Massachusetts Governor Candidates Discuss Health Care: Charlie Baker

Posted in Health Policy, Health Reform, Malpractice, Mass. Governor Campaign, Mass. Legislature, Payment Reform on September 27th, 2010 by MMS – 1 Comment

Charlie Baker, running for governor of Massachusetts, discusses his views on health care for the Massachusetts Medical Society. See other candidates’ videos, as they become available, at

Massachusetts Governor Candidates Discuss Health Care: Deval Patrick

Posted in Health Reform, Malpractice, Mass. Governor Campaign, Payment Reform on September 23rd, 2010 by MMS – 1 Comment

Deval Patrick, running for re-election as governor of Massachusetts, discusses his views on health care for the Massachusetts Medical Society. See other candidates’ videos, as they become available, at

Survey Says: 9 of 10 Physicians Blame Lawsuit Fears for Overtesting

Posted in Malpractice on June 29th, 2010 by MMS Communications – 1 Comment

The results were resounding, and added more substance to the notion that the fear of being sued pervades the practice of medicine.  In a survey of 1,231 physicians across the country, more than 90 percent of responding physicians blamed the fear of being sued for overtesting – one facet of medical care usually cited in any discussion of cost containment. 

The survey was published Monday [June 28] in the Archives of Internal Medicine, and its findings echoed a recent Associated Press news story that said fears of lawsuits are the main reason for overtreating in the emergency department.

The survey asked but two questions: “Do physicians order more tests and procedures than patients need to protect themselves from malpractice suits?” And, “Are protections against unwarranted malpractice lawsuits needed to decrease the unnecessary use of diagnostic tests?” Ninety-one percent of respondents, who included emergency physicians, surgeons, primary care doctors and other specialists, agreed with both statements. 

Dr. Tara Bishop, co-author of the study and an internist at the Mount Sinai School of Medicine in New York, told AP that the results agree with what she hears from colleagues, that defensive medicine costs the health care system billions of dollar a year, and that many doctors fear being sued even when they follow standard-of-care guidelines.

The findings are also consistent with the results of several other surveys, including the MMS Survey on Defensive Medicine, published in 2008.

MMS to Participate in Patient Safety, Medical Malpractice Projects

Posted in Health Policy, Health Reform, Malpractice on June 14th, 2010 by MMS Communications – Comments Off on MMS to Participate in Patient Safety, Medical Malpractice Projects

By Alice Coombs, M.D., MMS President

justice scales 1I’m pleased to report that Massachusetts has received two grants from the U.S. Department of Health and Human Services to fund planning and demonstration projects to improve patient safety and reform the medical liability system.  The grants for the projects – both of which include the Medical Society as a collaborator – are part of an initiative announced by President Obama last September in his address to Congress and were announced on Friday as part of a $25 million program by HHS’s Agency for Healthcare Research and Quality.

Our state was one of only two (along with Washington) to receive both a demonstration and a planning grant. Seven projects were awarded a demonstration grant; only 13 a planning grant.

That Massachusetts has received two grants is good news indeed. It is first a testimony to the work that so many in the state are doing in the area of patient safety and recognizes the Commonwealth as a leader in patient safety and reducing medical errors. Second, it signifies recognition that the medical liability system is sorely lacking, and the need to fix it remains a priority in health care reform.

Such recognition comes right from The White House itself.  Writing on The White House Blog, Ezekiel J. Emanuel, M.D., Ph.D., the President’s Special Advisor for Health Policy with the Office of Management and Budget, said “The HHS Patient Safety and Medical Liability initiative program represents the largest investment in malpractice reform by the Federal government in at least 20 years. It will give states and health systems the information they need to improve their malpractice systems, making them more fair and efficient for both patients and doctors.” 

The Medical Society is playing key roles in both projects. For Dr. Kenneth Sands’ project at Beth Israel Deaconess Medical Center, we’ll be sharing information on tort reform and medical liability models and assisting in the distribution of educational materials.  For Alice Bonner’s project at the Department of Public Health, we’ll be performing an advisory role in providing the physician perspective on medical errors, and we”ll be working with other participating partners in educational programs.

Details on all the projects are available at the Agency for Healthcare Research and Quality’s website at Medical Liability Reform & Patient Safety Initiative.

Mass. Practice Environment Dips Again

Posted in Health Policy, Malpractice, Medicine, Primary Care on May 25th, 2010 by MMS Communications – Comments Off on Mass. Practice Environment Dips Again

MMSIndex_colorMake it 16 down years out of 18.  The MMS Physician Practice Environment, a statistical reading of nine measures affecting the practice climate for physicians in the state, took yet another dip in 2009 and hit a record low.

Four factors led the decline in 2009: professional liability rates, the increasing use of emergency rooms by patients, an aging physician population, and the increasing cost of maintaining a practice.

“A strong physician practice environment is essential to maintain a strong physician workforce,” said MMS President Alice Coombs, M.D., commenting on the analysis in a posting on WBUR’s Commonhealth website.  “And its importance should be self-evident: it has a direct influence on patient care. Yet this latest analysis brings us more sobering news.”

Of the measures leading the decline, Dr. Coombs said professional liability and emergency room use were the most troublesome. Professional liability has been the driving force behind the decline of the index for years, and Dr. Coombs said a “critical step forward to improving the practice environment would be to enact liability reform.”  The rise in emergency room use highlights a new and disturbing dimension of the index, as it points to the delivery of primary care taking place in emergency departments.

A picture of the state’s practice environment from year to year is valuable by itself. But the MMS analysis includes a index for the nation as a whole, providing a reference point to judge changes in the state.  And a comparison reveals stark differences between the state and the rest of the nation as the four factors leading the state’s decline increased at a rate substantially faster than the national rate. The conclusion: when it comes to providing a good practice environment for physicians, Massachusetts and the nation are headed in opposite directions. Since 2006, the Massachusetts Index has declined 1.5 percent, while the U.S. Index has advanced 1.2 percent.

“Reversing the decline in the physician practice environment will lead to a stronger, more viable health care delivery system,” Dr. Coombs wrote. “The current climate should be cause for concern. And action.”

Read Dr. Coomb’s post on WBUR’s Commonhealth

Dr. Izenstein: 3 Basics for Health Care Reform

Posted in Defensive medicine, Health Reform, Malpractice, Primary Care on November 2nd, 2009 by MMS Communications – Comments Off on Dr. Izenstein: 3 Basics for Health Care Reform
Dr. Barry Izenstein, Governor of the Massachusetts Chapter of the American College of Physicians, in a letter to the editor of the Springfield Republican published November 1, says “Let us not get caught up in silly, petty, unfounded arguments when it comes to health-care reform. Indeed, if the current bill fails, the result will be more uninsured patients and more families going bankrupt because of high health-care premiums and bills.” Dr. Izenstein lays out three objectives for health care reform: provide all american with access to affordable health insurance; create incentives to reverse a “growing and catatrophic shortage” of primary care physicians; and reform the medical liability system. 

Read Health Care Reform is Good for Patients
The Republican, Springfield, November 1, 2009

Defensive Medicine: Myth or Reality?

Posted in Defensive medicine, Malpractice on January 23rd, 2009 by MMS – Comments Off on Defensive Medicine: Myth or Reality?

Here's an emergency doc whose blog post this week makes his vote clear: Defensive medicine is real.

He writes, "By the end of the shift, I was getting annoyed with myself because I kept
second-guessing my decisions to order tests that would most likely be normal."

He adds, "Many physicians are afraid to practice rational medicine based upon clinical
judgment and physical examination skills. No one wants to face the liability."

Read the whole post – it's worth your time.

Defensive Medicine Costs Mass. at Least $1.4 Billion

Posted in Malpractice on November 17th, 2008 by MMS – 1 Comment

Surgeons- tiny image
Today, the Mass. Medical Society released a study showing that defensive medicine wastes at least $1.4 billion annually in Massachusetts. These are tests, procedures, referrals,
hospitalizations, or prescriptions ordered by physicians, solely out an excessive concern over being sued. Dr. Alan Woodward said, “Physicians practice defensive medicine because
they don’t trust the medical liability system."

This is a low-ball figure, coming from a survey of just eight specialties. This estimate does not include tests and diagnostic procedures ordered by
physicians in other specialties, observation admissions to hospitals,
specialty referrals and consultations, or unnecessary prescriptions. The
eight specialties represented in the survey account for only 46 percent
of the physicians in the state.

While defensive medicine has been studied by many researchers, we believe it's the first study of defensive medicine of this scope ever conducted.

Read a news release about the study.
Read a summary of the study.