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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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LeFever, D. C., Esfahani, D. R., Kandregula, S., Trosclair, K., Demand, A., Vega, A., Stacy, J., Hussein, N., Dossani, R. H., Pendharkar, A. V., et al. (2021) · World Neurosurgery · doi:10.1016/j.wneu.2021.03.039 · Cited by 5
Why are neurosurgeons sued? A single-center, half-decade review
Esemen, Y., Mostofi, A., Crocker, M., & Pereira, E. A. C. (2021) · British Journal of Neurosurgery · doi:10.1080/02688697.2021.1973370 · Cited by 5
“Neurosurgeons are at high risk for allegations of malpractice.(5) This is not surprising given the acuity of neurosurgical patients presenting with debilitating and complex pathologies.”
BackgroundDebono, B., Gerson, C., Moing, V. L., Houselstein, T., Bougeard, R., Lonjon, G., & Lonjon, N. (2021) · World Neurosurgery · doi:10.1016/j.wneu.2021.12.022 · Cited by 5
Medical Malpractice Litigation Involving Arteriovenous Malformations of the Central Nervous System
Singh, R., Shlobin, N. A., Romaniuk, R. A., Luan, K., Suárez-Meade, P., Potts, M. B., Meyer, F. B., & Quiñones‐Hinojosa, A. (2022) · World Neurosurgery · doi:10.1016/j.wneu.2022.01.087 · Cited by 5
Radwanski, R. E., Winston, G. M., Younus, I., Guadix, S. W., Shlobin, N. A., Rothbaum, M. G., Kortz, M. W., Campbell, J. M., Evins, A. I., Greenfield, J. P., et al. (2022) · World Neurosurgery · doi:10.1016/j.wneu.2021.11.022 · Cited by 5
Fritz, C. G., Romeo, D. J., Lowery, A. S., & Rajasekaran, K. (2023) · American Journal of Rhinology and Allergy · doi:10.1177/19458924221148566 · Cited by 5
“Otolaryngology has a high rate of malpractice litigation, rivaling that of other surgical specialties such as neurosurgery and orthopedic surgery.(21,22) Prior medicolegal examinations in otolaryngology highlight that incomplete informed consent is frequently cited in malpractice litigation.”
BackgroundMalpractice Litigation Related to Diagnosis and Treatment of Intracranial Aneurysms
Khan, A. M., Khunte, M., Wu, X. J., Bajaj, S., Payabvash, S., Wintermark, M., Matouk, C. C., Seidenwurm, D. J., Gandhi, D., Parizel, P. M., et al. (2023) · American Journal of Neuroradiology · doi:10.3174/ajnr.a7828 · Cited by 5
The importance of patient safety
Arimany–Manso, J., & Martín-Fumadó, C. (2017) · Medicina Clínica (English Edition) · doi:10.1016/j.medcle.2017.04.017 · Cited by 5
Rahmati, M. H., Hyman, D. A., Black, B. S., Liu, J., & Silver, C. M. (2018) · Journal of Empirical Legal Studies · doi:10.1111/jels.12173 · Cited by 5
Radiation protection: Factors influencing compliance to referral guidelines in minor chest trauma
Tack, D., Louagé, F., Muylem, A. V., Howarth, N., & Gevenois, P. A. (2017) · European Radiology · doi:10.1007/s00330-017-5093-4 · Cited by 5
Evolving Autopsy Practice Models
Williamson, A. K. (2018) · Springer eBooks · doi:10.1007/978-3-319-98373-8_4 · Cited by 5
Alimohammadi, H., Hatamabadi, H., Khodayari, A., & Azimi, M. D. Z. (2019) · Archives of Academic Emergency Medicine · doi:10.22037/aaem.v7i1.290 · Cited by 5
“More than 75% of emergency medicine specialists encounter these kinds of complaints at some point in their career (1).”
Bielen, S., Grajzl, P., & Marneffe, W. (2019) · The European Journal of Health Economics · doi:10.1007/s10198-019-01093-8 · Cited by 5
Torres, A., Konda, S., Nino, T., & de Golian, E. (2015) · Clinics in Dermatology · doi:10.1016/j.clindermatol.2015.07.001 · Cited by 5
Have You Had an ERCP Lawsuit Yet?
Cotton, P. B. (2015) · Gastroenterology Nursing · doi:10.1097/sga.0000000000000095 · Cited by 5
“Precutting is a valuable technique in a very few cases (e.g., impacted stone), but is not a substitute for good cannulation technique (Jena et al., 2011).”
BackgroundCommunication-related allegations against physicians caring for premature infants
Nguyen, J. T., Muniraman, H., Cascione, M., & Ramanathan, R. (2017) · Journal of Perinatology · doi:10.1038/jp.2017.113 · Cited by 5
Lepard, J. R., Walters, B. C., & Rozzelle, C. J. (2018) · Journal of Neurosurgery Spine · doi:10.3171/2017.3.spine16832 · Cited by 5
Jeyalingam, T., Matelski, J. J., Alam, A. Q., Liu, J. J., Goldberg, H. R., Klemensberg, J., & Bell, C. M. (2018) · The Joint Commission Journal on Quality and Patient Safety · doi:10.1016/j.jcjq.2017.12.003 · Cited by 5
Insurance Crisis or Liability Crisis? Medical Malpractice Claiming in Illinois, 1980-2010
Rahmati, M. H., Hyman, D. A., Black, B. S., & Silver, C. M. (2014) · Journal of Empirical Legal Studies · doi:10.1111/jels.12113 · Cited by 5
Malpractice Claims: It’s a Crapshoot—Time to Stop the Self-Blame and Ask Different Questions
Sachs, C. J. (2017) · Annals of Emergency Medicine · doi:10.1016/j.annemergmed.2017.09.013 · Cited by 5
“We may suffer for years from a form of posttraumatic stress disorder termed malpractice stress syndrome.(6,7) Lawsuits may taint our future interactions with patients and threaten our well-being at work for years and potentially for the duration of our careers.”
BackgroundLearning From Medical Litigation
Forrest, C., Madden, D., O’Sullivan, M. J., & O’Reilly, S. (2023) · JCO Oncology Practice · doi:10.1200/op.22.00763 · Cited by 5
A Model for Malpractice Preparedness for Plastic Surgery Residents
Chandawarkar, S. K., Reisman, N. R., & Janis, J. E. (2025) · Plastic & Reconstructive Surgery Global Open · doi:10.1097/gox.0000000000006951 · Cited by 4
Erel, S., & Kılıç, A. G. (2025) · Saudi Journal of Anaesthesia · doi:10.4103/sja.sja_164_25 · Cited by 4
“…this percentage was significantly higher than that reported by our counterparts in the US—where anesthesiologists face approximately 5% of medical claims annually, [28] and 10% of these claim payments exceed $1 million [29] —with only 47% expressing concerns about liability and malpractice.”
Perioperative Pharmacologic Prophylaxis of Venous Thromboembolism: A Professional Liability Analysis
Anteby, R., López‐Verdugo, F., Aaron, D. G., Polk, H. C., & Qadan, M. (2022) · Journal of Surgical Research · doi:10.1016/j.jss.2021.11.019 · Cited by 4
Anger: an underappreciated destructive force in healthcare
Grunebaum, A. N., McLeod‐Sordjan, R., Pollet, S. L., Moreno, J., Bornstein, E., Lewis, D., Katz, A. A., Warman, A., Dudenhausen, J. W., & Chervenak, F. A. (2023) · Journal of Perinatal Medicine · doi:10.1515/jpm-2023-0099 · Cited by 5
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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