Researchers writing in the New England Journal of Medicine examined a database of malpractice claims to identify the risks of being sued across various specialties and cumulatively over a lifetime of physician practice. (NEJM Article) Each year about 7.4% of physicians were sued and about 22% of the claims led to a payment. (This means that almost 80% of filed claims did not result in any payment to a patient, but still extracted a cost in legal fees and the doctor’s time.) By the time they are 65, almost 100% of physicians in higher-risk specialties will have had a malpractice claim filed against them, and even in the low-risk specialties, 75% of the doctors will have been sued.
As might be expected, surgeons faced the highest risks; 19% of neurosurgeons and thoracic-cardiovascular surgeons had a claim in any given year, and 15% of general surgeons were sued. The lower risk specialties included an annual claim risk of 2.6% for psychiatrists, 3.1% for pediatricians and 5.2% for family practice doctors. The average indemnity payout was about $275,000; which was highly skewed by a few very large payments. Dermatology had the lowest average payment and pediatrics the highest, which might be expected because of the emotion people feel when children are hurt. Not shown were the legal costs, which are substantial.
Some policymakers (usually those well-funded by plaintiffs’ lawyers) will point to what seems like a low annual incidence of malpractice suits and say it shows there really isn’t a problem that needs to be addressed, ignoring the cumulative risk. But the other, and we think better, way to look at it is that the low incidence means it really can’t make much difference to eliminate this excuse for doctors to practice defensive medicine which also happens to bolster their income. An astounding percent of all the money spent in regard to alleged malpractice winds up in the hands of lawyers, not patients. There has to be a better way to deal with physician errors, one that is more rational and that accepts the notion that doctors after all are human and are going to make mistakes from time-to-time.