Study: About 1% of Physicians Account for nearly 32% of Medical Malpractice Payout Claims

Background

Malpractice suits are part and parcel of the risks involved in healthcare.  However, the majority of doctors are rarely accused or involved in malpractice suits.  Though data on malpractice suits and claims awarded do exist with National Practitioner Data Bank, this data is not open to scrutiny by public.  However, a study conducted by a group of researchers led by Dr. David LStuddert, a medical law expert at Stanford Law School, were granted access to this data to analyze the prevalence and characteristics of physicians prone to malpractice claims.  The aim of the study was to understand the distribution of malpractice claims among physicians.  If physicians, who were claim-prone accounted for the major share of all claims, would the ability to identify them lead to better and improved healthcare.

Methodology

The team, accessing data from the National Practitioner Data Bank, analyzed 66,425 claims that were paid against 54,099 physicians, from the year 2005 through 2014.  Using this data, the team calculated concentrations of claims against physicians.  Multivariable recurrent-event survival analysis was used to identify characteristics of physicians that were at high risk for recurrent claims, and to quantify the risk levels over time.

Results

  • 1% of all physicians accounted for 32% of paid claims.
  • Out of the number of physicians in the study with claims paid, 84% incurred paid claims just once, thus accounting for 68 percent of all claims paid.
  • 16% of physicians had at least two paid claims against them, which accounted for 68% of all paid claims.
  • Physicians with at least three paid claims amounted to 4%, making them accountable for 12% of all claims paid.
  • Adjusted analyses revealed that the risk of recurrence increased with the number of previous paid claims.  However, the risk of recurrence also varied according to the physician’s specialty – neurosurgeons were more likely to have a larger number of paid claims as compared to a psychiatrist.

The study however revealed that there were a substantial number of physicians within the high risk specialties who had multiple malpractice suits against them and were thus responsible for a disproportionate number of paid claims.  Doctors with paid claims end up paying thousands of dollars but still continue practicing after the case, with an increased chance of getting sued again.  This does not necessarily imply that they are bad or incompetent doctors.  In a lot of cases, doctors get sued for doing something wrong and unfortunately not understanding the mistake, continue doing that again.  On the other hand, there are doctors who are willing to undertake riskier interventions as they probably believe that the end justifies the cause.

The research also showed that male doctors were sued more than female doctors.  Similarly, more experienced doctors and those with osteopathic degrees were more likely to be sued than MDs.

Conclusion

The study reveals that a small number of physicians with distinctive characteristics accounted for a disproportionately large number of paid malpractice claims.  The question here is – can they be identified?  Is there any evidence of any other form of disciplinary action against these physicians?  Can this data be linked to other measures of quality?   While healthcare economists can hope to develop interventions that might mitigate the risk posed by these claim prone doctors, that day is still a long way off.

Nevertheless, the study is a first step, and does shine a light on the problem.


References

  1. BOODMAN, E. (2016, January 27). Small share of doctors account for bulk of malpractice payouts. Retrieved February 27, 2016, from http://www.statnews.com: http://www.statnews.com/2016/01/27/doctors-malpractice-claims/
  2. David M. Studdert, L. S. (2016, January 28). Prevalence and Characteristics of Physicians Prone to Malpractice Claims. Retrieved February 27, 2016, from http://www.nejm.org: http://www.nejm.org/doi/full/10.1056/NEJMsa1506137?query=featured_home&
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