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Craig Kelley
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New study on medical malpractice: how much are doctors really at risk?

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Debates about reforming our civil justice system—particularly in the area of medical malpractice claims—are a hot topic for attorneys, physicians, insurance companies and politicians. The central issue is a dividing one: are doctors brought to court more than they should be or are patients just getting justice? Although accusations often flow in both directions, there is relatively little hard data to help us understand what’s really happening.

But now, a new study released by the New England Journal of Medicine in August might provide some guidance. The study steps into the tort reform debate concerning medical malpractice claims with an important analysis of just how often physicians are actually being brought into the courtroom and just how much of a monetary risk those physicians face. The researchers examined the medical malpractice claims that were submitted to a large insurance company, attempting to determine three things:

  • The proportion of physicians who face a malpractice claim in a given year
  • The proportion of physicians who actually make a payment on a claim and the amount of that payment
  • The risk of a physician facing a malpractice claim during the entirety of their career

The scope of this study is impressive, especially in contrast to previous studies on similar issues. In total, the data that the researchers used included records for nearly 41,000 physicians nationwide and who represented at least 24 different specialties over a time span between 1991 through 2005. By looking at these physicians’ insurance records, the researchers were able to discern how many of them actually faced malpractice suits and how big—in terms of dollars—those suits were.

A few interesting things emerged from the numbers that the researchers looked at:

  • First, each year, approximately 7.4% of the physicians faced a malpractice claim. But this number varied greatly depending on the specialty. For example, 19% of neurosurgeons faced a claim, but only 2.6% of psychiatrists did.
  • Second, around 1.6% of physicians each year made some sort of indemnity payment. This number, too, varied depending on the specialty but did not always align with the likelihood of a claim. For example, gynecologists were the most likely to have paid a claim, but 12th most likely to face a claim.
  • Third, the average amount actually paid was $274,887, another number that varied depending on specialty and that did not necessarily align with the likelihood of a claim. For example, neurosurgeons were most likely to face a claim, but the amount they would actually pay was less than other specialties.

Taken together, what the numbers showed is that the majority of doctors who practice in areas such as internal medicine, family medicine and pathology will never make a malpractice payment in their life. Another interesting finding that the researchers uncovered was whether patients are actually winning on the claims that they file and the numbers showed that insurance companies deny far more medical claims than they pay out.

While this study focused only on insurance claims, which don’t always lead to a lawsuit, it still contributes a lot to the tort reform debate if for no other reason than it demonstrates the complexity of the issue. Blanket statements such as “plaintiffs always win” or “doctors face too much liability” simply aren’t specific enough. Specialty matters. So does the amount doctors are actually paying. Being more specific—and using real data to actually make arguments—will help the debate respond to the needs of individual patients and the concerns of doctors.

2 Comments

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  1. Cilla Mitchell says:
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    “Debates about reforming our civil justice system-particularly in the area of medical malpractice claims-are hot topics for attorneys, physicians, insurance companies and politicians.”

    What about the collateral damage left behind when doctors are negligent and murder patients without accountability? If the patient’s safety and rights are not considered, and accountability is impossible under Tort Reform, then my advice is for the doctors, politicians, and everyone who is so concerned about medical malpractice and how doctors are really at risk to double up on their life insurance because loved ones who are left behind, will have no recourse but to use their own brand of justice.

    Providing a link to a video showing just how Tort Reform is working out in Texas, or not.

    http://www.youtube.com/watch?v=JT7rxa21_Xo

    If you are unable to access link, just Google Cleveland Mark Mitchell, then click on youtube Cleveland Mark Mitchell December 12 1950 – April 26 2008.

    I doubt anyone can argue with me after viewing the video about people finding their own brand of justice.

  2. Razia says:
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    I think the reason there hasn’t been any reform in the medical malpractice / medical malpractice insurance world is because there doesn’t seem to be a good answer. On one hand the amount of medical malpractice that happens everyday that never reaches a lawyer or court room is huge. However it often doesn’t reach the court room because the damage isn’t bad enough to warrant anyone’s time.(on a monetary level) One the other hand though the amount of people trying to take advantage of doctors just to make a buck is a significant problem. This is evidenced by medical malpractice insurance carriers having 85% of their claims get dismissed with no payment. (see http://www.equotemd.com/blog ) I suspect it will continue the way it is until a good idea that is fair to both sides is presented.
    Razia