MormonDevil, The Harvard study you quoted is 6 years old, which, in the medical field is an eternity. This research would be considered out of date in many respects. Furthermore, if you read the paper, the author (who is a JD, I might add. Conflict of interest, anyone?) estimates the cost of defensive medicine to be $46 million. It's an estimate, aka a guess. In Figure 1 in the paper, the author herself lists the Quality of Evidence supporting the $46 million figure to be Low. Why? Because estimating the cost of defensive medicine accurately is impossible. You just can't measure it. Much of the defensive medicine practiced by physicians is subconscious and untraceable. Anecdotally, it is my opinion as an ER doc that the 2.4% is much too low.

It is also my opinion that the majority of medmal cases are unnecessary and/or vindictive money grabs. I don't doubt that there are victims of malpractice (comes with the territory). I do doubt that the best way to make meaningful change to improve patient outcomes is to sue. There are many other, equally effective outlets to influence change in the way a health system and/or provider practices. This makes no difference to a patient who feels that a doctor isn't "sorry enough" for what they did to grandma or a lawyer who has bills to pay and a case they consider winnable.

Additionally, the "recourse for victims" line is one that I hear parroted by JD after JD. No amount of punitive damages awarded by a jury will bring grandma back. Since when can you affix a dollar amount to someone's pain and suffering? The idea that a certain amount of money should be awarded for an unfortunate outcome is a ludicrous charade.

What medmal is really about is winning the case for your client (Reference: that 2 day "ethics class" you had in law school that everybody knew was a joke), regardless of ethical considerations. Let's call a spade a spade here. As a medical student, I volunteered to help a UVA law friend in a "practice medmal case." Hearing lawyers talk about medicine would've been laughable, if it hadn't been so terrifying.

How would you feel going to work and knowing that any one of a thousand decisions you make could end your career, drive you into bankruptcy, disrupt your family life, and destroy your professional reputation? This is real stuff to a doctor. Medmal is a leach that needs serious reform. There needs to be punitive disincentivizers to lawyers who lose (or even settle) a medmal case.

TL;DR: If you support medmal in its current form, you are wrong.