Which doctors get sued the most?

The Pediatric Insider

© 2016 Roy Benaroch, MD

A study published this week in the New England Journal of Medicine can teach us a few things about doctors and lawsuits. While many docs will go their entire careers without a single malpractice suit, a small proportion seem to attract a whole lot of litigation. There might be a lesson there.

It’s a big-data study, to say the least. Professors from both the Stanford, CA medical and law schools put their huge-brained heads together, along with collaborators from Australia and the US Department of Health and Human Services. They used the National Practitioner Data Bank (NPDB), a “confidential” depository of all paid lawsuits in the US, along with American Medical Association data on every single doctor, MD and DO. 10 years of data, from 2005 through 2014, were examined, including information on 66,426 malpractice suits from 915,564 physicians. The NPDB only includes information on “paid claims”—meaning a verdict or settlement that results in money going to a plaintiff. Lawsuits that were dismissed or dropped could not be included in this study.

Some interesting findings:

  • Only 6% of physicians, overall, had a paid claim in the 10 year study period. In other words, the vast majority of docs don’t settle or lose lawsuits.
  • Only about 30% of filed claims result in any payments at all—most lawsuits are just dropped without money changing hands (this was not from the data of the current study, but from a reference in the ‘discussion’ section.)
  • Only 3% of paid claims went to satisfy court verdicts. When malpractice suits end with money changing hands, it’s nearly always as a settlement, not as a verdict. These things, it turns out, rarely “go to court.”
  • The mean claim payment was $371,000; the median was $204,000. If you wish to learn more about the difference between mean and median, go back to middle school.
  • Though most physicians had zero claims, a disproportionate number accounted for multiple claims. Approximately 1% of all physicians owned 32% of all monies paid to plaintiffs, and just 0.2% accounted for 12%.
  • A physician’s risk of future claims – of being successfully sued ‘again’ – increased by more and more as the number of previous lawsuits accumulated. Compared with physicians who had been sued once previously, physicians who had been sued twice had twice the risk of a subsequent lawsuit; physicians with three previous claims had three times the risk of another recurrence. It goes up even more from there.
  • Male physicians had about a 38% higher risk of a subsequent lawsuit, and younger physicians had a lower risk than older docs.

What can we learn from all of this? Though malpractice litigation and a “fear of lawsuits” is a frequent topic of discussion among physicians, most of us don’t get sued, most suits don’t get paid, and even suits that do get paid are usually in settlements, not at the end of court dramas. And a relatively small number of docs seems to account for a disproportionately large percentage of legal action.

The authors of this study didn’t speculate on why some docs are sued more frequently than others. An overly-simple answer is that some docs just aren’t very good—but that misses some important truths. The risk of a lawsuit is only partially related to bad medicine and bad outcomes. A lot of the risk, really, comes down to poor communication, and sometimes bad luck. It’s also likely that some of these “frequent targets” are docs who serve the riskiest, sickest patients that no one else will touch. Those very fragile patients likely have the worst chance of a good outcome, even though thy might be under the care of the most talented and smartest docs. No good deed goes unpunished, you know. Still, if you learn that your doc has been sued 7 times, it might be time to go looking for another physician. You don’t want to end up on the plaintiff’s side of the table.

I fell asleep.

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3 Comments on “Which doctors get sued the most?”

  1. Jeanne Keller Says:

    One important thing to note is that due to tort reform, at least in the state of GA, most doctors who “deviate from standard medical practice” are never sued. Why? Best to talk to an attorney friend who specializes in medical malpractice. In lay man’s terms it is becuase the caps on the dollar amount of winning a suit has led to two outcomes.
    1). The insurance companies, who lobbied for tort reform, often settled cases out of court. The cost of taking a suit to court in 2008 in Atlanta was $80k for the plaintiff. So post-tort reform the insurance companies now push all these cases into the court room. Why?
    2). Most medical malpractice attorneys bill on the percentage basis of winnings. Due to the cap on winnings, this means their client has to fork over the $80K or the attorney has to risk their own money. So now medical malpractice attorneys only take the seriously lucrative cases where someone has lost their livelihood and the winnings are worth it to both.
    In my opinion and experience, due to tort reform in GA there are doctors who get away with “deviating from standard medical practice” and harm their patients with impunity.


  2. Dr. Roy Says:

    Jeanne, are there any data to support your claim that caps on damages (typically non-economic damages) leads to a decline in the quality of medical care?


  3. wzrd1 Says:

    Doc, I didn’t get that reading from what Jeanne wrote.
    Legal actions are less likely, as the attorney wouldn’t accept a case that could cost more than would be earned.
    Hence, the number of legal proceedings drop for many cases where there hasn’t been significant, visible injury and loss of income.
    That said, the only possible impact in the quality of care from the potential threat of legal action would be unnecessary testing and unneeded prescriptions, all with a mental framework of “CYA”.

    I do agree that one should evaluate a physician who has had a half dozen legal actions brought against him or her, although that could be a result of the type of practice as well.
    If it’s a neurosurgeon, a bit of looking to see what actions were brought and why would be in order. If it’s a primary or primary pediatrician, yeah, looking for a replacement might be a good idea.

    At the beginning of the year, I was seeking a new primary, for my brand new medical insurance (our other providers weren’t available for some reason). I searched for patient satisfaction, taking that with a grain of salt, I also searched for court records regarding the physician and the practice he is a member of. The former was excellent, the latter was absent.
    I’ll forgive his forgetting to feel my thyroid, as I was well above stage 2 hypertensive and tachycardic and he further was distracted by atrial flutter. He did at least order a TSH test and from that result, FT4 and FT4.
    Those weren’t extremely encouraging, as they were extremely high. An iodine uptake test was ordered and rapidly rescheduled to be performed in the hospital, rather than at a local radiology practice that was previously scheduled at.
    That tells me that he treats issues conservatively, but also rapidly addresses potential hazards in diagnostic procedures.
    In short, I continuously evaluate my physician, just as my physician continuously evaluates my medical condition.
    But, I also communicate with my physician, as we’re a team in maintaining my health. Such as when I noticed that my blood pressure increased at the end of the day, I suggested increasing my beta blocker to BID, which he agreed and called the pharmacy with my updated dosage. Something heartening, as far too many of my physicians in the past entirely failed to do that, resulting in problems at the pharmacy at “early” refill time.


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