National Practitioner Data Bank data shows that in most states only about two percent of physicians have been responsible for over half of all the money paid out for malpractice since 1990. NPDB data also shows that quite often these two percent have multiple payments in their records but no action by state licensing boards to revoke their licenses or restrict their practices. Similarly, most often no action has been taken by hospital peer reviewers to revoke or restrict their clinical privileges. So the “repeat offenders” continue commit more malpractice.

Dr. Perlman ought to rechannel her frustration into an effort to get the licensing boards and peer reviewers to get serious about protecting the public from physicians with a pattern of malpractice.

It is also worth noting that there are fewer than 20,000 malpractice payments each year for all causes although the Institute of Medicine estimates that there are about 100,000 deaths each year from malpractice. Other sources double that number. Only about 28 percent of malpractice payments involve patient death. Thus we can estimate that at most only about 3 to 6 percent of all malpractice victims receive any malpractice payment.

The real problem isn’t malpractice payments. To save money and reduce malpractice insurance premiums — and more importantly, to save lives and prevent injury — we need true malpractice reform that reduces malpractice itself. We need to stop treating the symptoms — malpractice payments — and instead treat the disease — malpractice.