpractice tells the story and presents the results
of the Harvard Medical Practice Study, the largest and most
comprehensive investigation ever undertaken of the performance of
the medical malpractice system. The Harvard study was commissioned
by the government of New York in 1986, in the midst of a
malpractice crisis that had driven insurance premiums for surgeons
and obstetricians in New York City to nearly $200,000 a year. The
Harvard-based team of doctors, lawyers, economists, and
statisticians set out to investigate what was actually happening to
patients in hospitals and to doctors in courtrooms, launching a far
more informed debate about the future of medical liability in the
1990s. Careful analysis of the medical records of 30,000 patients
hospitalized in 1984 showed that approximately one in twenty-five
patients suffered a disabling medical injury, one quarter of these
as a result of the negligence of a doctor or other provider. After
assembling all the malpractice claims filed in New York State since
1975, the authors found that just one in eight patients who had
been victims of negligence actually filed a malpractice claim, and
more than two-thirds of these claims were filed by the wrong
patients. The study team then interviewed injured patients in the
sample to discover the actual financial loss they had experienced:
the key finding was that for roughly the same dollar amount now
being spent on a tort system that compensates only a handful of
victims, it would be possible to fund comprehensive disability
insurance for all patients significantly disabled by a medical
accident. The authors, who came to the project from very different
perspectives about the present malpractice system, are now in
agreement about the value of a new model of medical liability.
Rather than merely tinker with the current system which fixes
primary legal responsibility on individual doctors who can be
proved medically negligent, legislatures should encourage health
care organizations to take responsibility for the financial losses
of all patients injured in their care.
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