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The medical society's goal should be to reduce the number of malpractice incidents.
Reducing the amount of malpractice incidents, not the amount of malpractice awards, will reduce the cost of malpractice insurance.
Reducing the number of bad doctors will reduce the amount of malpractice incidents, cutting the cost of malpractice insurance for the good doctors who for too long have paid to cover the mistakes of a small number of inept peers.
Secondly, our baseline analysis estimated the association between malpractice incidents and one year lagged physician spending (categorized into fifths).
We addressed this problem for each specialty by estimating the association between adjusted physician level spending and subsequent malpractice incidents, including hospital specific fixed effects.
We used two approaches to analyze whether our measures of physician resource use in a year were associated with alleged malpractice incidents in the following year.
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For example, among internists, the probability of experiencing an alleged malpractice incident in the following year ranged from 1.5%95%5% confidence interval 1.2%to1.7.7%) in the bottom spending fifth ($19 725£12800800; €17 400) per hospital admission) to 0.3% (0.2%to0.5.5%) in the top fifth ($39 379 per hospital admission).
Similarly, for obstetricians we computed average malpractice incident rates according to fifth of adjusted caesarean rates.
We therefore assumed that four or five years after an alleged malpractice incident would be enough for most malpractice claims to be closed for physicians for whom we had spending data in 2009 (for example, physicians with a malpractice incident in January 2009 would have nearly five years for a claim to be closed to appear in our data).
Increasing average risk adjusted caesarean rates for each obstetrician year was associated with decreases in the probability that an obstetrician experienced an alleged malpractice incident in the subsequent year (table 5).
Across all specialties there was a negative association between the fifth of risk adjusted average spending for a given physician year and the probability of facing an alleged malpractice incident in the subsequent year (table 2).
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com