Medical malpractice premiums cost an average of $18,400 in 2000, down from the 1986 average of $20,106 in inflation-adjusted dollars, according to a study published on Tuesday in Health Affairs, the Boston Herald reports (Heldt Powell, Boston Herald, 5/8). Researchers at Suffolk University Law School examined surveys from 1970 to 2000 conducted by the American Medical Association's Center for Health Services Research and its successor, the Center for Health Policy Research. The nationwide surveys looked at samples of all self-employed physicians in regards to their income, practice expenses and practice characteristics. The researchers finds that malpractice premiums increased from 6% of physicians' total expenses in 1970 to 11% of expenses in 1986. Premiums fell to 6% of expenses in 1996 and then increased to 7% of expenses in 2000. The study found that premiums for self-employed physicians were lower in 1996 than in 1986 after adjusting for inflation, but "other practice expenses increased substantially." It adds that premiums increased between 1996 and 2000 "but had little impact on total practice expenses or net practice income nationally, within regions or within practice specialties" (Rodwin et al., "Malpractice Premiums and Physicians' Income: Perceptions of a Crisis Conflict With Empirical Evidence," Health Affairs, 5/8). Marc Rodwin, lead author of the study and a law professor at Suffolk, said, "There's no way you can call it a crisis because the numbers are too small." However, Alan Harvey, president of the Massachusetts Medical Society, said malpractice rates in Massachusetts have increased 132% in the last 12 years. "The problem is it's an uncontrolled cost for physicians," he said (Boston Herald, 5/8). The study is available online.

Opinion Piece
AMA "ignores its data when proclaiming a malpractice crisis," Rodwin writes in a Louisville Courier-Journal opinion piece. Rodwin writes that while premiums declined from 1986 to 1996 when adjusted for inflation, "total practice costs shot up from $186,000 to $247,000" in inflation-adjusted dollars. "If there's no premium crisis, why are doctors and senators rushing to legislate? Physicians feel beleaguered by reduced fees, market competition and health insurers who second-guess their work," Rodwin writes. He adds, "Malpractice has become a symbol to them of everything wrong with medicine -- a convenient scapegoat" (Rodwin, Louisville Courier-Journal, 5/9).

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