NCPA - National Center for Policy Analysis


June 8, 2005

Direct tort reform increases physician supply and impacts where doctors choose to practice, according to studies by the Journal of the American Medical Association (JAMA) and Health Affairs.

The first study, by JAMA, surveyed physicians with 20 or more years of experience against doctors with less than 20 years of experience to determine the effect of caps on malpractice lawsuits. The results (through the years 1985 to 2001) show that physician services, in both categories, rose in every state:

  • The number of doctors in states with caps on medical malpractice lawsuits grew 2.4 percent more than states without torts, and the number of states adopting reforms experienced a 3.3 percent increase.
  • Additionally, states with caps saw a 9.6 percent increase in overall doctor services.
  • More growth came from doctors with 20 or more years of experience.
  • Currently, 27 states have capped payouts for noneconomic "pain and suffering" in medical malpractice cases.

Overall, the supply of professionally active doctors increased from 497,140 in 1985 to 709,168 in 2001, says JAMA.

The second study reiterated that the presence of caps directly impacts where doctors choose to practice, says Health Affairs.

  • Caps on noneconomic damages in 27 states were associated with a 2.2 percent increase in physicians (that's five doctors per 100,000 people).
  • Rural counties with a cap had 3.2 percent more physicians than counties sans caps.

Surgeons and obstetricians are the most influenced by the presence or absence of caps. Doctors are fleeing counties without caps and increasing medical liability premiums for a more secure environment, conclude the researchers.

Source: Marguerite Higgins, "Medical services rise with suit limits," Washington Times, June 1, 2005; based upon: Daniel P. Kessler et al., "Impact of Malpractice Reforms on the Supply of Physician Services," Journal of the American Medical Association, Vol. 293, No. 22, June 1, 2005; and David Dranove and Anne Gron, "Effects Of The Malpractice Crisis On Access To And Incidence Of High-Risk Procedures: Evidence From Florida," Health Affairs, May/June 2005.

For JAMA study (subscription required):

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