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 avoidable costs. Everyone pays the price.

Some plaintiffs sue for medical malpractice just because they harbor a grievance against a doctor and their 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 such a client, they hire a medical expert and pay this expert to opine that there is medical malpractice. Then they file a lawsuit, and the doctor, who is the subject of this grievance, is served. The doctor notifies the malpractice carrier. The carrier hires a defense attorney. The defense attorney hires another medical expert who is paid to opine that there is no medical malpractice.

There is discovery and eventually a trial. The outcome is not as uncertain as one might believe. Most of the time, physicians prevail.

However, this cascade of events is repeated 85,000 times a year. The cost exceeds $56 billion per year. Curiously, this figure has not changed since first published 15 years ago.

Although there are $56 billion at stake, the attitude fostered by many is “this is just the cost of doing business.” To those, I have two words: “avoidable costs.”

If $56 billion is just the cost of doing business, in what world are there no incentives to control costs, particularly avoidable costs? If you are of the notion that you are insulated from avoidable costs, I disabuse you of that notion with one question: “What happens whenever you make an appointment with a doctor?”

Here is what happens. Unless you see concierge physicians (which is another story altogether), if you think that you made an appointment with your private doctor, you are sadly mistaken. You made an appointment with an agent of a network. The doctor is an agent of the network because the doctor found a way to control his or her avoidable costs by joining a network. An increase in a medical malpractice premium is no longer their financial burden. The network covers the doctor, and the network may, itself, be self-insured.

In return, you become a bargaining chip for the network in its negotiations with your health insurance because the network is paid by it according to capitation or the number of insured lives enrolled in the network. Whether you realize it or not, when your doctor joined the network, you became enrolled. In addition, the doctor delivers care to you in accordance with “best practices.” Best practices are not standards of care; they are designed to reduce costs for the network. Remember this the next time you receive a bill for a medical service.

Plaintiff attorneys claim that they are only doing their jobs and they are paid by contingency fees only when they win. By doing their jobs, plaintiff attorneys file 85,000 malpractice lawsuits per year, many of which are frivolous. Whether a client realizes it or not, the client often covers litigation expenses, avoidable or not. Plaintiff attorneys could not care less because they make over $2 billion per year just from settled cases (27,000 settlements).

Defense attorneys also claim that they are only doing their jobs, but they are paid billable hours by the malpractice carrier. They make another $2 billion, win or lose, whether the claim is frivolous or not. Medical experts make still another $2 billion per year. Medical experts are not called “hired guns” by accident. In the final analysis, these account for $6 billion of that $56 billion which began this discussion of avoidable costs.

The $56 billion are, ultimately, paid by malpractice carriers, which are paid by networks in the health care system, which are paid by health insurances, Medicare, and Medicaid, which are paid by you and by your taxes.

I develop a decision-making tool, which determines if a complication is a medical error or an error-of-nature with 95 percent confidence. Errors-of-nature instigate frivolous medical malpractice lawsuits and underlie most avoidable costs. Because my tool is used only by me, I would be the first to admit that it does not control this virtual epidemic of frivolous lawsuits. However, at least I am protected. You are not.

Howard Smith is an obstetrics-gynecology physician.