# The Ongoing Medical Malpractice Issue: A Constant Struggle in Healthcare
In 2004, the American Medical Association (AMA) formally recognized a **”medical malpractice crisis.”** At that point, a startling 34% of physicians across the U.S. had experienced a lawsuit. This predicament jeopardized the integrity of **medical practice**, resulted in hospital closures, raised malpractice insurance costs significantly, and rendered coverage for high-risk fields like obstetrics prohibitively expensive.
By 2017, the situation had deteriorated further, with **55% of all U.S. physicians** contending with a lawsuit. Despite numerous initiatives—amounting to **over 100 tort reforms**—the legal environment still posed risks to physicians’ ability to provide care. Nonetheless, national health policies—such as **Hillarycare and Obamacare**—largely overlooked this concern, concentrating on healthcare access instead of the **litigation challenges faced by practitioners.**
## The Facts of Medical Malpractice: Personal Accounts
### A Doctor’s Encounter with Malpractice Litigation
**Dr. Howard Smith**, an OB/GYN who served over thirty years in Washington, D.C., has direct knowledge of the obstacles presented by medical malpractice. Operating in **the country’s legal center**, characterized by **the highest claims severity in the U.S.**, he was involved in three distinct legal cases from **1978 to 1990**—a harsh reality for many practitioners.
1. **A Lawsuit Involving Down Syndrome:**
– The trial ended in a mistrial on its first day.
– Nonetheless, Dr. Smith’s insurance provider opted for a settlement of **$35,000** to reduce legal expenses.
2. **Cerebral Palsy Case and an Emergency C-section:**
– Medical records verified **placental insufficiency**, irregular monitoring, and a complicated pregnancy.
– However, a lawsuit ensued, culminating in the case being **settled out of court** during a shift between his malpractice insurance providers.
3. **Surgical Injury Claim:**
– The carrier required a settlement under a **”cooperation clause.”**
Confronted with a **$140,000 yearly malpractice insurance premium**, Dr. Smith exited high-risk obstetrics to focus on office-based gynecology. Subsequently, he pursued a **Master’s in Healthcare Administration**, empowering him to create a **decision-making model grounded in hypothesis testing.**
### A Different Perspective on Medical Malpractice Defense
Dr. Smith’s **decision-making model** relies on **statistical hypothesis testing, guaranteeing that medical opinions achieve a 95% confidence level—more stringent than the legal sector’s standard of just **”50% confidence plus a scintilla.”**
His approach was successful in two later lawsuits:
1. **Hormone Replacement Therapy Case:**
– He prescribed **Prempro (Premarin and Provera)** to a menopausal patient.
– Following a **stroke suffered six months later**, a lawsuit was lodged against him, her internist, surgeon, and the pharmaceutical firm.
– Dr. Smith recorded in the patient’s file:
_”Random occurrences notwithstanding, there is 95 percent confidence that the use of Prempro is both safe and effective.”_
– By presenting his **decision-making model as evidence, the lawsuit against him was dismissed with prejudice**, preventing any re-filing.
2. **Medical Weight Loss Case (2020-2021):**
– Utilizing the same **95% confidence documentation**, he was again **dismissed with prejudice** two months after giving his deposition.
– Nevertheless, his employer was forced to settle.
## Reasons Why Medical Malpractice Continuously Remains an Unsolved Crisis
Despite years of legislative attempts, the **medical malpractice crisis endures**. Various factors contribute to this:
1. **Influence of the Legal Sector:**
– **Plaintiff attorneys profit financially** from settlements, regardless of the case’s actual validity.
– Malpractice claims are frequently **settled to avert lengthy court disputes** rather than based on factual determinations.
2. **Flaws in the Malpractice Insurance System:**
– Insurance firms often prefer **settlements over trials**, even when the physician wishes to contest the case.
– The **cooperation clause** compels doctors to conform to insurer choices, frequently at their professional and ethical detriment.
3. **Escalating Physician Burnout and Career Shifts:**
– Numerous doctors, including Dr. Smith, **leave high-risk specialties** due to fears of lawsuits and soaring insurance costs.
– The exit of skilled specialists restricts **patient access to essential healthcare services.**
4. **Failures of Insurance Companies:**
– In 2001, one of Dr. Smith’s insurers recorded **$6.7 million in claims while earning only $6.2 million in premiums**.
– By 2005, it had **