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Malpractice Risk According to Physician Specialty

2012; Lippincott Williams & Wilkins; Volume: 67; Issue: 2 Linguagem: Inglês

10.1097/ogx.0b013e318247c521

1533-9866

Anupam B. Jena, Seth A. Seabury, Darius Lakdawalla, Amitabh Chandra,

Healthcare Policy and Management

According to physician specialty, there are no recent data on the proportion of physicians who are likely to face malpractice claims, the size of payments, and the cumulative risk of being sued during a physician's career. Earlier studies were limited by use of older data without broad geographic coverage, use of self reports with small sample size and low response rates, and insufficient information on physician specialty and size of payments. The aim of this study was to determine the proportion of physicians facing a malpractice claim in a given year and making an indemnity payment and to estimate the size of the payment. The investigators used physician-level malpractice claims obtained from the database of a large professional liability insurer to characterize malpractice risk among physicians in 25 specialties. Malpractice data from 1991 through 2005 were analyzed for a total of 40,916 physicians across 233,738 physician years of coverage. The cumulative risk of ever being sued was estimated among physicians in high- and low-risk specialties. Although 7.4% of all physicians faced a malpractice claim each year, only 1.6% of claims led to an indemnity payment (i.e., <20% of claims resulted in an indemnity payment). The proportion of physicians facing a claim each year was highest in surgical specialties: neurosurgery (19.1%), thoracic-cardiovascular surgery (18.9%), and general surgery (15.3%). As would be expected, physicians in nonsurgical specialties had fewer annual claims: family medicine (5.2%), pediatrics (3.1%), and psychiatry (2.6%). Among all physicians, the mean indemnity payment was $274,887 (in 2008 dollars), and the median was $111,749. The average size of the indemnity payment in high-risk specialties such as obstetrics and general surgery was considerably lower than in some low-risk specialties such as pediatrics and pathology, despite the substantially lower likelihood of annual claims in the latter. The cumulative career risk of a malpractice claim by the age of 65 years was 75% for physicians in low-risk specialties and 99% for physicians in high-risk specialties. These findings show substantial variability across specialties in the likelihood of malpractice suits and the size of indemnity payments. The cumulative career risk of facing a malpractice claim is high for all specialties, but most claims do not lead to indemnity payments.