Wednesday, August 17, 2011

For your “tort reform” file: Recent study of medical malpractice closed claims shows no payment in 78% of claims

            A recent study published in the New England Journal of Medicine examined malpractice data (closed claims only) 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 study found that 78% of all closed claims did not result in payments to claimants.  Of the claims on which there was a payment, the mean indemnity payment was $274,887, and the median was $111,749.  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 article continues:

Outlier awards, which were defined as those exceeding $1 million, were infrequent, in part because the full size of outlier awards would not have been recorded if they had exceeded individual policy limits. Among all physician-years, 66 payments exceeded this amount, accounting for less than 1% Our study uncovered an important aspect of malpractice liability: the high likelihood of claims that do not result in payments to a plaintiff. Annual rates of claims leading to indemnity payments ranged from 1% to 5% across specialties, whereas rates of all claims ranged from 5% to 22%. Our projections suggest that nearly all physicians in high-risk specialties will face at least one claim during their career; however, a substantial minority will not have to make an indemnity payment.

Our results may speak to why physicians consistently report concern over malpractice . . . Concern among physicians over malpractice risk varies far less considerably across states than do objective measures of malpractice risk according to state (e.g., rates of paid claims, average payment sizes, malpractice premiums, and state tort reforms). For example, 65% of physicians practicing in states in the bottom third of rates for paid malpractice claims (5.5 paid claims per 1000 physicians) express substantial concern over malpractice, as compared with 67% of physicians in the top third (14.6 claims per 1000 physicians). 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.  

Hat tip to MedPage Today, “Malpractice: Many Claims but Few Big Paydays,” by Todd Neale.

--Patricia Hatamyar Moore

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