A New England Journal of Medical study found that one percent (1%) of all doctors account for 32 percent of all paid malpractice claims, and the more often a doctor is sued, the more likely he or she will be sued again. Researchers poured over ten years of paid malpractice claims using a federal government database, the National Practitioner Data Bank, which includes 66,426 claims against 54,099 doctors.
The study noted that the distribution of malpractice claims among physicians is not well understood. However, the authors concluded that if physicians who are repeatedly sued account for a substantial share of all claims, then the ability to identify them at an early stage could assist in efforts to improve care.
RESULTS
The study found that among physicians with paid claims, 84% incurred only one during the study period (accounting for 68% of all paid claims), 16% had at least two paid claims (accounting for 32% of the claims), and 4% had at least three paid claims (accounting for 12% of the claims). Risks of recurrence appeared to vary widely according to specialty. For instance, the risk among neurosurgeons was four times as great as the risk among psychiatrists, a statistic that makes sense given the nature of the work at hand.
CONCLUSIONS
The study concluded that over a ten year period of time, a comparatively small number of physicians with distinctive characteristics accounted for a disproportionately sizeable number of paid malpractice claims.
Amazingly, a doctor who had two paid claims was twice as likely to have another as a doctor who had one, and a doctor who had six or more paid claims was 12 times as likely to have another.
As noted above, the study found that specialties matter: Neurosurgeons and orthopedic surgeons were about twice as likely to have a paid claim as internists, while pediatricians were 30 percent less likely to have one.
Additionally, age and sex matter: After accounting for the number of years in practice, doctors under 35 years of age were one-third as likely to have a recurrence as older colleagues, and male physicians had a 38 percent higher risk of recurrence as female physicians.
Importantly, the lead author, David Studdert, found that, “Ninety-four percent of all doctors have no claims, but doctors who accumulate multiple claims are a problem, and a threat to the health care system. Identifying these high-risk doctors is a key first step toward doing something about the problem.”
KEY FINDINGS
- The average physician spends nearly 11 percent of an assumed forty-year career with an unresolved, open malpractice claim.
- The long time it takes for a case to be resolved is distressing for both doctor and patient.
RECOMMENDATIONS
- Malpractice reforms also need to focus on the time required to resolve claims.
- The think tank, Rand, found that the U.S. malpractice system is widely regarded as inefficient, in part because of the time required to resolve malpractice cases. Analyzing data from 40,916 physicians covered by a nationwide insurer, Rand found that the average physician spends 50.7 months, almost 11%, of an assumed forty-year career with an unresolved, open malpractice claim. Although damages are a factor in how doctors perceive medical malpractice, even more distressing for the doctor and the patient may be the amount of time these claims take to be adjudicated. Rand concluded that this fact makes it important to assess malpractice reforms by how well they are able to reduce the time of malpractice litigation without undermining the needs of the affected patient.
Sources: http://www.nejm.org/doi/full/10.1056/NEJMsa1506137; http://www.rand.org/pubs/external_publications/EP51278.html
