PCPs highly likely to face malpractice suits but not to pay claims

Family medicine practitioners have a lower probability of being sued for malpractice than most specialties but still have at least a 75% chance of facing a lawsuit before typical retirement age, according to a new study.

Researchers from Harvard University 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). 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 were analyzed for 25 specialties. The cumulative risk of ever being sued was broken out in high- and low-risk categories.

The study, published in the August 18 issue of the New England Journal of Medicine, found that malpractice risk for family medicine was 5.2% compared to the 7.4% average. The risk for internal medicine was slightly above average, but the greatest risk of facing a lawsuit were in neurosurgery, thoracic-cardiovascular survey, and general surgery, all above 15%. For those specialties, the lifetime risk of being sued was 99%.

Being named in a lawsuit did not necessarily correlate to the risk of having to make a payment or the size of that payment, however. In fact, 78% of all claims resulted in no payments.

“Although the frequency and average size of paid claims may not fully explain perceptions among physicians,” according to the authors, “one may speculate that the large number of claims that do not lead to payment may shape perceived malpractice risk. Physicians can insure against indemnity payments through malpractice insurance, but they cannot insure against the indirect costs of litigation, such as time, stress, added work, and reputational damage.”

The mean indemnity payment for all physicians was $274,887 but varied widely from $117,832 for dermatology to $520,923 for pediatrics. Mean payments for family medicine were very close to the average. Internal medicine specialists paid out slightly more, over $300,000.

“Although these annual rates of paid claims are low, the annual and career risks of any malpractice claim are high, suggesting that the risk of being sued alone may create a tangible fear among physicians,” the authors wrote.

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