NEJM: Neurosurgeons face the most malpractice claims

Topics: Outcomes, Quality, Performance Improvement, Safety, Medical Errors

August 18, 2011

About one in 14 physicians have a malpractice claim filed against them in an average year, and most physicians will face at least one malpractice claim during their careers, according to a study in NEJM.

For the study, Harvard University researchers and colleagues analyzed a national database of a single liability insurer for 40,916 U.S. physicians. The data represented claims from 1991 through 2005 for physicians across 25 specialties.

Overall, the findings showed that 7.5% of physicians have a malpractice claim filed against them annually. Surgeons faced claims more often than physicians in other specialties. For every year across the study period, an average of 19.1% of neurosurgeons, 18.9% of thoracic-cardiovascular surgeons, and 15.3% of general surgeons faced a lawsuit. Meanwhile, only 5.2% of family physicians, 3.1% of pediatricians, and 2.6% of psychiatrists were sued annually.

Even among the lower-risk specialties, three-quarters of physicians will face a malpractice claim before they retire, according to the study. Among all physicians, 99% will have a malpractice claim by the time they turn 65, the study found.

However, the researchers noted that about 78% of overall claims did not result in payments, with either the court dismissing the case or patients dropping it. The findings also showed that there was little correlation between the likelihood of being sued for malpractice and the size of payouts. Typically, pediatricians paid the most for claims, with the average pediatric claim costing more than $520,000, compared with the average claim of about $275,000.

The authors wrote, "Although these annual rates of paid claims are low, the annual and career risks of any malpractice claim are high, suggesting that the risk of being sued alone may create tangible fear among physicians." They added, "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" (Neale, MedPage Today, 8/17; AP/Washington Post, 8/17; Hobson, "Health Blog," Wall Street Journal, 8/17).