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Malpractice Risk According to Physician Specialty
Open accessAbstract
BACKGROUND: Data are lacking on the proportion of physicians who face malpractice claims in a year, the size of those claims, and the cumulative career malpractice risk according to specialty. METHODS: We analyzed malpractice data from 1991 through 2005 for all physicians who were covered by a large professional liability insurer with a nationwide client base (40,916 physicians and 233,738 physician-years of coverage). For 25 specialties, we reported the proportion of physicians who had malpractice claims in a year, the proportion of claims leading to an indemnity payment (compensation paid to a plaintiff), and the size of indemnity payments. We estimated the cumulative risk of ever being sued among physicians in high- and low-risk specialties. RESULTS: Each year during the study period, 7.4% of all physicians had a malpractice claim, with 1.6% having a claim leading to a payment (i.e., 78% of all claims did not result in payments to claimants). The proportion of physicians facing a claim each year ranged from 19.1% in neurosurgery, 18.9% in thoracic-cardiovascular surgery, and 15.3% in general surgery to 5.2% in family medicine, 3.1% in pediatrics, and 2.6% in psychiatry. The mean indemnity payment was $274,887, and the median was $111,749. Mean payments ranged from $117,832 for dermatology to $520,923 for pediatrics. It was estimated that by the age of 65 years, 75% of physicians in low-risk specialties had faced a malpractice claim, as compared with 99% of physicians in high-risk specialties. CONCLUSIONS: There is substantial variation in the likelihood of malpractice suits and the size of indemnity payments across specialties. The cumulative risk of facing a malpractice claim is high in all specialties, although most claims do not lead to payments to plaintiffs. (Funded by the RAND Institute for Civil Justice and the National Institute on Aging.).
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“Although psychiatry is at low risk of malpractice claims in comparison to other specialties 275 , surveys in different countries report that the majority of interviewed psychiatrists acknowledged having resorted to defensive practices, which, in their opinion, compromised the quality of the provided care 274,276,277 .”
From Ethical challenges in contemporary psychiatry: an overview and an appraisal of possible strategies and research needs (2024) · cites this paper as [275]
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Medical Malpractice in Bariatric Surgery: a Review of 140 Medicolegal Claims
Choudhry, A. J., Haddad, N. N., Martin, M. J., Thiels, C. A., Habermann, E. B., & Zielinski, M. D. (2016) · Journal of Gastrointestinal Surgery · doi:10.1007/s11605-016-3273-1 · Cited by 25
The Role of Apology Laws in Medical Malpractice.
Ross, N. E., & Newman, W. J. (2021) · PubMed · doi:10.29158/jaapl.200107-20 · Cited by 25
“Examining only one specialty limits confounding effects, but the inclusion of surgeons and non-surgeons enables the comparison of these two distinct types of physicians and their differing risks of malpractice suits.(19,21,81) Restricting this analysis to one specialty limits the study’s generalizability, however, par…”
BackgroundMedical Liability: Review of a Whole Year of Judgments of the Civil Court of Rome
Treglia, M., Pallocci, M., Passalacqua, P., Giammatteo, J., Luca, L. D., Mauriello, S., Cisterna, A. M., & Marsella, L. T. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18116019 · Cited by 25
“In this regard, it has been estimated that, for consultants specializing in specialties at higher risk, the possibility of being involved in litigation within the age of 45 is 88% [18].”
BackgroundSteele, L., Mukherjee, S., Stratton‐Powell, A. A., Anderson, I., & Timothy, J. (2015) · British Journal of Neurosurgery · doi:10.3109/02688697.2015.1054362 · Cited by 25
Medical malpractice and hernia repair: An analysis of case law
Walters, A. L., Dacey, K. T., Zemlyak, A. Y., Lincourt, A. E., & Heniford, B. T. (2012) · Journal of Surgical Research · doi:10.1016/j.jss.2012.04.028 · Cited by 25
Enforcement of the Emergency Medical Treatment and Labor Act, 2005 to 2014
Terp, S., Seabury, S. A., Arora, S., Eads, A., Lam, C. N., & Menchine, M. D. (2016) · Annals of Emergency Medicine · doi:10.1016/j.annemergmed.2016.05.021 · Cited by 25
Self-citationHanganu, B., Iorga, M., Muraru, I.-D., & Ioan, B. G. (2020) · Medicina · doi:10.3390/medicina56060259 · Cited by 25
“Obstetrics and gynecology, general surgery, and orthopedics and traumatology also occupy the first places in studies conducted in other countries, such as the United Kingdom, China or the United States of America [4,7,17].”
BackgroundInfluentialComparison of Emergency Medicine Malpractice Cases Involving Residents to Nonresident Cases
Gurley, K. L., Grossman, S. A., Janes, M., Yu-Moe, C. W., Song, E., Tibbles, C. D., Shapiro, N. I., & Rosen, C. L. (2018) · Academic Emergency Medicine · doi:10.1111/acem.13430 · Cited by 23
Overview of medical malpractice in neurosurgery
Larkin, C. J., Roumeliotis, A. G., Karras, C. L., Murthy, N. K., Karras, M. F., Tran, H. M., Yerneni, K., & Potts, M. B. (2020) · Neurosurgical FOCUS · doi:10.3171/2020.8.focus20588 · Cited by 24
The Therapeutic Relationship in China: A Systematic Review and Meta-Analysis
Mao, Y., Wei, N., Zhang, N., Xie, T., Liu, J., Lu, Y., & Zhu, B. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18073460 · Cited by 24
“In the United States, the number of medical disputes more than tripled from 1991 to 2005 [9].”
BackgroundTime trends of assessments for medical dispute cases in T aiwan: a 20‐year nationwide study
Wu, C., Weng, H., & Chen, R. ‐. (2013) · Internal Medicine Journal · doi:10.1111/imj.12105 · Cited by 24
Reducing Risk with Clinical Decision Support
Maloney, F. L., Feblowitz, J. C., Samal, L., Sato, L., Wright, A. T., & Zuccotti, G. (2014) · Applied Clinical Informatics · doi:10.4338/aci-2014-02-ra-0018 · Cited by 24
“6% made a payment for resolution of the claim [8].”
BackgroundOetgen, M. E., & Parikh, P. D. (2015) · Journal of Pediatric Orthopaedics · doi:10.1097/bpo.0000000000000412 · Cited by 24
Defense Costs of Medical Malpractice Claims
Seabury, S. A., Chandra, A., Lakdawalla, D. N., & Jena, A. B. (2012) · New England Journal of Medicine · doi:10.1056/nejmc1114805 · Cited by 24
Self-citationDamage Caps and the Labor Supply of Physicians: Evidence from the Third Reform Wave
Paik, M., Black, B. S., & Hyman, D. A. (2016) · American Law and Economics Review · doi:10.1093/aler/ahw009 · Cited by 24
Catastrophic Medical Malpractice Payouts in Spain
Arimany–Manso, J., Durán, E. L. G., Barbería, E., Benet-Travé, J., & Martín-Fumadó, C. (2014) · Journal for Healthcare Quality · doi:10.1111/jhq.12074 · Cited by 23
Venkatesh, A. K., & Schuur, J. D. (2013) · The American Journal of Emergency Medicine · doi:10.1016/j.ajem.2013.07.019 · Cited by 23
“The evidence regarding liability’s contribution to “defensive medicine” has been equivocal [48], and emergency physicians are sued at the same rate as the medical profession’s average [49].”
BackgroundUnsolicited Patient Complaints in Ophthalmology
Kohanim, S., Sternberg, P. W., Karrass, J., Cooper, W. O., & Pichert, J. W. (2015) · Ophthalmology · doi:10.1016/j.ophtha.2015.10.010 · Cited by 23
Lawsuits After Primary and Revision Total Knee Arthroplasty: A Malpractice Claims Analysis
Patterson, D. C., Grelsamer, R. P., Bronson, M. J., & Moucha, C. S. (2017) · Journal of the American Academy of Orthopaedic Surgeons · doi:10.5435/jaaos-d-16-00736 · Cited by 23
Surviving a Medical Malpractice Lawsuit
Bookman, K. J., & Zane, R. D. (2020) · Emergency Medicine Clinics of North America · doi:10.1016/j.emc.2020.01.006 · Cited by 23
Hwang, R., Park, H. Y., Sheppard, W. L., & Bernthal, N. M. (2020) · Clinical Orthopaedics and Related Research · doi:10.1097/corr.0000000000001340 · Cited by 22
“Each year, an estimated 7% of physicians across all specialties will face a malpractice claim, with approximately 20% of these claims resulting in an indemnity payment [16].”
BackgroundInfluentialIntelligent Tutoring Systems: Re-Envisioning Surgical Education in Response to COVID-19
Mirchi, N., Ledwos, N., & Maestro, R. F. D. (2020) · Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques · doi:10.1017/cjn.2020.202 · Cited by 29
Metadata
- Authors
- Jena, A. B., Seabury, S., Lakdawalla, D., & Chandra, A.
- Affiliations
- Harvard University (US)
- RAND Corporation (US)
- University of Southern California (US)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2011-08-18
- Volume
- 365
- Issue
- 7
- Pages
- 629-636
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- PMC
- PMC3204310
- OpenAlex
- W2148118870
- Cited by
- 1,180
- References
- 19
- Citations by year
- 2026: 59 · 2025: 71 · 2024: 83 · 2023: 101 · 2022: 84 · 2021: 95 · 2020: 86 · 2019: 106 · 2018: 97 · 2017: 89 · 2016: 71 · 2015: 75 · 2014: 55 · 2013: 58 · 2012: 42
- FWCI
- 122.24
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5r01ag031544-05)
- National Institute on Aging (7R01AG031544, RC4AG039036, P01 AG19783-02, R01 AG031544, P30AG043073, P01AG019783, P30AG024968)
- Topics
- Social Sciences › Law › Medical Malpractice and Liability Issues
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Patient Safety and Medication Errors
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Keywords
- medical malpractice, malpractice claims, physician specialty, professional liability insurance, indemnity payments, neurosurgery, general practice, general surgery
- MeSH terms
- Malpractice, Medicine, Physicians, Risk, Specialties, Surgical, United States, Models, Statistical, Physicians, Primary Care
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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