Study: Most doctors will face at least one malpractice suit

Jessica M. Karmasek Aug. 19, 2011, 12:40pm

BOSTON (Legal Newsline) -- A comprehensive study of medical malpractice claims, published this week, revealed that about 1 in 14 doctors is the target of a claim each year.

The study, published Thursday on the New England Journal of Medicine's website, also showed that most physicians and surgeons will face at least one malpractice suit in their careers.

Researchers said they obtained physician-level data on malpractice claims from a large, physician-owned professional liability insurer that provided coverage to physicians in every state and the District of Columbia.

The procedures for safeguarding this data were approved by the institutional review board at the RAND Institute for Civil Justice, the article said.

RAND is a nonprofit institution that helps "improve policy and decision-making through research and analysis," according to its website.

According to the study, data included records on closed malpractice claims for 40,916 physicians who were covered for at least one policy year from 1991 through 2005. The number of physicians grew steadily from 12,498 in 1991 to 17,376 in 2005, the study noted.

Researchers identified 24 specialties that had at least 200 physicians represented in the sample. The most common specialties were anesthesiology, family general practice and internal medicine.

Physicians ages 30-70 were included in the study. The average age of physicians in all specialties was 49.

Data on other demographic characteristics were not available.

According to the study's results, 7.4 percent of all physicians had a malpractice claim each year during the study period. Nearly 2 percent had a claim leading to a payment.

Broken down by specialty, the proportion of physicians facing a claim each year ranged from 19.1 percent in neurosurgery, 18.9 percent in thoracic-cardiovascular surgery and 15.3 percent in general surgery to 5.2 percent in family medicine, 3.1 percent in pediatrics and 2.6 percent in psychiatry.

The study revealed that the mean indemnity payment was $274,887 and the median was $111,749. More specifically, mean payments ranged from $117,832 for dermatology to $520,923 for pediatrics.

However, perhaps the most telling statistic of the study's results is that by the age of 65, it was estimated that 75 percent of physicians in low-risk specialties had faced a malpractice claim.

It was estimated that 99 percent of physicians in high-risk specialties had faced a claim by the same age.

The study's authors said there is substantial variation in the likelihood of malpractice suits and the size of indemnity payments across specialties.

"The cumulative risk of facing a malpractice claim is high in all specialties, although most claims do not lead to payments to plaintiffs," they wrote.

Specialties in which the largest proportion of physicians faced a claim were not necessarily those with the highest average payment size, the authors said.

"For example, physicians in obstetrics and general surgery -- both fields that are regarded as high-risk specialties -- were substantially more likely to face a claim than pediatricians and pathologists, yet the average payments among pediatricians and pathologists were considerably greater," they wrote.

The study, funded by RAND and in part by the National Institute on Aging, uncovered what the authors call "an important aspect" of malpractice liability: the high likelihood of claims that do not result in payments to a plaintiff.

Annual rates of claims leading to indemnity payments ranged from 1 to 5 percent across specialties, whereas rates of all claims ranged from 5 to 22 percent, the study found.

"Our projections suggest that nearly all physicians in high-risk specialties will face at least one claim during their career; however, a substantial minority will not have to make an indemnity payment," the authors wrote.

The authors said the perceived threat of malpractice among physicians may boil down to three factors: the risk of a claim, the probability of a claim leading to a payment and the size of payment.

"Although the frequency and average size of paid claims may not fully explain perceptions among physicians, one may speculate that the large number of claims that do not lead to payment may shape perceived malpractice risk," the authors wrote.

"Physicians can insure against indemnity payments through malpractice insurance, but they cannot insure against the indirect costs of litigation, such as time, stress, added work and reputational damage."

The study's authors are Anupam B. Jena, a resident in the Department of Internal Medicine at Massachusetts General Hospital, Harvard Medical School; Seth Seabury, a RAND economist who holds a Ph.D. from Columbia University; Darius Lakdawalla, director of research at the Schaeffer Center for Health Policy and Economics at the University of Southern California; and Amitabh Chandra, an economist and a professor of Public Policy at the Harvard Kennedy School of Government.

From Legal Newsline: Reach Jessica Karmasek by email at

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