Letters Physician spending and risk of malpractice claims

Authors’ reply to Barbieri and Kovarik, Mariani, and Waxman and Kanzaria

BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h6774 (Published 14 December 2015) Cite this as: BMJ 2015;351:h6774
  1. Anupam B Jena, associate professor12,
  2. Lena Schoemaker, research assistant3,
  3. Jay Bhattacharya, professor23,
  4. Seth A Seabury, associate professor24
  1. 1Department of Health Care Policy, Harvard Medical School, Boston, MA 02115, USA; and Massachusetts General Hospital, Boston, MA, USA
  2. 2National Bureau of Economic Research, Cambridge, MA, USA
  3. 3Center for Primary Care and Outcomes Research, Stanford University School of Medicine, Stanford, CA, USA
  4. 4Department of Emergency Medicine and Leonard D Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, USA
  1. jena{at}hcp.med.harvard.edu

Barbieri and Kovarik raise several interesting points regarding our study and the empirical malpractice literature in general.1 2 It is important to note that our study intended to explore the positive question of how physicians’ use of resources relates to subsequent malpractice risk rather than whether physicians “should” spend more to reduce liability. This last question relies on notions of causality and economic welfare that we could not answer. However, we recognise the implications of our findings for physicians’ behaviour, particularly given the important role that malpractice plays in physicians’ practice. …

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