Law Matters

This chapter explores theories about how laws and organizations influence each other. First, the chapter explores the purpose of tort laws and the goals of the tort reform movement and uses them to define provider-friendly and patient-friendly tort regimes. An analysis of the effects of tort laws on obstetric malpractice lawsuits illustrates that, contrary to expectations, the rate of lawsuits is higher in states where tort reforms have reduced healthcare providers’ liability risk. The chapter then uses reproductive justice theory to examine reproductive health laws that govern contraception, abortion, midwifery, prenatal substance use, and fetal rights. These laws define fetus-centered and woman-centered reproductive rights regimes.

A Home of Our Own: The National Patient Safety

Prior to the first Annenberg Conference, none of us who were interested in patient safety had given any thought to forming a national organization—except for Marty Hatlie, the AMA’s legal counsel. Marty was intrigued by the success of the Anesthesia Patient Safety Foundation (APSF) that Jeep Pierce and Jeff Cooper had founded. He envisioned the formation of a similar national organization as the centerpiece of the refashioning of the AMA’s stance on patient safety after its stinging legislative defeat of tort reform.

The Ivory Tower is no More in the Nineties

This chapter explains the 1990s as a time when Alternative Dispute Resolution (ADR) or the antilaw movement was being vigorously sold to the American people. It talks about Professor Kagan, who wrote about formal adversarial litigation and Stewart Macaulay, who weighed in on the arguments. It also includes that the San Francisco Chronicle weighed in on the author's theory of “coercive harmony” via Norman Larson, and George McGovern who wrote apologetically about the tort reform battle. The chapter analyses the publication of the author's Mintz lecture on Controlling Processes that came in 1996, which stimulated correspondence between her and psychologists who specialize in cults and the deprogramming of people. It explores letters that commented on disparate issues providing advice to younger anthropologists like David Price, who was dealing with the taboo subject of militarism and anthropology.

Status of current medicolegal reform in the United States: a neurosurgical perspective

OBJECTIVEThere are approximately 85,000 lawsuits filed against medical practitioners every year in the US. Among these lawsuits, neurosurgery has been identified as a “high-risk specialty” with exceptional chance of having medical malpractice suits filed. Major issues affecting the overall medicolegal environment include tort reform, the formation of medical review panels, the increasing practice of defensive medicine, and the rising costs of medical insurance. In this study, the authors provide a concise update of the current medicolegal environments of the 50 states and provide a general guide to favorable and unfavorable states in which to practice neurosurgery.METHODSData were acquired related to state-by-state medical review panel status, noneconomic damage caps, economic damage caps, and civil suit filing fees. States were placed into 5 categories based on the status of their current medicolegal environment.RESULTSOf the 50 states in the US, 18 have established a medical review panel process. Fifteen states have a mandatory medical review process, whereas 3 states rely on a voluntary process. Thirty-five states have tort reform and have placed a cap on noneconomic damages. These caps range from $250,000 to $2,350,000, with the median cap of $465,900. Only 8 states have placed a cap on total economic damages. These caps range from $500,000 to $2,350,000, with the median cap of $1,050,000. All states have a filing fee for a medical malpractice lawsuit. These costs range from $37 to $884, with the median cost for filing of $335.CONCLUSIONSMedicolegal healthcare reform will continue to play a vital role in physicians’ lives. It will dictate if physicians may practice proactively or be forced to act defensively. With medicolegal reform varying greatly among states, it will ultimately dictate if physicians move into or away from certain states and thus guide the availability of healthcare services. A desirable legal system for neurosurgeons, including caps on economic and noneconomic damages and availability of medical review panels, can lead to safer practice.