Expert Commentary

Malpractice risk according to physician specialty

2011 study in the New England Journal of Medicine on the proportion of physicians facing malpractice claims and the cumulative career risk of being sued.

Physicians perform medical procedure

The size and rate of malpractice suits against United States physicians has long been the subject of controversy; the issue has played a strong role in the political debates over health care reform and the continuing rise of insurance costs.

A 2011 study published in the New England Journal of Medicine, “Malpractice Risk According to Physician Specialty,” utilized 14 years of malpractice data obtained from a large medical liability insurer covering more than 40,000 doctors across 25 specialties.  By analyzing the annual number of claims and the proportion of those claims that led to indemnity payments and size of payments, the study sought to estimate the risk of being sued among physicians across specialties. Researchers involved in the study were based at Massachusetts General Hospital, Harvard Medical School, the RAND Corporation, the University of Southern California, and the Harvard Kennedy School.

The study’s findings include:

  • Annually, between 1991 and 2005, 7.4% of all physicians had a malpractice claim, with 1.6% having a claim that led to an indemnity payment.
  • By the age of 45, up to 36% of physicians in low-risk specialties were projected to have faced their first claim. For high-risk specialties this figure was as high as 88%. By age 65, the proportion for low-risk specialties is estimated to be as high as 75% and for high-risk specialties is fully 99%.
  • Between 1991 and 2003, the proportion of claims against physicians in low-risk specialties decreased from 8.3% to 5.8%.  Additionally, claims against practitioners in high-risk specialties were at their highest from 1996 to 2000.
  • The average cost of an indemnity payout was $274,887, with some specialties such as pediatrics averaging as high as $520,924.
  • Despite the high cost of some payouts and the pervasive concern of physicians, the researchers found that only 1% to 5% of claims resulted in payments.

In conclusion, the authors write: “High rates of malpractice claims that do not lead to indemnity payments, as well as a high cumulative career malpractice risk in both high and low-risk specialties, may help to explain perceived malpractice risk among U.S. physicians.”

Tags: safety, health care reform, law

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