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The Medical Malpractice Myth 1st Edition

18 customer reviews
ISBN-13: 978-0226036489
ISBN-10: 0226036480
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Editorial Reviews

From Publishers Weekly

In January 2005, President Bush declared the medical malpractice liability system "out of control." The president's speech was merely an echo of what doctors and politicians (mostly Republicans) have been saying for years—that medical malpractice premiums are skyrocketing due to an explosion in malpractice litigation. Along comes Baker, director of the Insurance Law Center at the University of Connecticut School of Law, to puncture "the medical malpractice myth" with a talent for reasoned argument and incisiveness. He counters that the real problem is "too much medical malpractice, not too much litigation," and that the cost of malpractice is lost lives and the "pain and suffering of tens of thousands of people every year"—most of whom do not sue. Baker argues that the rise in medical premiums has more to do with economic cycles and the competitive nature of the insurance industry than runaway juries. Finally, Baker offers an alternative in the form of evidence-based medical liability reform that seeks to decrease the incidence of malpractice and also protect doctors from rising premium costs. Having worked with insurance companies, law firms and doctors, Baker brings experience and perspective to his book, which is sure to be important and controversial in future debates. (Nov.)
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.


The Medical Malpractice Myth is a terrific book that succeeds fully in realizing its basic goals of offering an accessible debunking of the medical malpractice myth, redefining the key problems at stake related to medical malpractice, and pointing the way toward more effective and politically appealing reform policies that address the ‘real’ issues. Tom Baker’s work has a far better chance for generating a wide readership and public influence than any other book on the topic.”--Michael McCann, Gordon Hirabayashi Professor for the Advancement of Citizenship, University of Washington, and coauthor of Distorting the Law

(Michael McCann)

“An outstanding accomplishment—accurate, reader-friendly, and highly relevant to the current debate about tort reform. Tom Baker has done a marvelous job confronting existing medical malpractice myths, and, though his proposal for medical liability reform will no doubt meet resistance on a number of fronts, it will certainly provoke discussion.”--Neil Vidmar, Russell M. Robinson II Professor of Law, Duke Law School, and author of Medical Malpractice and the American Jury

(Neil Vidmar)

“Finally someone has demonstrated how complex this challenge really is. Narrow, facile answers won’t solve the problem.”--Senator Richard J. Durbin, Assistant Democratic Leader, United States Senate

(Senator Richard J. Durbin)

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Product Details

  • Hardcover: 222 pages
  • Publisher: University Of Chicago Press; 1 edition (December 1, 2005)
  • Language: English
  • ISBN-10: 0226036480
  • ISBN-13: 978-0226036489
  • Product Dimensions: 6 x 0.8 x 9 inches
  • Shipping Weight: 1.2 pounds (View shipping rates and policies)
  • Average Customer Review: 3.9 out of 5 stars  See all reviews (18 customer reviews)
  • Amazon Best Sellers Rank: #2,044,403 in Books (See Top 100 in Books)

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Most Helpful Customer Reviews

48 of 54 people found the following review helpful By Peter Siegelman on December 12, 2005
Format: Hardcover
This book is a model for what social science can do, in four ways.

First, it takes on an important topic--one that has generated incredible heat in the popular press and in political circles.

Second, it takes an entirely fair perspective. Old fashioned as it may seem, the author is actually interested in finding out the truth about the med mal problem.

Third, it surveys the available literature in the social sciences, reads and cogently digests every significant study, and assess the merits of each. The author is not an economist, but his understanding of economics and his sober and astute assessment of the quantitative AND qualitative evidence is terrific.

Finally, the book does all this with a clarity and cogency of writing that make it eminently readable. This is not a dull slog through endless tables and figures. While the empirical evidence is discussed, and there is even some attention paid to issues of methodological reliability and so on, the prose is lucid and no one interested in the topic will find it tough going in the least.

In fact, no one interested in the topic--from doctor to lawyer to politico--can afford not to read this book. If only more social science were this good, the world would be a better place.
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26 of 32 people found the following review helpful By Marc Mayerson on January 29, 2006
Format: Hardcover
This is a copy of my review from the Insurance Scrawl blog, [...] :

Nearly 100,000 killed last year, the same rate as in the ongoing, repellent genocide in Darfur. But this figure is the estimate of the number of Americans who die annually due to medical-malpractice errors.

That's one of the key points emphasized in the trenchant new book by Professor Tom Baker, The Medical Malpractice Myth (2005). Baker's slim, accessible, engaging, and well-written volume argues that the prevailing myths concerning medical malpractice and doctors' liability-insurance premiums are the stuff of urban legend.

One of the key contributions of the book is to assemble in one handy place the current literature about the amount of medical malpractice, the number of med-mal claims, the settlement/judgment costs and transaction costs of these cases, insurance premiums, and ups and downs in insurance markets. Baker argues convincingly that there is an epidemic of medical practice in the United States, nearly 100,000 preventable deaths annually, with only a fraction of claims being pursued (and most nonmeritorious claims are resolved before trial and often are dropped). The number of deaths annually exceeds automobile-related and workplace-related deaths combined, yet the medical-liability insurance premiums in toto are a small fraction of the premiums collected for auto and worker's comp.

Baker approaches his study with an open mind and transparently - he shows the reader the evidence, the bases for his interpretation of the evidence, and honestly identifies where the data are uncertain, limited or unclear. The book is quite refreshing in this regard, given the jeremiads one usually sees in these discussions.
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7 of 8 people found the following review helpful By TGM on December 19, 2012
Format: Paperback
If Tom Baker came into my Emergency Department as a patient, he would almost certainly get MORE care (studies, procedures, consultations), but there is a very good chance that it would be worse for his health. However it would not be from malicious or punitive intent.

Like nearly all outsiders, and unfortunately most physicians, Baker underestimates the impact of doing more medicine in order to be more careful. A fantastic literature is now emerging exploring the problem of overzealous medical care. See Shannon Brownlee's "Overtreated," Gilbert Welch's "Overdiagnosed," or the really superb "Hippocrates Shadow" by David Newman. It is the effect of the confluence of money, technology, consumers' expectation of immediate and complete satisfaction, and physicians' overconfidence in the salvific power of our craft.

The problem is that despite the enormous contributions of technology, medical diagnosis is not nearly accurate enough, and as a result there will be increased cost in terms of risk (I'm not talking about money here) to pursuing earlier diagnosis. This has to do with the basic statistical notion of the FALSE POSITIVE. When diagnostic tests are less than 100% accurate then they will occasionally yield false results - this is obvious.

What is not obvious is the paradoxical effect of applying imperfect tests to low-risk populations. When I have a test that is "only" 99% accurate, and I apply it to a patient group that has a 1% chance of having the condition in question, fully ONE HALF of those who have a positive test result will be FALSE POSITIVE. If the previous factual statistical statement doesn't cause you some psychic distress, then keep reading it until you begin to understand the implications.
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17 of 22 people found the following review helpful By Linda on May 5, 2007
Format: Hardcover Verified Purchase
This book is a must read for anyone who thinks that tort reform is a good idea. We've tried it in California. The effect has been to effectively immunize health care providers from liability by closing the courthouse door to claims of medical negligence. There is no incentive to improve the health care system or to address the systemic problems that cause most injuries and deaths.

Medical negligence is a fact. Our government estimates that as many as 98,000 people per year die from preventable medical errors. The cost of these errors is enormous and, when our civil justice system is crippled by tort reform, those costs are often shouldered by the public through increased taxes and fees.

Tort law is designed to do two things: to provide just and reasonable compensation to people injured by the negligence or carelessness of another and to discourage behavior likely to result in injury. When we "dis-incentivize" good medical practices by immunizing health care providers, we make it more, not less, likely that people will be injured as a result of medical errors.

There is no evidence of which I am aware that these reforms have benefitted anyone other than big insurance companies. In California, it is increasingly difficult or impossible for patients who are injured by medical errors to receive "just and reasonable" compensation for the harm caused. The cost of litigating such cases is prohibitive in light of the 32-year-old MICRA cap which limits damages to $250,000 in most cases - even those involving gross negligence or the death of a child.
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