The Flip Side of the Medical Malpractice Coin

Val Jones, MD

American physicians are appropriately frustrated about the high cost of medical malpractice insurance, and the frequency with which false and/or exaggerated claims are filed against them. In the Philadelphia region, a spine surgeon must pay upwards of $300,000.00 a year in malpractice insurance. The law allows Obstetricians to be sued for mishandling the birthing process until the “child” is 20 years old. In many states, there is no cap on the amount of money awarded in a true case of negligence, and juries set the pay out – which can exceed 20 million dollars per verdict.

Interestingly, Texas instituted a new policy in which firm caps were placed on malpractice claims. The cost of medical malpractice insurance dropped precipitously, and over 7000 physicians flooded into the state.

I recently interviewed Canadian Senator Michael Kirby about the medical malpractice process in Canada, and he laughed at how litigious the American system is. He said that keeping the malpractice system from being abused is quite simple: fine plaintiffs who bring forth frivolous suits, set caps on pay outs, and allow awards to be set by judges, not juries. You can listen to our discussion here.

However, there is a flip side to this coin – when providers are permitted to practice without any real legal recourse. I was astonished to learn (from my blogging colleague across the pond, Dr. John Crippen), that in New Zealand midwives are permitted to practice without any form of malpractice insurance. In fact, a recent case demonstrated obvious negligence resulting in the death of a newborn baby. What recourse did the mother have? Apparently, her legal actions resulted in a payout of $2,000.00 and a promise of closer oversight of the practices of midwives.


On the spectrum of “reasonableness” for medical malpractice policy, I believe the Canadians win, followed perhaps by Texans. What do you think?

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