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The researchers, led by Daniel A. Waxman, examined 3.8 million Medicare patient records from hospital emergency departments from 1997 to 2011, comparing care in three states that enacted strict malpractice reform laws about a decade earlier (Georgia, Texas and South Carolina) to care in neighboring states that did not enact such laws.
Texas law included remedies against retaliation for whistleblowers, but no known U.S. state had whistleblower laws that addressed appropriate prosecutorial conduct. According to the Texas Nurses Association, "No one ever imagined that a nurse would be criminally prosecuted for reporting a patient care concern to a licensing agency."
In common law jurisdictions, medical malpractice liability is normally based on the tort of negligence. [3]Although the law of medical malpractice differs significantly between nations, as a broad general rule liability follows when a health care practitioner does not show a fair, reasonable and competent degree of skill when providing medical care to a patient. [3]
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The American Association of Colleges of Nurses cited studies estimating that a shortage of registered nurses would reach 230,000 by 2025 as America ages, with over 135,000 open positions during 2007. An additional 30% more nurses would have to graduate annually to keep up with demand.
Defensive medicine takes two main forms: assurance behavior and avoidance behavior.Assurance behavior involves the charging of additional, unnecessary services to a) reduce adverse outcomes, b) deter patients from filing medical malpractice claims, or c) preempt any future legal action by documenting that the practitioner is practicing according to the standard of care.
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