Malpractice liability plays only a limited and inconsistent role in doing what it should: giving doctors an incentive to practice safely.
Medical mistakes are dangerous, costly, and often hidden until it's too late. Patients do their best not to think about them, because of their need to trust in their doctors. Who wants to study a surgeon's error rates right before going under the knife? For their part, doctors don't like to admit they erred, especially when they might get sued. But a culture that avoids confronting mistakes will only perpetuate them.
Medical leaders and patient groups have made some progress reducing one type of error: infections contracted in hospitals. Organizations like the Institute for Healthcare Improvement and medical schools like Johns Hopkins University have engaged and educated doctors and nurses about preventing these infections. Consumers Union and other patient groups have won enactment of legislation in 30 states to require hospitals to report how often their patients contract a preventable infection. Congress has provided funds for additional infection reporting in the Affordable Care Act (ACA). As a result of all of this effort, infection rates are declining. The Centers for Disease Control and Prevention has found declines of as much as 58 percent for various hospital infections over the last several years.
However, there remain a vast number of safety problems in desperate need of improvement. Thirteen years ago, the Institute of Medicine estimated that between 44,000 and 98,000 hospital patients die each year from preventable medical errors. That's roughly the same level of deaths revealed in a recent study by the Inspector General at the Department of Health and Human Services, which pegs the number of Medicare patient deaths from preventable errors at 79,000 each year. In addition to the senseless tragedy of unnecessary death, such errors cost Medicare nearly $2 billion annually, in part because many non-lethally injured patients require additional care to fix the mistakes.