Frivolous medical malpractice lawsuits are endemic and infect everyone whether they realize it or not. The greed of plaintiffs, attorneys, medical experts, and malpractice carriers, coupled with the ineptitude of the tort system, causes hopelessness in physicians. Everyone else pays the price.

Plaintiffs sue for malpractice even when a claim has no attributable merit. Plaintiff attorneys, who are looking for business, advertise “if we don’t win, you don’t pay.” Once they attract a client, they hire a medical expert and pay it to opine that there is medical malpractice. Then they file a lawsuit and the doctor is served. The doctor notifies the malpractice carrier. The carrier hires a defense attorney. The defense attorney hires another medical expert and pays it to opine that there is no medical malpractice.

Now, the games begin. There is discovery and eventually a trial. The most notorious result of the tort system is a medical malpractice verdict for $229.6 million. It takes 3 years to litigate and another 2 years for an appeal to overturn it. The jury never learns that the lawsuit is patently frivolous and is caused by an error of nature, which is beyond the control of any defendant.

This cascade of events is repeated 85,000 times a year. The cost to everyone surmounts $56 billion and, curiously, this figure has not changed since first published 15 years ago.

Although there is $56 billion, if not more, at stake, the attitude fostered by many is “this is just the cost of doing business.” Those who promote this attitude profit the most, and those who are complacent to it pay the most. If $56 billion is just the cost of doing business, in what world are there no incentives to control costs? Those who promote this attitude are avoidable costs. Those who are complacent would not know an avoidable cost if it bites them.

If you are of the notion that you are insulated from these costs, I disabuse you of that notion with one question. What happens whenever you make an appointment with a doctor?

If you think that you make an appointment with your private doctor, you are sadly mistaken. You make an appointment with an agent of a network. Likely, the doctor is an agent of the network because the doctor found a way to control an unavoidable cost by joining a network. A malpractice premium is no longer the financial burden for the doctor. The network covers the doctor. The network may, itself, be self-insured.

In return, you become a bargaining chip for the network in its negotiations with your health insurance. The network is paid by capitation. In addition, the doctor delivers care to you in compliance with “best practices” designed to reduce costs for the network. The doctor forsakes professional autonomy. This is our health care system.

Plaintiff attorneys claim that they are only doing their jobs and they are paid by contingency fees. Defense attorneys claim the same and are paid by the malpractice carrier. Also, a recent survey by the American Foundation of Physicians never once refers to medical malpractice as a cause of professional dissatisfaction, indicating that doctors could not care less.

However, plaintiff attorneys file 85,000 malpractice lawsuits per year. They make over $2 billion just from settlements in 27,000 of them. Defense attorneys make another $2 billion. Each medical expert makes $100,000. Finally, the aforementioned survey was prepared from responses to a questionnaire by 17,000 out of 1 million American physicians and, in its 67 pages and thousands of words, the words “medical malpractice,” “insurance,” “liability,” and “lawsuits” are nowhere to be found, implying that a question is never even asked.

The $56 billion are, ultimately, paid by malpractice carriers, which are paid by the health care system, which is paid by health insurances, Medicare, and Medicaid, which are paid by you and by your taxes to the tune of, at least, $56 billion per year.

I develop a decision-making tool which determines if a complication is a medical error or an error of nature with 95 percent confidence. Whether it controls this epidemic of frivolous lawsuits remains to be seen. In the meantime, I am protected and you are not.

Howard Smith is an obstetrics-gynecology physician.