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Study: Distribution of Medical Malpractice Claims

There have been a number of studies comparing doctors with several malpractice claims against them with those who have few or none. The studies have consistently found systematic differences in sex, age, specialty, certification, training, and complaint histories, and yet few studies have analyzed the nature of the unbalanced distribution itself.

Since claim-prone physicians account for such a large portion of all claims, it would of course be valuable to be able to identify them early on before they can accumulate troubling track records. Attempts to predict malpractice claims have met with mixed success; thus, the medical malpractice system remains a reactive enterprise rather than as a system meant to deter substandard care.

Using data from the National Practitioner Data Bank, doctors analyzed nearly 66,500 claims paid against approximately 54,000 doctors between 2005 and 2014 in order to try and identify characteristics of doctors at high risk for recurrent claims. The results of the study indicated that approximately 34 percent of paid claims came from only one percent of doctors. Among doctors with paid claims, 84 percent incurred only one claim during the study period, with 16 percent incurring two claims and four percent with three or more claims. Researchers found that the risk of recurrence increased with the number of previous paid claims; those with three or more claims were three times more likely to have another claim within two years. The risks of recurrence also varied widely according to the specialty, with neurosurgeons, for example, facing more malpractice claims than psychiatrists.

This research suggests that it may actually be feasible to make identifications before something bad happens, allowing the medical malpractice system to be more proactive. Liability insurers and healthcare organizations could use this information constructively to intervene with high-risk doctors through things like supervision, training, and peer counseling, improving the overall quality of care that patients experience.

Source: Studdert, David M., Marie M. Bismark, Michelle M. Mello, Harnam Singh, and Matthew J. Spittal. "Prevalence and Characteristics of Physicians Prone to Malpractice Claims." N Engl J Med 374.4 (2016): 354-62. New England Journal of Medicine. Web.