Strict Liability for Medical Malpractice? The Impact of Increasing Malpractice Liability on Obstetrician Behavior in Taiwan

Thursday, April 22, 2010
12:00 PM - 1:30 PM
Philippines Conference Room

The extent and existence of "defensive medicine" -- excessive medical care to defend a physician against malpractice claims -- is a perennial subject of both policy and academic debate.  For example, malpractice liability and associated defensive medicine are among the most-cited reasons for escalating health-care spending in the United States.

In this colloquium, Dr. Brian Chen will present results from his research investigating the extent of defensive medicine in Taiwan. He studies the impact of a series of court rulings in Taiwan that increased physicians’ liability risks, and a subsequent amendment to the law that reversed the courts’ rulings, on physicians’ test-ordering behavior and propensity to perform Caesarean sections.  He finds that physicians faced with higher malpractice pressure increased laboratory tests as expected, but unexpectedly reduced Caesarean sections.  (The reduction in Caesarean deliveries may be due to the fact that liability risks were more closely aligned with physicians’ standard of care after the court rulings.) After the law was amended to negate the court decisions, physicians reversed their previous behavior by reducing laboratory tests and increasing Caesarean deliveries.

This pattern of behavior is highly suggestive of the existence of defensive medicine among physicians in Taiwan. In other words, by studying physicians' response to legal changes in Taiwan, we find that greater malpractice liability may, under certain circumstances, prompt physicians to perform more services without necessarily improving patient health.

Dr. Brian Chen recently completed his Ph.D. in Business Administration in the Business and Public Policy Group at the Haas School of Business, University of California at Berkeley. He received a Juris Doctor from Stanford Law School in 1997, and graduated summa cum laude from Harvard College in 1992.