How often physicians alter their clinical behavior because of the threat malpractice liability, termed defensive medicine, and consequences those changes, are central questions in ongoing medical reform debate.To study prevalence characteristics medicine among practicing high-liability specialties during a period substantial instability environment.Mail survey 6 at high risk litigation (emergency general surgery, orthopedic neurosurgery, obstetrics/gynecology, radiology) Pennsylvania May...

In the current debate over tort reform, critics of medical malpractice system charge that frivolous litigation--claims lack evidence injury, substandard care, or both--is common and costly.Trained physicians reviewed a random sample 1452 closed claims from five liability insurers to determine whether injury had occurred and, if so, it was due error. We analyzed prevalence, characteristics, litigation outcomes, costs lacked error.For 3 percent claims, there were no verifiable injuries, 37 did...

Concerns about reducing the rate of growth health expenditures have reignited interest in medical liability reforms and their potential to save money by practice defensive medicine. It is not easy estimate costs system, however. This article identifies various components system costs, generates national estimates for each component, discusses level evidence available support estimates. Overall annual including medicine, are estimated be $55.6 billion 2008 dollars, or 2.4 percent total care spending.

On April 20, 2010, Arizona State University (ASU) agreed to pay $700,000 41 members of the Havasupai Indian tribe settle legal claims that university researchers improperly used members' blood samples in genetic research.1 The settlement closes a difficult chapter for both parties but leaves open bedeviling question research: What constitutes adequate informed consent biospecimens collected research be stored and future, possibly unrelated studies? case illuminates clashing values have...

Thinking Globally, Acting Locally The defining feature of the U.S. response to Covid-19 has been localized action against a global threat. Under our federalist system, what more can federal gov...

Clinical Characteristics of Patients With 2019 Novel Coronavirus (2019-nCoV)–Infected Pneumonia in Wuhan, China

Sharing of participant-level clinical trial data has potential benefits, but concerns about harms to research participants have led some pharmaceutical sponsors and investigators urge caution. Little is known participants' perceptions the risks sharing.

HIPAA and Protecting Health Information in the 21st CenturyIn March 2018, Trump administration announced a new initiative, MyHealthEData, to give patients greater access their electronic health record insurance claims information. 1 The Centers for Medicare & Medicaid Services will connect beneficiaries with data increase pressure on plans care organizations use systems that allow send information where they like.MyHealthEData is part of broader movement make patient improve health.The seeks...

This JAMA Forum discusses the possibilities, limitations, and risks of physician use large language models (such as ChatGPT) along with improvements required to improve accuracy technology.

The authors review challenges arising in malpractice litigation related to software errors inform health care organizations and physicians about liability risk from AI adoption strategies mitigate risk.

This Health Policy Report describes the malpractice system in United States, examines its shortcomings, and analyzes forces that have led to past current crises. The authors review options for reform of U.S. system. Conventional tort reforms include caps on damages, limits attorneys' fees, shortening statute limitations. Experts also proposed major reforms, such as enterprise liability or administrative compensation.

A major medical malpractice crisis is unfolding in the United States today. The American Medical Association has identified 18 states which physicians and institutional health care providers are having grave difficulties obtaining affordable professional liability insurance. In past two years, insurance premiums these have increased dramatically for high-risk specialties such as obstetrics, emergency medicine, general surgery, surgical subspecialties, radiology (see Figure). Another 26 on...

The growing prevalence of obesity among adults and children has prompted legal initiatives designed to combat this public health problem. authors describe litigation legislation that target discuss the potential for law reduce in United States.

Studdert et al. describe recent efforts by the federal government and professional organizations to tighten regulation of financial associations between physicians pharmaceutical industry. Payments doctors (including gifts consulting fees) drug companies are violations anti-kickback law if payments have potential increase recipients' prescriptions for companies' products. The Office Inspector General, Pharmaceutical Research Manufacturers America, physicians' issued guidelines prohibiting...

Since the 1990s, nationwide rates of vaginal birth after cesarean section (VBAC) have decreased sharply and increased sharply. Both trends are consistent with clinical behavior aimed at reducing obstetricians' exposure to malpractice litigation.To estimate effects pressure on VBAC section.We used state-level longitudinal mixed-effects regression models examine data from Natality Detail File births in United States (1991-2003). Malpractice was measured by liability insurance premiums tort...

Context: Public health law has received considerable attention in recent years and become an essential field public health. research, however, less attention. Methods: Expert commentary. Findings: This article explores defined as the scientific study of relation legal practices to population The offers a logic model research typology approaches studying effects on Research content prevalence laws, processes adopting implementing extent which mechanisms through affects outcomes can use...

Although enthusiasm for health care reform is resounding in Washington these days, the specific shape will take and compromises that have to be made along way are opaque. Currently, much of discussion centers on possibilities insurance mandates, a public plan modeled after Medicare, methods used control costs.1 Many other issues addressed, including physician payment reform, future Medicare Advantage, providers' participation programs, role expansions Medicaid, course, funding mechanism any...

The authors review the potential benefits and unintended consequences of broad sharing participant-level data from clinical trials. Several options for governance structures that could be implemented to provide expanded access trial are discussed.

Physicians contend that the threat of malpractice lawsuits forces them to practice defensive medicine, which in turn raises cost health care. This argument underlies efforts change laws through legislative tort reform. We evaluated physicians' perceptions about claims states where more objective indicators risk, such as premiums, varied considerably. found high levels concern among both generalists and specialists measures risk were low. also relatively modest differences concerns across...

The question is not whether to use new data sources but how

The distribution of malpractice claims among physicians is not well understood. If claim-prone account for a substantial share all claims, the ability to reliably identify them at an early stage could guide efforts improve care.Using data from National Practitioner Data Bank, we analyzed 66,426 paid against 54,099 2005 through 2014. We calculated concentrations physicians. used multivariable recurrent-event survival analysis characteristics high risk recurrent and quantify levels over...

State prescription drug monitoring programs (PDMPs) aim to reduce risky controlled-substance prescribing, but early had limited impact. Several states implemented robust features in 2012–13, such as mandates that prescribers register with the program and regularly check its registry database. Some allow fulfill latter requirement by designating delegates registry. The effects of PDMP have not been fully assessed. We used commercial claims data examine implementing PDMPs four on overall...

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