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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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“All rights reserved of its physicians facing a malpractice suit annually.(2) In 2014, the last year for which the National Practitioner Data Basewas available, malpractice payments totaled $2.”
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Engelhard, S. B., Aronow, M. E., Shah, C. T., Sim, A. J., & Reddy, A. K. (2017) · Ocular Oncology and Pathology · doi:10.1159/000479559 · Cited by 12
Medical practice and malpractice litigation in an evolutionary context
Antoci, A., Maccioni, A. F., & Russu, P. (2018) · Journal of Evolutionary Economics · doi:10.1007/s00191-018-0578-0 · Cited by 12
Marcus, H. J., Jain, A., Grieve, J., & Dorward, N. (2018) · World Neurosurgery · doi:10.1016/j.wneu.2018.07.102 · Cited by 12
“Unsurprisingly, a recent study found that neurosurgery was the clinical specialty subject to the most medicolegal claims.(4)”
BackgroundAn Innovative Approach for Familiarizing Surgeons with Malpractice Litigation
Juo, Y., Lewis, C. E., Hanna, C., Reber, H. A., & Tillou, A. (2018) · Journal of surgical education · doi:10.1016/j.jsurg.2018.06.002 · Cited by 12
Medical malpractice in Iran: A systematic review.
Raeissi, P., Mirghaed, M. T., Sepehrian, R., Afshari, M., & Rajabi, M. R. (2019) · Europe PMC (PubMed Central) · doi:10.34171/mjiri.33.110 · Cited by 12
“The results of this study are consistent with the findings of studies conducted in Turkey (54), Taiwan (55), Germany (56), United Kingdom (57), USA (58), and Saudi Arabia (59), in which gynaecologists had the highest number of complaints.”
ResultThe Impact of Medical Malpractice Reforms
Liu, J., & Hyman, D. A. (2020) · Annual Review of Law and Social Science · doi:10.1146/annurev-lawsocsci-060120-093911 · Cited by 12
Status of current medicolegal reform in the United States: a neurosurgical perspective
LeFever, D. C., Demand, A., Kandregula, S., Vega, A., Hobley, B., Paterson, S., Trosclair, K., Menger, R., Kosty, J. A., & Guthikonda, B. (2020) · Neurosurgical FOCUS · doi:10.3171/2020.8.focus20616 · Cited by 12
The Depiction of Medical Errors in a Sample of Medical Television Shows
Carney, M., King, T. S., Yumen, A., Harnish-Cruz, C., Scales, R., & Olympia, R. P. (2020) · Cureus · doi:10.7759/cureus.11994 · Cited by 12
“4% of physicians have a malpractice claim filed against them each year, only 22% of these claims hold up in a court of law and result in compensation [18,19].”
BackgroundRawal, R. B., Kilpatrick, L. A., Wood, J., & Drake, A. F. (2016) · International Journal of Pediatric Otorhinolaryngology · doi:10.1016/j.ijporl.2016.09.030 · Cited by 13
Unsolicited Patient Complaints among Otolaryngologists
Nassiri, A. M., Pichert, J. W., Domenico, H. J., Galloway, M. B., Cooper, W. O., & Bennett, M. L. (2019) · Otolaryngology · doi:10.1177/0194599818823706 · Cited by 12
Medical Malpractice and Physician Discipline: The Good, The Bad and The Ugly
Hyman, D. A., Rahmati, M. H., & Black, B. S. (2020) · Journal of Empirical Legal Studies · doi:10.1111/jels.12277 · Cited by 12
Does defensive medicine protect doctors against malpractice claims?
Bishop, T. F., & Pesko, M. F. (2015) · BMJ · doi:10.1136/bmj.h5786 · Cited by 12
Do Plastic Surgery Residents Get Sued? An Analysis of Malpractice Lawsuits
Gibstein, A. R., Jabori, S. K., Watane, A., Slavin, B. R., ElAbd, R., & Singh, D. P. (2023) · Plastic & Reconstructive Surgery Global Open · doi:10.1097/gox.0000000000004721 · Cited by 11
Medical Malpractice and Diagnostic Radiology: Challenges and Opportunities
Sumner, C., Kietzman, A. T., Kadom, N., Frigini, L. A., Makary, M. S., Martin, A., McKnight, C. D., Retrouvey, M., Spieler, B. M., & Griffith, B. D. (2023) · Academic Radiology · doi:10.1016/j.acra.2023.08.015 · Cited by 13
Kusumoto, F. M., Ross, J. M., Wright, D., Chazal, R. A., & Anderson, R. (2024) · Risk Management and Healthcare Policy · doi:10.2147/rmhp.s403710 · Cited by 11
“2,3,12 In the current study, nonclinical parameters are observed as commonly as clinical parameters.”
BackgroundNeurosurgical Malpractice Litigation: A Systematic Review and Meta-Analysis
Iqbal, J., Shafique, M. A., Mustafa, M. S., Covell, M. M., Fatima, A., Saboor, H. A., Nadeem, A., Iqbal, A., Iqbal, M. F., Rangwala, B. S., et al. (2024) · World Neurosurgery · doi:10.1016/j.wneu.2024.04.112 · Cited by 11
Diagnostic Delay in Soft Tissue Sarcomas: A Review
Fernández, J. Á., Gómez, B., Gómez, D. D., López, I., Lozano, P., Muñoz, P., Muñoz‐Casares, F. C., Olivares-Ripoll, V., Vasques, H., & Asencio, J. M. (2025) · Cancers · doi:10.3390/cancers17111861 · Cited by 13
“These data contrast with that observed in high-risk specialties, such as general surgery and orthopedics, where 15% of physicians will face a malpractice claim [86,87].”
Expert Witness Testimony Guidelines
Svider, P. F., Eloy, J. A., Baredes, S., Setzen, M., & Folbe, A. J. (2014) · Otolaryngology · doi:10.1177/0194599814556721 · Cited by 11
Analysis of Medical Malpractice Outcomes for Sports Orthopedic Procedures
Gatto, J. D., Park, H. Y., Hwang, R., Aderibigbe, T., McClintick, D. J., Shahinyan, R. H., Sekimura, T. K., Subhash, A. K., Bernthal, N. M., & Petrigliano, F. A. (2021) · Orthopedics · doi:10.3928/01477447-20211101-06 · Cited by 11
Deng, T., Liu, Y., Gael, A., Fu, X., Deng, X., Liu, Y., Wu, Y., Wu, Y., Wang, H., Deng, Y., et al. (2022) · Frontiers in Physiology · doi:10.3389/fphys.2022.862732 · Cited by 11
Liability impact of the hospitalist model of care
Schaffer, A. C., Puopolo, A. L., Raman, S., & Kachalia, A. B. (2014) · Journal of Hospital Medicine · doi:10.1002/jhm.2244 · Cited by 11
Wu, K.-H., Cheng, H.-H., Cheng, F., Wu, C.-H., Yen, P.-C., Yen, Y.-L., & Hsu, T. (2015) · International Journal for Quality in Health Care · doi:10.1093/intqhc/mzv093 · Cited by 11
“The risk of being sued and the liability crisis may create stress among physicians [4] and may lead to alterations in defensive medicine [3].”
BackgroundCleft Lip and Cleft Palate Surgery: Malpractice Litigation Outcomes
Justin, G. A., & Brietzke, S. E. (2016) · The Cleft Palate-Craniofacial Journal · doi:10.1597/15-285 · Cited by 11
Rasul, V. H., Cheraghi, M. A., & Moqadam, Z. B. (2015) · Europe PMC (PubMed Central) · Cited by 11
Characteristics of Lawyers Who Are Subject to Complaints and Misconduct Findings
Sklar, T., Taouk, Y., Studdert, D. M., Spittal, M. J., Paterson, R., & Bismark, M. (2017) · Journal of Empirical Legal Studies · doi:10.1111/jels.12216 · Cited by 11
“Over the last decade a substantive body of empirical scholarship has improved medical regulators’ understanding of patterns of complaints, malpractice claims, and disciplinary actions (Studdert et al. 2016; Jena et al. 2011; Rolph et al. 2007).”
A comparison of malpractice lawsuits mediated and judged in court in China
Li, Y., Gao, D. W., Liang, W., Qiu, L., Liu, X., Zhang, L., & Deng, Z.-H. (2018) · Journal of Forensic and Legal Medicine · doi:10.1016/j.jflm.2018.01.002 · Cited by 11
Medical Malpractice Following Carpal Tunnel Surgery
Gil, J. A., Bokshan, S. L., Genovese, T. J., Got, C. J., & Daniels, A. H. (2018) · Orthopedics · doi:10.3928/01477447-20180524-05 · Cited by 11
Personal Safety of the Plastic Surgeon: Keeping Yourself Healthy While You Work
Nagarkar, P. A. (2018) · Plastic & Reconstructive Surgery · doi:10.1097/prs.0000000000004474 · Cited by 11
Kim, E., Wu, H. Y., Simpson, K. M., Patzkowsky, K. E., & Wang, K. (2018) · Journal of Minimally Invasive Gynecology · doi:10.1016/j.jmig.2018.11.003 · Cited by 11
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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