Emergency Medicine Physicians and Medical Liability Reform

According to an article from Kaiser Health News, the number of emergency room visits rose by about ten percent, or 13 million visits, to more than 136 million visits in 2009. The Centers for Disease Control and Prevention estimates this to be the largest increase ever. One factor contributing to this increase has to do with the Emergency Medical Treatment and Labor Act passed in 1986. This act requires hospitals to provide emergency services to all patients, regardless of their ability to pay for medical services rendered. The law, in and of itself, has driven up the number of patients seeking out emergency rooms and thus the number of overcrowded emergency departments in the nation. Another concern for emergency physicians comes from the Affordable Care Act which will require hospitals to reduce their readmittance rates by coordinating care or be financially penalized. This means physicians will be pressured by hospitals not to admit patients who cannot pay because the hospital will not receive payment from those patients. On the other hand, physicians will also feel pressure from their own conscience, from the family members of patients unable to pay, and from the continual specter of lawsuits.

All of these factors have led some emergency room physicians to focus on a possible means to reduce the nation’s health care costs—medical liability reform which they believe will discourage defensive medicine practice. One of the issues being discussed at the annual American College of Emergency Physicians conference this week is how many emergency physicians would like reform that would include indemnification based on recognized guidelines, caps on non-economic damages, and medical courts where providers would be judged by their medical peers. One important piece of evidence against medical liability reform is a study showing the number of congestive heart failure patients discharged from the emergency department dropped by sixty-three percent between 2006 and 2010 likely due to an increase in concerns about medical malpractice litigation.

What are your thoughts regarding medical liability reform?