Physicians are not as likely as once thought to leave their practices due to spikes in malpractice premiums, according to a new Harvard study that counted procedures rather than polled physicians.
The study looked at the effect of a "crisis" in premium hikes between 1999 to 2003 in Pennsylvania, a state historically most heavily impacted by premium hikes.
The study, released April 24 in Health Affairs and funded by the Pew Charitable Trusts, was based on Pennsylvania state-run insurance administrative records between 1993 and 2002 from funds requiring physician participation.
According to co-author Michelle Mello of the Harvard School of Public Health, the study found that most high-risk specialists, such as obstetrics/gynecology and cardiology, held steady the number of procedures performed during the "crisis" period.
"Physicians in Pennsylvania clearly experienced considerable distress during the malpractice crisis," Mello said. "But when we look statewide, it appears that most were able to hold their ranks, preventing the physician exodus that many feared - or at least forestalling it until the next malpractice crisis comes along."
Mello and her coauthors said their study has more conclusive results than typical physician surveys because it measured the number of procedures performed rather than relying on what physicians self-reported.
"Physicians may change their minds, or they may find that it's harder than they thought to make changes to their practice," Mello said.
According to researchers of the study, few issues in health policy have spurred as heated a public debate as the effects of rising malpractice insurance premiums on the supply of health care services. "Over the past six years of malpractice crisis, interest groups and legislators have clashed over whether the upswing in insurance costs threatens access to care and therefore merits an aggressive policy response," the researchers said.