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Risk of Having to Pay a Malpractice Claim Drops for Physicians

BOSTON — Pediatricians might be able to relax a bit about the likelihood of their having to pay a malpractice claim, but cardiologists won’t be able to let down their guard as much.

That news comes from a study published recently in JAMA Internal Medicine and based on information from the National Practitioner Data Bank (NPDB) for a 22-year period ending in 2014. Brigham and Women's Hospital-led researchers used the data to tease out trends on the rate of malpractice claims paid on behalf of U.S. physicians across medical specialties.

"We've found that there was an overall drop in the amount of paid claims across all specialties, but that the magnitude of the decline was markedly different by specialty," explained lead author Adam Schaffer, MD, a hospitalist at BWH.

With the rate of claims plummeting 55.7% across the board, pediatricians were the big winners, with a 75.8% decline, while that measure for cardiologists dropped only 13.5% overall. The mean payment was $329,576, according to the report.

Also significant were average increases in dollar amounts, which fluctuated among specialists from $114,410 in gastroenterology — the average payment was $390,538 in the last five years of the study period compared to $276,128 in the first four years — to $138,708 in pathology — $473,957 more recently vs. $335,249 at the beginning of the study.

Meanwhile, for general practice, payment increases averaged $17,431, from $218,350 in 1992-1996 to $353,473 in the five years ending in 2014.

At the same time, paid claims of $1 million-plus shot up to 8% of malpractice cases involving compensation, from 6.2% at the beginning of the study period. Most of those sky-high payments involved deaths of patients, study authors noted.

Diagnostic error topped the list of most common reasons for malpractice payments, at 31.8%; for pathologists, that represented 87% of cases.

"Previous research has shown that physicians' perceptions of their risk of liability can influence their clinical decision-making, and a better understanding of the causes of variation among specialties in paid malpractice claims may both improve patient safety and reduce liability risk," added senior author Allen Kachalia, MD, JD, chief quality officer at BWH.