How often are doctors sued for malpractice?

[InNotOf]

Yeah, I know it depends on the specialty, but how frequently does it generally happen?

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[Faebinder]

I believe the average now is once per 7 years that a case goes all the way to court.... (I am not counting the ones that get dismissed before they call everyone..)

 

[resxn]

I believe the average now is once per 7 years that a case goes all the way to court.... (I am not counting the ones that get dismissed before they call everyone..)

I find it hard to believe that an MD on average will go to court 4 times in a typical 30 year career. Of course, it is specialty based and their are physicians who are sued well over the average and skew the numbers, but please.

Physicians Insurance stats show that only 3% of all suits brought against a physician end up in court and only 17% of these result in a decision for the plaintiff. Now what percentage of them are settled out of court with the plaintiff taking a profitable sum is unclear paritally because that data is only voluntarily reported.

Every physician regardless of how well liked or not can count on having a claim placed against them. Fortunately, the numbers show that it is rare to go to court and rare to lose if you do.

 

[mtDNA]

I asked this question of the docs that I shadowed when I was in undergrad. All of them had gone to court at least once, but none had ever had to pay out. I think that being sued as a doc is just part of life, but probably a pretty small percentage of docs ever lose a case.

 

[docB]

I find it hard to believe that an MD on average will go to court 4 times in a typical 30 year career. Of course, it is specialty based and their are physicians who are sued well over the average and skew the numbers, but please.

Physicians Insurance stats show that only 3% of all suits brought against a physician end up in court and only 17% of these result in a decision for the plaintiff. Now what percentage of them are settled out of court with the plaintiff taking a profitable sum is unclear paritally because that data is only voluntarily reported.

Every physician regardless of how well liked or not can count on having a claim placed against them. Fortunately, the numbers show that it is rare to go to court and rare to lose if you do.

They may be taliking about cases that go to deposition which is like going to court. That happens frequently.

 

[docB]

I asked this question of the docs that I shadowed when I was in undergrad. All of them had gone to court at least once, but none had ever had to pay out. I think that being sued as a doc is just part of life, but probably a pretty small percentage of docs ever lose a case.

Losing a case is not uncommon. Having to pay out on a settlement is not uncommon either.

 

[resxn]

Losing a case is not uncommon. Having to pay out on a settlement is not uncommon either.

Please use numbers to support that subjective claim. I think that you are incorrect.

In 2005 there were 17.1 malpractice claims paid for every 1,000 active non-federally employed physicians in the U.S. (source: Kaiser foundation: http://www.statehealthfacts.org/cgi-bin/healthfacts.cgi?action=compare&category=Providers+%26+Service+Use&subcategory=Medical+Malpractice&topic=Paid+Medical+Malpractice+Claims)

Assuming every doc is at equal risk, this translates to 1.71% risk of losing to a claim for any given doc in 2005. I certainly would categorize that as uncommon. Multiply that by a 30 year career, and you might be able to claim it's not uncommon.

 

[docB]

Please use numbers to support that subjective claim. I think that you are incorrect.

I'm not really interested in looking up or throwing around a lot of stats. You think docs don't get sued a lot, good for you.

Assuming every doc is at equal risk, this translates to 1.71% risk of losing to a claim for any given doc in 2005. I certainly would categorize that as uncommon. Multiply that by a 30 year career, and you might be able to claim it's not uncommon.

You want to feel good that there's "only" a 1.7% chance of paying out in any given year? Great. Let me point out that that 1.7% chance is based on suits where you went into the data bank. It doesn't count the suits where you lost weeks of personal, uncompensated time in lawyer consultations, depositions, etc. and then the suit was won, dismissed or given up.

And every doc is not at equal risk. Your personal liability hinges on what specialty you are in and where you are.

Let me also add that just having a suit filed against you will ruin several years of your life win or lose.

So if you really think that getting sued is rare and the having to payout is the most important marker and is even more rare I really envy you.

 

[resxn]

I'm not really interested in looking up or throwing around a lot of stats. You think docs don't get sued a lot, good for you.

Then don't spout off about what is and isn't "a lot" without backing up your claim. Geez, I can fly. Trust me.

You want to feel good that there's "only" a 1.7% chance of paying out in any given year? Great. Let me point out that that 1.7% chance is based on suits where you went into the data bank. It doesn't count the suits where you lost weeks of personal, uncompensated time in lawyer consultations, depositions, etc. and then the suit was won, dismissed or given up.

I never said I felt good about it. Seriously, don't get all offended that the numbers support what they do. I 100% agree that getting sued sucks, and it is a miserable experience, and causes one to lose sleep, and it's often frivolous but still costs our collective stomachs to ulcerate.

The quantitative point is, it doesn't happen a lot. The qualitative assumption I don't think anyone would disagree with is that it sucks when it does.

And every doc is not at equal risk. Your personal liability hinges on what specialty you are in and where you are.

Thanks. Didn't realize that. Even though that's what I quite clearly stated in a previous post. Next time I try to put numbers out there, I'll dumb it down a bit.

Let me also add that just having a suit filed against you will ruin several years of your life win or lose.

Agreed. Well maybe not several years for those frivolous claims, but it certainly ruins your life for a certain period of time.

So if you really think that getting sued is rare and the having to payout is the most important marker and is even more rare I really envy you.

It's not "rare" to get sued. You previously stated that it was not uncommon to lose. I show you numbers deomonstrating that simply is not true. It's rare to have to pay out. It's a fact that it's rare. It's not something that I think.

I never claimed that having to pay out is the most important marker. I just showed that it happens only 1.7% of the time in the previous year.

Often people will envy a logical stance. Oops there I used "often" without citing numbers. Perhaps I should go break that down by specialty and geographic location. I'll be right back.

 

[Faebinder]

Please use numbers to support that subjective claim. I think that you are incorrect.

In 2005 there were 17.1 malpractice claims paid for every 1,000 active non-federally employed physicians in the U.S. (source: Kaiser foundation: http://www.statehealthfacts.org/cgi-bin/healthfacts.cgi?action=compare&category=Providers+%26+Service+Use&subcategory=Medical+Malpractice&topic=Paid+Medical+Malpractice+Claims)

Assuming every doc is at equal risk, this translates to 1.71% risk of losing to a claim for any given doc in 2005. I certainly would categorize that as uncommon. Multiply that by a 30 year career, and you might be able to claim it's not uncommon.

You know even 17% is a lot.... that means your chance of getting sued and paying in 7 years is nearly 100% which is what I said.. Especially when we are talking payments that come out to be 10 times the annual salary of a physician...

 

[resxn]

You know even 17% is a lot.... that means your chance of getting sued and paying in 7 years is nearly 100% which is what I said.. Especially when we are talking payments that come out to be 10 times the annual salary of a physician...

I would agree 17% is a lot (that would be nearly 1 in 5 docs lost a claim), but that is 10x the actual number of 1.7%.

Also, percentages are not additive. If your chance this year was 1.7% your chance over the course of 2 years is not 2.4%. The reason this is true is that a small percentage of physicians account for the majority of lawsuits.

Thus, your chance of getting sued AND paying in 7 years is not even close to 100%.

 

[Faebinder]

I would agree 17% is a lot (that would be nearly 1 in 5 docs lost a claim), but that is 10x the actual number of 1.7%.

Also, percentages are not additive. If your chance this year was 1.7% your chance over the course of 2 years is not 2.4%. The reason this is true is that a small percentage of physicians account for the majority of lawsuits.

Thus, your chance of getting sued AND paying in 7 years is not even close to 100%.

Ya 1.7% agreed.. This includes people that hardly patient interact like Pathologists and Diagnostic Radiologists.

 

[resxn]

Ya 1.7% agreed.. This includes people that hardly patient interact like Pathologists and Diagnostic Radiologists.

If you think that pathologists and radiologists are not sued you are out of your mind. They are among the specialties most often sued for failure to diagnose. The single most common law suit brought against physicians.

Also, to update my above post. I cannot link the actually study online, but I found it quoted in the following news article http://newstandardnews.net/content/index.cfm/items/4093

In that data, it shows that 6% of all physicians were responsible for >50% of all malpractice pay outs between 1991-2005. Again, this further demonstrates that it is not common (unless you're one of the 6%) to lose on a claim.

As for your supposition that all docs are at near 100% risk of being sued in 7 years, the same data shows that the overwhelming majority--85%--of physicians were not involved in a single payout (meaning settlement or jury verdict) since the data bank cited in my above post was created over 2 decades ago.

Arguably, that does not indicate that the overwhelming majority of docs don't get sued, but it does prove my point succinctly.

 

[docB]

Arguably, that does not indicate that the overwhelming majority of docs don't get sued, but it does prove my point succinctly.

And just what is your point? Oh, and we're well past the don't get offended stage. You found some stat that only .17% of all suits pay out without respect to region, specialty, etc. and that stat has no bearing at all on the overall number of suits a doc will have to endure in a career. So you want us all to be happy and just quit worrying about getting sued? What planet are you a "practicing doctor" on?

 

[resxn]

And just what is your point? Oh, and we're well past the don't get offended stage. You found some stat that only .17% of all suits pay out without respect to region, specialty, etc. and that stat has no bearing at all on the overall number of suits a doc will have to endure in a career. So you want us all to be happy and just quit worrying about getting sued? What planet are you a "practicing doctor" on?

Easy there, big fella. I am not telling anyone to "quit worrying about getting sued."

I never said any such thing nor claim that it's not a worry for many docs. Heck, I even think about it from time to time.

What I do want is for those in our profession to have realistic facts and understand what the truth is.

I "found some stat" and that that stat has "no bearing?" Do you even know what the hell your talking about? The Kaiser foundation is the leading socioeconomic group studying medicine in the US today. I'm not pulling random facts out of my butt. I'm supporting my position with data.

It's stupid to be afraid of what you don't understand. If you want to go through your career shaking in your shoes that you are certain to get sued in the next 5 years, then by all means do it. Practice defensive medicine. Order inappropriate tests. Call in the consults instead of managing a patient yourself. CYA and get sued anyway, or at least get poor sleep worrying about it all night.

I for one don't want to be that guy: "Oh dear. The world is flat. The earth is the center of the universe. Man will never travel to the moon. Infections are spread by bad air." Blah blah blah.

You're past offense? Too bad your not past getting informed. I've read some of your posts on the EM forum and elsewhere. You seem to be very well spoken and very helpful to many of the people here so why jump down my throat when all I originally asked for was facts to back up your claim. And I did so politely. Sorry you've been offended. I really only want to discuss the factual information. If my original response to your claim came across as a personal attack, I assure you it was not meant as such. However, I stand by my request to back up statements with data. It's the lifeblood of medicine anyway.

 

[docB]

Again. What is your point? Getting sued is rare? Don't practice defensive medicine?

So you want us to be informed? Great. Duly noted. Now that we are all well armed with your info about what the Kaiser foundation reports what difference does that make to a doc working the pit every day?

You want to discuss factual info? Here you go:

As an EM doc I work every day under the pressure of a high risk specialty.

I have seen friends and partners ruined by BS suits filed just to line the pockets of lawyers.

I put up with patients who routinely threaten to sue to try to extort narcotics, handicapped stickers, antibiotics for bronchitis, work notes and whatever else they desire.

About 0.10 of every doller I bill (not collect, bill) goes to med mal.

If you only think about getting sued "from time to time" you aren't even practicing on the same planet I am.

Again. What's your point by trying to minimize the med mal risk we are saddled with by a dysfunctional legal system?

 

[resxn]

Again. What is your point? Getting sued is rare? Don't practice defensive medicine?

So you want us to be informed? Great. Duly noted. Now that we are all well armed with your info about what the Kaiser foundation reports what difference does that make to a doc working the pit every day?

You want to discuss factual info? Here you go:

As an EM doc I work every day under the pressure of a high risk specialty.

I have seen friends and partners ruined by BS suits filed just to line the pockets of lawyers.

I put up with patients who routinely threaten to sue to try to extort narcotics, handicapped stickers, antibiotics for bronchitis, work notes and whatever else they desire.

About 0.10 of every doller I bill (not collect, bill) goes to med mal.

If you only think about getting sued "from time to time" you aren't even practicing on the same planet I am.

Again. What's your point by trying to minimize the med mal risk we are saddled with by a dysfunctional legal system?

Are you even having the same discussion as I am? You're attacking me for reasons that are insane.

I'll say this once and for all. My point is to show the facts, not to minimize the risks of getting sued. I'm pointing out the truth, you're blowing the risks out of proportion. EM is one of the top 3 specialties to get sued along with OB and Gen Surg. I understand that. You obviously need to be aware, but to blow it out of proportion is just ignorant.

I also never said that the system isn't dysfunctional. It is a complete cluster. But if your argument is based in hyperbole, no one is ever going to listen to you. A rational and logical approach is how to gain trust and make changes. Not running around in circles like your hair is lit on fire.

I'm disgusted with the current system. Liability reform is essential. Premium rate hikes especially in the first 4 years of this decade are ridiculous. Any state without caps on non-economic damages is a chief component of the mess we're now in.

I'll put these numbers out so we're all on the exact same page. Objective data from Medical Economics Magazine--all available on-line. Interpret it as you wish. By these I repeat I'm neither minimalizing or maximizing the problem, I'm simply reporting the facts:

In a survey 7,000 physicians in 2003:
% that have been sued - 58
% who believe those cases had merit - 13
% who believe they will be sued in their career - 69
% who practice 'defensive' medicine to prevent suits - 76

Defensive Medicine stats
In the US, failure to diagnose breast cancer accounts for the largest volume of suits
In the US, false positive results are 2x more likely on screening mammogram than in Europe
False positive results increase the cost of screening by 33%
In 1996, the average estimated cost for defensive medicine was an increase by 5-9%. That number is felt to have only minimally increased since, but the cost of health care is exploding so the total dollar amount has also exploded.

Medical Malpractice Premiums and the current crisis
Avg increase in malpractice premiums 2002 was 11.3%, the largest in a decade
Malpractice insurance profitability is nearly double the profit margin than property and casualty insurance (14.2% v 8.2%)
80% of claims going to a trial are found without merit, yet avg defense for these cases is $24,699

Number of $1 million jury awards:
1990 1 in 50
2000 1 in 12
2003 1 in 2

Avg indemnity award up every year since 1995 and is outpacing inflation
$150,011 in 1995 to $270,460 in 2000 for PCP
2002 average of the members of the PIAA is $500,000
2003 average according to AMA is $3.5 million
2001 #4 most successful litigation in monetary award was for medical malpractice

Highest award thus far is $269 million awarded in Dallas, TX

PIAA data 2001
EM closed claims 2337; %paid w/ closeout 29%; Avg payout $144,092 ($167,466 is the average across all specialties); rank for specialty #5 best; overall best is derm; worst is neurology at #13 of those ranked, followed closely by OB/Gyn


I have loads and loads more data if anyone wants it, but I'm not going to sit here and debate those who never back up their opinions with more than emotion. I have better things to do than to try to create a discussion with irrational people.

So there you have it. Put to it whatever subjective words you want. Yes, doctors get sued. Yes, it sucks when it happens. Yes, it costs a lot of money to defend yourself. No, losing money to the plaintiff is not the most likely event when a claim is brought against you.

 

[resxn]

Again. What is your point? Getting sued is rare? Don't practice defensive medicine?

It's this to both: No but losing is. Yes.

You want to discuss factual info? Here you go:

As an EM doc I work every day under the pressure of a high risk specialty.

I have seen friends and partners ruined by BS suits filed just to line the pockets of lawyers.

I put up with patients who routinely threaten to sue to try to extort narcotics, handicapped stickers, antibiotics for bronchitis, work notes and whatever else they desire.

You're not alone. Every attending in every state deals with the same. You're no different. No one has ever said the ED is the place to go to see the polite patients.

About 0.10 of every doller I bill (not collect, bill) goes to med mal.

10% of your billings (over 10% of salary) goes to malpractice? Now you're not even in the top 5. You have every right to be pissed, though. Only 5% of my salary goes to medical malpractice insurance (significantly lower if compared to what I bill) and I hate that, but it's tolerable. Now if I was in OB in FL in 2003 and 90% of my salary went to malpractice, I'd be ripping my hair out in bunches.

If you only think about getting sued "from time to time" you aren't even practicing on the same planet I am.

Amen. I don't practice medicine trying to avoid getting sued. If I had to, I'd quit. I'm in it because I love it, not because I want to avoid making people mad.

Again. What's your point by trying to minimize the med mal risk we are saddled with by a dysfunctional legal system?

See the previous post. I've minimized nothing. But I don't act like I'm falling over the cliff just because I see it up ahead.

 

[tibor75]

Let me also add that just having a suit filed against you will ruin several years of your life win or lose..

Simply an ignorant comment. Plenty of docs get sued and have to go to court and their lives "aren't ruined"

Some people are able to handle adversity in their life.

Others obviously don't have the will to do so.

 

[deleted109597]

Simply an ignorant comment. Plenty of docs get sued and have to go to court and their lives "aren't ruined"

Some people are able to handle adversity in their life.

Others obviously don't have the will to do so.

Yeah, but a fair number do have their lives ruined. Try having your insurance company decide not to pay out because your lawsuit total is higher than they want to pay. The court still thinks you owe it, so you get to pay inordinate amounts of your salary as restitution. There's a doc in my state who had a $7 million award in a case that now effectively has no practice. It isn't because he can't handle adversity. It's because nobody will go to him, because the media around his case was ridiculous.
And I bet you can't find a state that doesn't have 100% of the neurosurgeons having had a lawsuit against them. Is this a problem with neurosurgery residency, or a problem with high risk specialties getting sued too much.

Oh, and losing the case isn't the only way to lose money. As has been mentioned before, you have to take days off of work for deposition, you have to pay a lawyer even if you are correct, and often you have to convince your insurance company not to settle even if they think you can win, because cases often cost more than the $100K or so they can settle with whatever scumbag brought the frivolous suit up. In their eyes (and their shareholder's), that is a win for them, but it isn't for the doc, trust me.

 

[resxn]

Yeah, but a fair number do have their lives ruined. Try having your insurance company decide not to pay out because your lawsuit total is higher than they want to pay. The court still thinks you owe it, so you get to pay inordinate amounts of your salary as restitution. There's a doc in my state who had a $7 million award in a case that now effectively has no practice. It isn't because he can't handle adversity. It's because nobody will go to him, because the media around his case was ridiculous.

No doubt it sucks to get sued and it can ruin lives.

And I bet you can't find a state that doesn't have 100% of the neurosurgeons having had a lawsuit against them. Is this a problem with neurosurgery residency, or a problem with high risk specialties getting sued too much.

My whole point in this thread has been to be realistic. I doubt every neurosurgeon in the country has had a suit filed against them. I'm sure the numbers are high, and I can find them and post them like I have above for Emergency Medicine if you'd like, but using ridiculous numbers will weaken our argument with Congress to institute tort reform.

The last time a medical liability tort reform bill was before Congress in the summer of 2005 it failed by one vote. Basically it was a bill instituting a national tort reform law for medical malpractice based on California's MICRA which has been so successful. If we are unrealistic in our own discussions, I fear we won't have a rationale argument to the politicians. And obviously, one vote can have a major impact. By the way, 97% of republicans and 4% of democrats voted in the affirmative for the bill.

Oh, and losing the case isn't the only way to lose money. As has been mentioned before, you have to take days off of work for deposition, you have to pay a lawyer even if you are correct, and often you have to convince your insurance company not to settle even if they think you can win, because cases often cost more than the $100K or so they can settle with whatever scumbag brought the frivolous suit up. In their eyes (and their shareholder's), that is a win for them, but it isn't for the doc, trust me.

The average cost of the defense of a case found to be without merit before even being tried was $24,699 in 2003. Obviously, that number is higher this year than 4 years ago, but it has not quadrupled. I'm sure there are costs that exceed $100k even before a settlement is reached, and that definitely kills the premiums for the affected doc and all docs in general.

Speaking of docs having their lives ruined. In my town there was a general surgeon fresh out of the military, 5 years after residency, and well-respected. He did a routine Lap Chole on a fellow retired general surgeon in the community. The patient died on the table and the general surgeon did everything right to try to save him. However, this young surgeon had to pack up and leave town after just a few months of being here and start a new practice in another state simply because of word of mouth. Getting sued, or even not getting sued and having some unluckly outcome, can screw a career.

 

[deleted109597]

My whole point in this thread has been to be realistic. I doubt every neurosurgeon in the country has had a suit filed against them.

#1

Today, half the neurosurgeons in the United States report a malpractice claim every year. It means that on the average, every neurosurgeon in the United States faces a malpractice claim every other year. If you're an obstetrician, an orthopedist, an emergency room physician, or a trauma surgeon, the numbers are similar.
...
And if you live in Washington, D.C., I hope you realize how little malpractice suits reflect on the quality of the physicians, because there isn't a single neurosurgeon in the city of Washington, D.C., who has not already been sued for medical malpractice.

#2

How else will the public learn that each neurosurgeon is sued once every 18 to 24 months

#3

One study conducted in Dade, Broward, and Palm Beach counties in Florida determined that greater than 94% of cardiovascular or thoracic surgeons have been sued. Those surveyed exhibited an average of 2.12 past lawsuits each with an average of 1.5 lawsuits pending and an average total of 3.62 lawsuits each so far in their career. (The study was called "Physician Professional Liability Survey" and was performed in November 2002 by RCH Healthcare Advisors, LLC for Floridians for Quality Affordable Healthcare.) Of course it could be worse and, for neurosurgeons, it is! Every neurosurgeon in South Florida has been sued, five times on average!

#4

"Statistically, every neurosurgeon in this country will be sued once over the next 3 years."

#5

In fact, 70 % of all doctors
who have practiced in Tennessee for more than 10 years have either been sued or have had a demand for
monetary damages. Every cardiac surgeon and 92% of OB/GYNs who have practiced for more than 10
years have had a claim.

Ok, so it's not limited to neurosurgeons. You'll find alarming stats for pretty much every state.

 

[resxn]

That's impressive for quote #1. Do you have the citation for those numbers? I'd like to add that to my library if you know it.

No doubt Florida is one of the worst places ever to practice. I'm not surprised about the numbers in those 3 counties. I also would bet they're higher for OB's. 90% of OB's and 87% of Ortho docs practicing in Mississippi state that they've had claims brought against them. MS is considered one of the worst states, however.

In that last quote, I'd also like to find where you got the stats for my own info. I often do presentations for this and numbers like that which are so impressive can be useful. I know that TN is also one of the worst states for chance of getting sued.

In all 3 states (well 2 and one district) which you mention, the average is over 30% higher than the national numbers. Obviously, something to think about if you plan on working in them. Texas was one of the worst states for years and was a state in "crisis" according to the AMA as recently as 2003. However, they passed a tort reform bill that has dramatically changed the landscape. TX actually was just cited in "Physicans Practice" for Feb 2007 as one of the 5 best states in which to practice and they cited the tort reform as a major factor. The physician lobby was so effective that the legislature even amended the state constitution to ensure that the tort reform law would not be deemed unconsitutional.

Just goes to show what a good lobby on solid footing can do.

Thanks for the info.

 

[deleted109597]

#5's data comes from SVMIC, the state coop for malpractice insurance that exists in TN (and is really the only way any doctors exist in the state).

Number #1 comes from Dr. Richard Anderson, and he doesn't cite it. But it came up in lots of searches. I'll try and hunt it down for you.

 

[resxn]

A few more stats pulled from the NPDB from "Physician's Practice" business journal out this week. For those who care.

According to the National Practitioner Database 2004 Annual Report, most physicians are not repeat offenders when it comes to medical malpractice. Only a small portion of physicians are responsible for the bulk of the dollars paid out for medical malpractice. Notably, those with multiple malpractice decisions against them tend to have other types of adverse actions against them as well. Consider these statistics:

Physicians account for nearly 80 percent of all medical malpractice reports (as opposed to nurses, dentists, etc.). However, malpractice payment reports decreased 6.8 percent between 2001 and 2004, from 18,996 to 17,696.

The median payout is $170,000, but varies widely across states. Illinois had the highest at $375,000, while Utah ranked lowest at $50,000.

Nearly 70 percent of all physicians had only one adverse action report (i.e, not necessarily medical malpractice); 82 percent of these had only one medical malpractice report.

The 5 percent of physicians with the largest cumulative malpractice payments were responsible for nearly one-third of the total amount paid out by physicians.

Between September 1, 1990, and December 31, 2004, eleven percent of those with the highest total payments comprised 50 percent of the total malpractice dollars paid out.
​

 

[Bricolage Healt]

The state laws regarding malpractice claims vary... in Florida specifically, an Insurance company has the right to settle a case without the doctors consent. So, if an insurance company decides it will cost less to settle a claim then to fight it, even if the doctor was not at fault, the insurance company has the right to settle the claim even without the doctors consent.

See the case:
Insurance Companies, not Doctors, hold rights to Fight Malpractice Claims