Malpractice, Outcomes, and Appropriateness of Care

by Albert P. Williams

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This paper reports on the need for more research on outcomes and appropriateness of medical care to develop a more rational system for preventing, punishing, and compensating for medical malpractice. Malpractice claims are clearly linked to outcomes of care, and a large proportion of court decisions settling these claims confuse bad outcomes with inappropriate care because of the lack of definitive research on how specific medical interventions affect patient outcomes. The author suggests that the medical malpractice system might be improved by conducting more research on outcomes and appropriateness of care to inform medical decisionmaking and to set standards relevant only to a certain class of malpractice problems, ones in which it was not appropriate to take a specific action. Developing more explicit standards of care treats both doctor and patient more equitably by offering a statement about range of expected risks and benefits of the intervention under consideration as well as providing a structure to ease problems of malpractice.

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