Physicians More Likely to Have Multiple Malpractice Claims

Physicians often view malpractice claims as mostly random events that reflect bad luck, rather than lack of skill.

But a new paper published February 13, 2023 in JAMA Health Forum examining all paid malpractice claims against U.S. physicians over 2004-2018 reports strong evidence that paid claims are far from random: Physicians with even a single paid claim are far likelier than those with no paid claims to pay additional claims in the future.

The effect held regardless of specialization or whether a doctor’s prior malpractice claims had been disclosed publicly, which suggests that in an average case, patients and attorneys who sued were unlikely to be acting on the belief that they could win a case in a risky subfield or against a vulnerable doctor.

“This study shows that even one paid malpractice claim roughly quadruples the likelihood that a physician will face another paid claim in the future. Predictive power increases with the number of paid claims,” said Bernard Black, one of the study’s authors and a professor of law at Northwestern Pritzker School of Law who specializes in health policy research.

Thus, according to Black, physicians with even a single paid claim – and certainly those with two or more claims – could benefit from graduated intervention, such as training and greater oversight, that could reduce future claims and patient harm.

The other authors of the study, “How Random Are Paid Medical Malpractice Claims?” include Prof. David A. Hyman of Georgetown University, Dr. Josh Lerner of NORC and Dr. David Magid of the University of Colorado.

The team found that in both high- and low-risk specialties, physicians with one paid claim over a five-year period were almost four times more likely to have one or more paid claims in the next five years, compared to physicians with no prior paid claims. The likelihood of future paid claims increased with the number of paid claims in the prior period.

They also found that the predictive power of a prior paid claim for future claims declines gradually as the time since the prior claim increases. As more time goes by, if no more claims emerge, it becomes less likely that a given physician will face another paid claim.

Public disclosure, which varies between states, does not affect the predictive power of prior paid claims. Thus, this predictive power does not result from a “blood in the water” effect, in which plaintiffs’ lawyers pursue doctors with prior paid claims.

These findings make it clear that most paid medical malpractice claims are not random events. Some paid claims may be false positives, that do not reflect actual error. But most are not, or else a single paid claim would not send such a strong signal of higher future claim risk.

The authors suggest interventions that will help protect patients from medical injury and reduce the likelihood of future claims.

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