Rates and Characteristics of Paid Malpractice Claims Among US Physicians by Specialty, 1992-2014
Adam C. Schaffer,Anupam B. Jena,Anupam B. Jena,Seth A. Seabury,Seth A. Seabury,Harnam Singh,Venkat Chalasani,Allen Kachalia +7 more
TLDR
The rate of malpractice claims paid on behalf of physicians in the United States declined substantially between 1992 and 2014, and mean compensation amounts and the percentage of paid claims exceeding $1 million increased, with wide differences in rates and characteristics across specialties.Abstract:
Importance Although physician concerns about medical malpractice are substantial, national data are lacking on the rate of claims paid on behalf of US physicians by specialty. Objective To characterize paid malpractice claims by specialty. Design, Setting, and Participants A comprehensive analysis was conducted of all paid malpractice claims, with linkage to physician specialty, from the National Practitioner Data Bank from January 1, 1992, to December 31, 2014, a period including an estimated 19.9 million physician-years. All dollar amounts were inflation adjusted to 2014 dollars using the Consumer Price Index. The dates on which this analysis was performed were from May 1, 2015, to February 20, 2016, and from October 25 to December 16, 2016. Main Outcomes and Measures For malpractice claims (n = 280 368) paid on behalf of physicians (in aggregate and by specialty): rates per physician-year, mean compensation amounts, the concentration of paid claims among a limited number of physicians, the proportion of paid claims that were greater than $1 million, severity of injury, and type of malpractice alleged. Results From 1992-1996 to 2009-2014, the rate of paid claims decreased by 55.7% (from 20.1 to 8.9 per 1000 physician-years; P P = .15) to a 75.8% decrease in pediatrics (from 9.9 to 2.4 per 1000 physician-years; P P P = .36) to $114 410 in gastroenterology (from $276 128 in 1992-1996 to $390 538 in 2009-2014; P P = .005). Of 280 368 paid claims, 21 271 (7.6%) exceeded $1 million (4304 of 69 617 [6.2%] in 1992-1996 and 4322 of 54 081 [8.0%] in 2009-2014), and 32.1% (35 293 of 109 865) involved a patient death. Diagnostic error was the most common type of allegation, present in 31.8% (35 349 of 111 066) of paid claims, ranging from 3.5% in anesthesiology (153 of 4317) to 87.0% in pathology (915 of 1052). Conclusions and Relevance Between 1992 and 2014, the rate of malpractice claims paid on behalf of physicians in the United States declined substantially. Mean compensation amounts and the percentage of paid claims exceeding $1 million increased, with wide differences in rates and characteristics across specialties. A better understanding of the causes of variation among specialties in paid malpractice claims may help reduce both patient injury and physicians’ risk of liability.read more
Citations
More filters
Journal ArticleDOI
Association of Delivery Mode With Pelvic Floor Disorders After Childbirth
TL;DR: The incidence of pelvic floor disorders after childbirth was described to identify maternal and obstetrical characteristics associated with patterns of incidence 1 to 2 decades after delivery and cesarean delivery was associated with significantly lower hazard for stress urinary incontinence, overactive bladder, and pelvic organ prolapse.
Journal ArticleDOI
Diagnostic error increases mortality and length of hospital stay in patients presenting through the emergency room
Wolf E. Hautz,Wolf E. Hautz,Juliane E. Kämmer,Juliane E. Kämmer,Stefanie C. Hautz,Thomas C. Sauter,Thomas C. Sauter,Laura Zwaan,Aristomenis K. Exadaktylos,Tanja Birrenbach,Volker Maier,Martin Müller,Stefan K. Schauber +12 more
TL;DR: Diagnostic discrepancies are a relevant healthcare problem in patients admitted through the emergency room because they occur in every ninth patient and are associated with increased in-hospital mortality.
Journal ArticleDOI
Patient, Provider, and Practice Characteristics Associated with Inappropriate Antimicrobial Prescribing in Ambulatory Practices.
TL;DR: The results suggest that patient, practice, and provider characteristics are associated with inappropriate antimicrobial prescribing, and future research should target antibiotic stewardship programs to specific patient and provider populations to reduce inappropriate prescribing.
Journal ArticleDOI
The value proposition of simulation-based education.
TL;DR: Clarifying the value proposition of simulation-based education will require a major national effort with funding from multiple sponsors and active engagement of a variety of stakeholders, and future work should focus on both outcomes and costs.
Journal ArticleDOI
Malpractice claims related to diagnostic errors in the hospital
Ashwin Gupta,Ashwin Gupta,Ashley Snyder,Allen Kachalia,Scott A. Flanders,Sanjay Saint,Sanjay Saint,Vineet Chopra,Vineet Chopra +8 more
TL;DR: Inpatient diagnosis-related malpractice payments are common and more often associated with disability and death than other claim types and research focused on understanding and mitigating diagnostic errors in hospital settings is necessary.
References
More filters
Journal ArticleDOI
A Surgical Safety Checklist to Reduce Morbidity and Mortality in a Global Population
Alex B. Haynes,Thomas G. Weiser,Thomas G. Weiser,William R. Berry,Stuart R. Lipsitz,Abdel-Hadi S. Breizat,E. Patchen Dellinger,Teodoro Herbosa,Sudhir Joseph,Pascience L. Kibatala,Marie Carmela,Mc Lapitan,Alan Merry,Krishna Moorthy,R. Reznick,Bryce R. Taylor,Atul A. Gawande +16 more
TL;DR: Implementation of the checklist was associated with concomitant reductions in the rates of death and complications among patients at least 16 years of age who were undergoing noncardiac surgery in a diverse group of hospitals.
Journal ArticleDOI
Defensive medicine among high-risk specialist physicians in a volatile malpractice environment.
David M. Studdert,Michelle M. Mello,William M. Sage,Catherine M. DesRoches,Jordon Peugh,Kinga Zapert,Troyen A. Brennan +6 more
TL;DR: Defensive medicine is highly prevalent among physicians in Pennsylvania who pay the most for liability insurance, with potentially serious implications for cost, access, and both technical and interpersonal quality of care.
Journal ArticleDOI
Malpractice Risk According to Physician Specialty
TL;DR: The cumulative risk of facing a malpractice claim is high in all specialties, although most claims do not lead to payments to plaintiffs, and there is substantial variation in the likelihood of malpractice suits and the size of indemnity payments across specialties.
Journal ArticleDOI
Claims, Errors, and Compensation Payments in Medical Malpractice Litigation
David M. Studdert,Michelle M. Mello,Atul A. Gawande,Tejal K. Gandhi,Allen Kachalia,Catherine Yoon,Ann Louise Puopolo,Troyen A. Brennan +7 more
TL;DR: Claims that lack evidence of error are not uncommon, but most are denied compensation, and the vast majority of expenditures go toward litigation over errors and payment of them.
Journal ArticleDOI
Changes in Medical Errors after Implementation of a Handoff Program
Amy J. Starmer,Amy J. Starmer,Nancy D. Spector,Rajendu Srivastava,Rajendu Srivastava,Daniel C. West,Glenn Rosenbluth,April D. Allen,Elizabeth Noble,Lisa L. Tse,Anuj K. Dalal,Carol A. Keohane,Stuart R. Lipsitz,Jeffrey M. Rothschild,Matthew F. Wien,Catherine Yoon,Katherine R. Zigmont,Karen M. Wilson,Jennifer K. O'Toole,Lauren G. Solan,Megan Aylor,Zia Bismilla,Maitreya Coffey,Sanjay Mahant,Rebecca Blankenburg,Lauren Destino,Jennifer L. Everhart,Shilpa J. Patel,Shilpa J. Patel,James F. Bale,Jaime Blank Spackman,Adam Stevenson,Sharon Calaman,F. Sessions Cole,Dorene F. Balmer,Jennifer Hepps,Joseph O. Lopreiato,Clifton E. Yu,Theodore C. Sectish,Christopher P. Landrigan +39 more
TL;DR: Implementation of the handoff program was associated with reductions in medical errors and in preventable adverse events and with improvements in communication, without a negative effect on workflow.