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A case study in progress: practice guidelines and the affirmative defense in Maine
1Maine Medical Association, Manchester.
The Joint Commission Journal on Quality Improvement
|August 1, 1993
Summary
The Maine Medical Liability Demonstration project uses an "affirmative defense" to reduce defensive medicine by granting physician immunity for following practice guidelines. Physicians are increasingly accepting this controversial approach despite legal challenges.
Area of Science:
- Medical malpractice law
- Healthcare policy
- Physician behavior
Background:
- Defensive medicine increases healthcare costs.
- Physicians face significant malpractice liability.
- Existing malpractice systems can discourage evidence-based practice.
Purpose of the Study:
- To evaluate the impact of the "affirmative defense" on physician practice.
- To assess the adoption and acceptance of practice guidelines in a liability context.
- To explore a novel approach to mitigating malpractice concerns.
Main Methods:
- Implementation of the "affirmative defense" in the Maine Medical Liability Demonstration project.
- Granting immunity to physicians adhering to established practice guidelines.
- Monitoring physician acceptance and challenges from legal stakeholders.
Main Results:
- Physicians are beginning to accept the "affirmative defense" program.
- The project aims to reduce defensive medical practices.
- Challenges from trial lawyers have been noted.
Conclusions:
- The "affirmative defense" shows potential for encouraging evidence-based practice.
- Physician acceptance is a key factor in the program's success.
- Further evaluation is needed to understand long-term effects on healthcare costs and quality.