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At What Cost

By Jock Hoffman, CRICO

Related to: Ambulatory, Emergency Medicine, Primary Care, Obstetrics, Other Specialties, Surgery

What does a malpractice claim really cost; and whose wallet, and practice, and psyche does it actually impact? Consider the potential costs and losses incurred in the aftermath of an adverse event that leads to a malpractice claim or suit being filed.

  • Cost of consequential care for the injured patient and/or absorption of care costs tied to the injury;
  • Loss of patient’s actual or potential income;
  • Loss of clinicians’ incomes during the time spent in association with the emotional and legal reverberations of the event;
  • Loss of practice/institution income due to negative publicity;
  • Cost to institution and/or health insurance provider for unwarranted defensive medicine;
  • Cost of medical experts to review the case and testify;
  • Cost of attorneys to pursue or defend the lawsuit;
  • Court costs;
  • Cost of settlement or indemnity payment; and
  • Cost of professional liability insurance premium increases.

And, of course, not all costs and losses associated with a medical malpractice case are financial.

preventable patient injury (or death) has a chilling effect on everyone involved. The patient and the social network he or she influences may shy away from important health care interactions. Sued clinicians may become distracted and unfocused, or develop practice biases that render them vulnerable to mistakes. Health care organizations may institute (costly) knee-jerk “improvements” that address only symptoms and fail to resolve the underlying problem.

But perhaps the most dangerous loss in the aftermath of a malpractice claim occurs when leadership focuses on that precipitating event and misses the signals emanating from the adverse events that continue to occur. Preventable adverse events expose unresolved problems…and portend malpractice exposure. Organizations and practice groups that routinely and effectively analyze their adverse events—especially in concert with malpractice data—are better positioned to understand and correct the underlying causes. They may not be able to keep those events out of the courtroom and off the bottom line, but they will be able to develop better systems, protocols, and training to reduce the occurrence of future events, lawsuits, and losses.


April 1, 2011
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