While most docs are sued few pay up: Study

By Dr. Ananya Mandal, MDAug 18 2011

A new study revealed that more than three in four US doctors will face a malpractice suit at some point in their careers, but cash is paid in only about 20 percent of cases. The analysis by researchers at several major US medical schools and the RAND Corporation, a non-profit research group, was published in the New England Journal of Medicine.

Lead author Anupam Jena of the Massachusetts General Hospital Department of Medicine said, “Naturally, physicians in each specialty believe they are getting sued more often than average. But while anecdotes abound, actual facts on who is getting sued and for how much have been unavailable until now.”

The team analyzed claims information from 1991 to 2005 from a major malpractice insurer, covering almost 41,000 physicians across the United States. The authors write, “During each year of the study period, 7.4 percent of all physicians had a claim filed against them, but only 1.6 percent made a malpractice payment.”

Specialties were divided into categories: high-risk included neurosurgery (19.1 percent), cardiovascular surgery (18.9 percent) and general surgery (15.3 percent). Family medicine (5.2 percent) pediatrics (3.1 percent) and psychiatry (2.6 percent) were low-risk. Doctors in the high-risk group were 99 percent sure to face a malpractice lawsuit at some point in their careers, compared to 75 percent in the low-risk groups. Co-author Seth Seabury of the RAND Corporation said, “It is a near certainty that, over a lengthy career, a physician in a high-risk specialty will be accused of malpractice, but the vast majority of these suits will be unsuccessful.”

Even though the high-risk specialties faced more lawsuits, they were not more likely to pay claims than low-risk doctors say researchers. Twenty percent of all claims resulted in some form of payment - the average amount being $275,000 - either by court judgment or settlement.

“We were surprised that the probability of facing at least one malpractice claim over the average physician's career was so high and particularly that so many claims did not result in payment,” said co-author Amitabh Chandra at the Harvard Kennedy School. Ninety-nine percent of specialists with high risk of malpractice, especially surgical specialties, will face a malpractice claim by the time they are 65 he said. “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,” he added.

Some lawmakers and health care organizations have advocated for national medical malpractice reform, or tort reform, as a means of lowering health care costs; California and Texas already have $250,000 caps noneconomic damages. However, there’s little evidence that proves these measures are lowering health care costs. Even without tort reform, Dr. Jena said that he believes the best solution is one that roots out frivolous claims.

“There are some claims which have merit and should be fully investigated and should be brought before a jury or settled, and there are also claims that don’t have that same merit. And those are the claims that we really should try to identify and limit early,” Dr. Jena said.