Malpractice liability is one of the biggest headaches for practicing physicians. For many it is one of the single largest costs of business and resolving claims can use up a lot of physician and administrator time. Some researchers have also expressed the view that malpractice liability is significantly driving up health care spending, not only in direct costs but by causing defensive medicine, in which physicians order tests and treatments just to protect themselves from claims. The American Medical Association has issued a report collecting some interesting information on malpractice exposure. (AMA Report)
The AMA analyzed some external information and also relied on data from its survey of about 5800 physicians. Overall, 42% of physicians have had a claim filed against them at some point in their careers, with about 95 claims per 100 physicians and over 20% of physicians being sued two or more times. About 5% were sued in the past year. The cumulative risk of being sued obviously increases with age and 60% of physicians over age 55 report at least one lifetime claim. High risk specialties like general surgery and obstetrics/gynecology had more than double the claim experience of low risk pediatrics and psychiatry. Women had about half the claims of men, but much of this effect was due to specialty, form of practice and age.
Of all malpractice claims, 65% end up being dropped or dismissed; about 30% settled or resolved by mediation or arbitration and 5% resolved by trial, with the defendant physician winning 90% of those. That means only 1% of all filed claims end up being won at trial by a plaintiff. Interestingly, research suggests that about as many claims are filed that are meritless as there are unfiled claims that did involve negligence or an error. The conclusion from this and other research should be that considering the complexity of their work and the inevitability of humans making mistakes in whatever they do, physicians do a remarkable job of not making errors. Another conclusion is that the system allows, even encourages frivolous claims that have a huge direct and indirect cost. If it weren’t for trial lawyer campaign contributions, it is also pretty obvious what the correct policy response should be.