The Rise of Litigation in the US


How did Americans become so litigious? What is the rationale of tort? Will tort reform work? I discuss these questions with Walter Olson, senior scholar at the Cato Institute, and author of the book, Litigation Explosion. 

Listen to our discussion on the Radiology Firing Line Series, hosted by the Journal of the American College of Radiology, and sponsored by Healthcare Administrative Partners.

2 replies »

  1. Just three observations. So, who really pays the bills for a hospital: probably pathology, radiology and surgery. Second, does a State’s number of attorneys per citizen apply? And finally, who really controls the legislature in the States with the highest pain and suffering awards? Hint: see State law process for medical Tort liability in Nebraska.

  2. That was an interesting discussion.

    What I wonder about is to what extent U.S. practice patterns incorporate our greater litigiousness and how do they compare to practice patterns in other developed countries. I know that the average hospital length of stay in the U.S. is, on average, no longer or even shorter than the length of stay in most other countries but much more happens to the patient while they’re in the hospital. Why is that?

    It’s also worth noting that patients don’t mind tests that are not painful or invasive as long as they don’t have to pay for them or don’t have to pay very much. Many patients equate more testing with thoroughness and generally think more care is better care even when it isn’t. Doctors get paid more for doing more. There are also a dozen or so places around the country with a high incidence of fraud including NYC, Chicago, Detroit, Tampa, Miami, Houston, LA, southern Louisiana and a few others. None of this is likely to be significantly mitigated by strategies like higher health insurance deductibles.

    Doctors want to avoid lawsuits at all costs and for good reason. If more testing raises healthcare costs, it’s not really their concern unless the patient brings it up as an issue and less expensive options can then be explored on a case by case basis while still delivering what is perceived to be the standard of care in that city or region.

    I was surprised that there was no discussion of the merits of specialized health courts during the discussion. Personally, I think we need to get medical malpractice cases out of the hands of juries who can be easily swayed by emotion. We need judges with specialized knowledge and the ability to hire neutral experts to sort through conflicting scientific claims. We also need safe harbor protection for doctors who follow evidence based guidelines and protocols where they exist which could be useful in protecting them from failure to diagnose lawsuits, especially cancer cases.