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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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BackgroundInfluentialEmergency Radiology: An Underappreciated Source of Liability Risk
Robinson, J. D., Hippe, D. S., DeConde, R. P., Zečević, M., & Mehta, N. R. (2019) · Journal of the American College of Radiology · doi:10.1016/j.jacr.2019.08.003 · Cited by 16
Villalobos, A., Horný, M., Hughes, D. R., & Duszak, R. (2020) · Journal of the American College of Radiology · doi:10.1016/j.jacr.2020.04.035 · Cited by 16
McLaughlin, N., Garrett, M. C., Emami, L., Foss, S. K., Klohn, J. L., & Martin, N. A. (2015) · Journal of neurosurgery · doi:10.3171/2014.11.jns132653 · Cited by 16
Malpractice in Treatment of Sinonasal Disease by Otolaryngologists
Winford, T. W., Wallin, J. L., Clinger, J. D., & Graham, A. M. (2015) · Otolaryngology · doi:10.1177/0194599814566787 · Cited by 16
“Recent studies have shown that rates of malpractice claims are plateauing, with most cases not resulting in payment to plaintiffs.(3,4) Regardless of the appropriateness of a lawsuit, any litigation is viewed as an attack on the character and competence of the physician involved.”
BackgroundRadvansky, B. M., Farver, W. T., Svider, P. F., Eloy, J. A., Gubenko, Y. A., & Eloy, J. D. (2015) · Anesthesia & Analgesia · doi:10.1213/ane.0000000000000673 · Cited by 16
“These sources included (1) private practice sites, (2) medical facility and hospital sites, (3) academic department sites, and (4) the U.”
BackgroundA Comparison of Defense and Plaintiff Expert Witnesses in Orthopaedic Surgery Malpractice Litigation
Park, H. Y., Zoller, S. D., Sheppard, W. L., Hegde, V. V., Smith, R. A., Borthwell, R. M., Clarkson, S. J., Hamad, C. D., Proal, J. D., & Bernthal, N. M. (2018) · Journal of Bone and Joint Surgery · doi:10.2106/jbjs.17.01146 · Cited by 16
Catastrophic cardiovascular complications from medical malpractice stress syndrome
Maroon, J. C. (2019) · Journal of neurosurgery · doi:10.3171/2019.1.jns183622 · Cited by 16
Communication in Neurosurgery—The Tower of Babel
Hartley, B. R., Hong, C., & Elowitz, E. (2019) · World Neurosurgery · doi:10.1016/j.wneu.2019.08.134 · Cited by 16
Galasso, A., & Luo, H. (2016) · National Bureau of Economic Research · doi:10.3386/w22712 · Cited by 16
Medical malpractice liability and physicians’ behavior: Experimental evidence
Castro, M. F., Ferrara, P. L., Guccio, C., & Lisi, D. (2019) · Journal of Economic Behavior & Organization · doi:10.1016/j.jebo.2019.08.006 · Cited by 15
Chen, A. J., Blumenthal, D. M., & Jena, A. B. (2018) · JAMA Network Open · doi:10.1001/jamanetworkopen.2018.5805 · Cited by 15
Self-citationTripathi, R., Ezaldein, H. H., Rajkumar, K., Bordeaux, J. S., & Scott, J. F. (2019) · JAMA Dermatology · doi:10.1001/jamadermatol.2019.0430 · Cited by 15
“Face, head, and/or neck 39 (47) 24 (71) 15 (31) Unspecified 3 (4) 2 (6) 1 (2) Health care professional specialty”
InfluentialMedical malpractice and meningiomas: an analysis of 47 cases
Boyke, A. E., Bader, E. R., Naidu, I., Lam, S., Alvi, M. A., Funari, A., & Agarwal, V. J. (2020) · Neurosurgical FOCUS · doi:10.3171/2020.8.focus20598 · Cited by 15
An Analysis of Medical Malpractice Litigations in Coronary Artery Bypass Grafting from 1994-2019
Palaniappan, A., & Sellke, F. W. (2021) · The Annals of Thoracic Surgery · doi:10.1016/j.athoracsur.2021.03.042 · Cited by 15
Effect of malpractice claims on orthopedic and traumatology physicians in Turkey: A survey study
Dırvar, F., Dırvar, S. U., Kaygusuz, M. A., Evren, B., & Öztürk, İ. (2021) · Acta Orthopaedica et Traumatologica Turcica · doi:10.5152/j.aott.2021.20167 · Cited by 16
“In the study by Jena et al., the rate of physicians who retired at the age of 65 years and have faced a trial related to malpractice was between 75% and 99% (20).”
BackgroundEndodontic malpractice litigations in the United States from 2000 to 2021
Wu, K., Hsieh, S., Yang, C.-N., Chen, Y., Lai, C., Lai, T.-J., & Kuo, M. Y. (2022) · Journal of Dental Sciences · doi:10.1016/j.jds.2022.11.008 · Cited by 15
“4% of physicians were involved in a malpractice claim annually, and 75%e99% of physicians in different specialties faced a claim before the age of 65.(3) Compensation payments for disputes involving errors were significantly higher than nonerrors.”
BackgroundContrast Agent Administration as a Source of Liability: A Legal Database Analysis
Khan, A. M., Bajaj, S., Khunte, M., Payabvash, S., Wintermark, M., Gandhi, D., Mezrich, J. L., & Malhotra, A. (2023) · Radiology · doi:10.1148/radiol.230802 · Cited by 15
Characteristics and trends of medical malpractice claims in Japan between 2006 and 2021
Taniguchi, K., Watari, T., & Nagoshi, K. (2023) · PLoS ONE · doi:10.1371/journal.pone.0296155 · Cited by 17
Resident Awareness of Documentation Requirements and Reimbursement: A Multi-Institutional Survey
Yount, K. W., Reames, B. N., Kensinger, C. D., Boeck, M. A., Thompson, P. W., Forrester, J. D., Upchurch, G. R., Gauger, P. G., Kron, I. L., & Lau, C. L. (2013) · The Annals of Thoracic Surgery · doi:10.1016/j.athoracsur.2013.09.100 · Cited by 15
“Even more difficult to quantify are the potential medical and legal costs of inadequate documentation, especially in cardiothoracic surgery, whose specialty incurs the second highest proportion of physicians facing malpractice claims [10].”
Analysis of closed malpractice medical claims against Taiwanese EDs: 2003 to 2012
Wu, K.-H., Wu, C.-H., Cheng, S.-Y., Lee, W.-H., & Kung, C. (2014) · The American Journal of Emergency Medicine · doi:10.1016/j.ajem.2014.05.033 · Cited by 15
“4% of physicians across specialties have a malpractice claim annually; the malpractice claim rate for EPs specifically is similar [21].”
BackgroundThe challenges of anaesthesia for the next decade
Clergue, F. (2015) · European Journal of Anaesthesiology · doi:10.1097/eja.0000000000000226 · Cited by 15
Nowotny, B., Loh, E., Lorenz, K., & Wallace, E. M. (2018) · Australian Health Review · doi:10.1071/ah17266 · Cited by 15
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.
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