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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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Malpractice Litigation in Vitreoretinal Surgery and Medical Retina
Engelhard, S. B., Justin, G. A., Zimmer-Galler, I. E., Sim, A. J., & Reddy, A. K. (2020) · Ophthalmic surgery, lasers & imaging retina · doi:10.3928/23258160-20200501-04 · Cited by 3
Ophthalmic Trauma Malpractice in the Ophthalmic Mutual Insurance Company Database
Justin, G. A., Woreta, F. A., Colyer, M. H., Auran, J. D., Pelton, R. W., Rapuano, C. J., & Menke, A. M. (2022) · Eye · doi:10.1038/s41433-021-01893-4 · Cited by 3
“But even in low-risk specialties such as ophthalmology, approximately 5% of ophthalmologists will be named in a malpractice suit by age 45, and 19% by age 65 [9].”
BackgroundTrends in emergency department litigation within the NHS: a retrospective database analysis
Tabner, A. J., Tilbury, N., Jones, M. A., Fakis, A., Evans, N., & Johnson, G. D. (2022) · Medico-Legal Journal · doi:10.1177/00258172211057000 · Cited by 3
“an above average rate of litigation in emergency medicine when compared to other specialties.(14) This study analyses data from clinical negligence claims related to ED care in the UK between 2006”
ResultMcDougall, A., Zhang, C., Yang, Q., Taylor, T., Neilson, H. K., Nuth, J., Tsai, E., Lee, S., Lefebvre, G., & Calder, L. A. (2022) · CMAJ Open · doi:10.9778/cmajo.20220075 · Cited by 3
“17,24,25 A recent analysis showed a significant positive association between the volume of patient safety events and civil legal cases in Canadian hospitals over a 10-year period, suggesting that improvements in patient safety could be associated with decreased medico-legal risk.”
Legal Considerations in Emergency Psychiatry
Rozel, J. S., Toohey, T. P., & Amin, P. (2023) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.20220071 · Cited by 3
Zhang, J. K., Botterbush, K. S., Mercier, P., & Mattei, T. A. (2022) · Neurosurgery · doi:10.1227/neu.0000000000002226 · Cited by 3
Canadian legal cases in ophthalmology: a closer look at 40 years’ worth of data
Salimi, A., Aldien, A. S., ElHawary, H., Ambikkumar, A., & Kapusta, M. A. (2023) · Canadian Journal of Ophthalmology · doi:10.1016/j.jcjo.2023.02.007 · Cited by 3
Medical Malpractice Lawsuits Involving Pediatric Trainees
Bradley, M., Golan, R., Agudelo, V., Thomas, N. D., & Donches, K. (2023) · Cureus · doi:10.7759/cureus.42814 · Cited by 3
“Pediatricians are estimated to have a 36% chance of facing their first claim by age 45, compared to 88% of physicians in high-risk specialties such as obstetrics and general surgery [2].”
BackgroundResultInfluentialAn interprofessional medical malpractice mock trial: event evolution and assessment of efficacy
Dickinson, K. J., Ward, W. L., Minarcin, R., Trudeau, C. R., & Neill, K. K. (2023) · International Journal of Healthcare Simulation · doi:10.54531/zxmk6987 · Cited by 3
Khan, A. M., Garg, T., Khunte, M., Bajaj, S., Wu, X. J., Mezrich, J. L., & Malhotra, A. (2023) · Journal of the American College of Radiology · doi:10.1016/j.jacr.2023.02.039 · Cited by 3
Doehring, M. C., Strachan, C. C., Haut, L., Crevier, K., Heniff, M. S., Crittendon, M., Connors, J. D. N., & Welch, J. L. (2023) · Clinical Practice and Cases in Emergency Medicine · doi:10.5811/cpcem.1377 · Cited by 3
Help, I’ve been sued! Demystifying the steps of malpractice litigation for the emergency radiologist
Mezrich, J. L. (2023) · Emergency Radiology · doi:10.1007/s10140-023-02190-1 · Cited by 3
“Jena et al. noted in 2011 that 90% of radiologists will have been sued at least once during their career by age 65 [4].”
Harlianto, N. I., & Harlianto, Z. N. (2023) · Healthcare · doi:10.3390/healthcare11243111 · Cited by 3
“In a USA-based study conducted by Jena et al. [1], orthopedic surgeons were twice as likely to be subject to a lawsuit compared to the average across all specialties (14% vs. 7.4%).”
BackgroundInfluentialParikh, R. B., Emanuel, E., Zhao, Y., Pagnotti, D. R., Pathak, P. S., Hagen, S., Pizza, D. A., & Navathe, A. S. (2024) · Health Affairs · doi:10.1377/hlthaff.2023.00928 · Cited by 3
A Retrospective Analysis of Urethroplasty and Medical Malpractice
Pandher, M., Khawaja, I., Boston, Z., Jain, K., Popovic, A., Prabu, R., & Alwaal, A. (2024) · Urology · doi:10.1016/j.urology.2024.09.011 · Cited by 3
Could Patient Engagement Promote a Health System Free From Malpractice Litigation Risk?
Miglioretti, M., Mariani, F., & Vecchio, L. P. (2016) · Advances in medical diagnosis, treatment, and care (AMDTC) book series · doi:10.4018/978-1-4666-9992-2.ch012 · Cited by 3
Parra, J. A. M., Eslava-Schmalbach, J. H., Jiménez, G., Montoya, L., Cediel-Carrillo, I. A., & Gaitán‐Duarte, H. (2018) · Colombian Journal of Anesthesiology · doi:10.1097/cj9.0000000000000022 · Cited by 3
“Población Rural 28 (10,1) 3 (4,5) 25 (11,9)”
How Does the Media Portray Neurosurgeons?
Motiwala, M., Ajmera, S., Akinduro, O., Wallace, D. A., Norrdahl, S. P., Schultz, A., Fraser, B. D., Saad, H., Justo, M., Dave, P., et al. (2018) · World Neurosurgery · doi:10.1016/j.wneu.2018.10.110 · Cited by 3
Medical malpractice in stress urinary incontinence management: A 30-year legal database review
Lynch, N. B., Xu, L., Ambinder, D., & Malik, R. D. (2021) · Current Urology · doi:10.1097/cu9.0000000000000033 · Cited by 3
“Gynecologists and urologists have an 8%and 11% chance of being litigated per year, respectively.([3]) For gynecologists and urologists, understanding the causes of”
BackgroundEscario, J. A. (2021) · Neurocirugía · doi:10.1016/j.neucir.2021.10.002 · Cited by 3
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
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