Malpractice Claims High, Case Losses Low for Physicians

Most physicians will be sued at least once for malpractice before age 65. That claim, however, seldom results in payment to the plaintiff - especially if it’s against a family medicine physician or a pediatrician.

That’s according to a recently released New England Journal of Medicine (NEJM) report.

The results reveal both good news and bad news for physicians.

“Our results may speak to why physicians consistently report concern over malpractice and the intense pressure to practice defensive medicine, despite evidence that the scope of defensive medicine is modest,” the study authors wrote.

In other words, despite the fact that physicians often do not have to pay the plaintiff when sued, they often have to face a malpractice case - which is perhaps, nearly as costly.

“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 authors note.

To conduct their analysis, the researchers analyzed physician-level malpractice claims obtained from a large professional liability insurer. Their data included coverage information for 40,000 physicians between 1991 and 2005.

Based on their findings, the researchers project that physicians practicing in “low-risk” specialties (which include pediatrics and family medicine) have a 36 percent chance of being sued by age 45. But the study also projects that only five percent of these physicians will have to make an indemnity payment (settle or pay the plaintiff).

Of course, the risk of being sued increases as physicians age. The researchers projected that by age 65, 75 percent of these “low-risk” physicians these physicians will be sued; and one out of every five will have to pay the plaintiff.

Projected malpractice risk and loss due to a claim is significantly higher for other specialties, like surgeons. Ninety-nine percent will be sued by age 65 and, according to the researchers, 71 percent will have to pay a claim.

For the Physician Insurers Association of America (PIAA), the national insurance industry trade association representing medical professional liability insurance companies, the NEJM report reinforces the need for various reforms which could reduce the number of malpractice claims.

“The vast majority of claims and suits brought against healthcare providers have no merit," PIAA President Brian Atchinson said in a statement. “As a result of our flawed and inefficient medical liability system, healthcare providers continue to be subjected to unnecessary stress and time away from caring for patients.”

The NEJM study findings are similar to AMA survey findings released in August 2010. That survey found that, while physicians are likely to be subject of a lawsuit at some point in their careers, the majority of claims are either dropped or dismissed.

For more information on malpractice rates, visit our recently updated Best States to Practice interactive map. It includes medical malpractice information - liability rates and the number of medical board disciplinary actions taken against physicians - on the state level.