Most doctors face lawsuits, but few lose them

Most physicians will be sued at least once during their career, but the majority of cases will end in their favor.

The frequency of medical liability claims varies by specialty, with neurosurgeons sued more often than other physicians, said a study in the Aug. 18 issue of The New England Journal of Medicine.

Researchers estimated that by age 65, 75% of physicians in low-risk specialties will have experienced a lawsuit, compared with 99% of physicians in high-risk specialties.

"The purpose of this study was to really try to understand what are the individual malpractice risks that physicians in each specialty face," said lead study author Anupam B. Jena, MD, an internist in the Dept. of Medicine at Massachusetts General Hospital and a clinical fellow at Harvard Medical School in Boston. "Naturally, physicians in each specialty believe they are getting sued more often than average."

Dr. Jena and his colleagues analyzed claims data on about 41,000 physicians between 1991 and 2005 from an unidentified national medical liability insurer. The study found that each year, an average 7.4% of physicians experienced a medical liability claim. But among those doctors, only 1.6% made payments to plaintiffs.

Among neurosurgeons, each year 19.1% were sued. About one in five thoracic-cardiovascular surgeons faced a claim, followed by 15.3% of general surgeons. Only 2.6% of psychiatrists were sued in a given year, the least of all specialties.

About 8% of internists and 5.2% of family physicians faced lawsuits.

Physicians sued more often do not necessarily pay higher awards to plaintiffs, the study found. Dermatologists paid an average award or settlement of $117,832, the least of any specialty. Pediatricians paid the most, an average of $520,923 per payment.

Study supports previous research

The findings are not surprising, said Brian Atchinson, president of the Physician Insurers Assn. of America.

"This study validates what PIAA has reported for decades -- that the vast majority of claims and suits brought against health care providers have no merit," Atchinson said in an email. "Our figures show that 70% of the claims and suits brought against doctors do not result in payments to patients. Furthermore, for claims resolved at verdict, the defense prevails 80% of the time. Despite these facts, as a result of our flawed and inefficient medical liability system, health care providers continue to be subjected to unnecessary stress and time away from caring for patients, as the study noted."

An analysis by PIAA found that the average cost of resolving a medical liability case in 2009 was $324,969, a rise of 13.9% from 2000.

The NEJM study results on frequency of lawsuits are similar to those of an American Medical Association survey released in 2010. The survey found more than 60% of physicians were sued by age 55.

The NEJM and AMA studies "paint a bleak picture of physicians' experiences with medical liability claims and bolsters the case for national and state level reform to rein in a broken legal system that invites abuse and excessive litigation," said AMA President Peter W. Carmel, MD. "Even though the vast majority of claims are dropped or decided in favor of physicians, the understandable fear of meritless lawsuits can profoundly influence which medical specialty physicians choose, where they practice and when they retire. This litigious climate hurts patients' access to health care at a time when we are also facing a shortage of physicians and other health professionals."

Authors of the NEJM study hope the piece will motivate physicians and others to discuss and implement more creative strategies to combat meritless claims, said co-study author Amitabh Chandra, a professor of public policy at Harvard Kennedy School. Traditional tort reforms such as damages caps are merely "patching portholes in the Titanic," he said.

Researchers said there were other costs the NEJM study did not capture, including the toll on physicians' emotions and reputation during a lawsuit.

"Although most cases get resolved in favor of doctors, it's a long, torturous legal process," Chandra said. "It's very slow, and the doctor is sitting there, sweating the whole time."