Which doctors get sued the most?
© 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.
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