malpractice, failure to provide professional services with the skill usually exhibited by responsible and careful members of the profession, resulting in injury, loss, or damage to the party contracting those services. Though accountants, lawyers, and other professionals can be charged with malpractice, the term is most commonly associated with medical professionals (e.g., doctors, nurses, hospital technicians.) Most medical malpractice suits are for negligence on the part of medical professionals in providing expected level of care. In recent decades, partially as a consequence of medical costs, there has been a considerable expansion of medical malpractice suits, though the number of malpractice claims represents only a small percentage (about 3%) of all cases of actual negligence. The direct costs of malpractice, such as settlements and insurance premiums, have tended, however, to remain relatively constant (about 0.5%) with respect to overall medical spending during the last 20 years. Malpractice has led to significantly higher rates for malpractice insurance and, some studies indicate, a “defensive” approach to medicine in which medical personnel are unwilling to order any potentially risky procedures, and protect themselves against subsequent legal action through excessive patient testing and treatment that does not improve the outcome. The most significant medical costs increases are believed to result from excessive testing and treatment, which have been estimated to be as much as six times as great as direct costs. There have been a number of proposed solutions to the increasing burden of malpractice costs, including compensation boards, no-fault statutes, limits on the amount of damages available in various malpractice suits, and an annual limit on the amount that malpractice insurance premiums can increase. Under the Employment Retirement Income Security Act (1974), managed-care organizations are protected from claims for damages resulting from a denial of benefits.

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