Specialty closely linked to success of medical liability actions

A new study suggests that a physician’s medical specialty plays a part in whether the doctor will have a more favorable — and quicker — lawsuit resolution.

Internists and internal medicine subspecialists were more likely than other physicians to have suits against them dismissed by courts, said the study in the May 14 Archives of Internal Medicine. The study found that 62% of suits against internists and internal medicine subspecialists were dismissed, while 37% of cases against pathologists were dismissed — the lowest rate among specialties. Across all specialities, 54% of cases were dismissed (link).

“Given the wide variation in risk factors and patient circumstances across specialties, it seems reasonable that this could lead to variation in case outcomes across specialties,” study co-author Seth Seabury, PhD, said in an email. He is a researcher with the RAND Corp. “As to why any particular specialty has particular average case outcomes, it is difficult to say without more precise details about the case. I suspect it mostly has something to do with the nature of the injuries that lead to suits against internists.”

Study co-author Anupam Jena, MD, said it’s difficult to tell why specialties have their cases dismissed at higher or lower rates. Pathology lawsuits generally relate to failure to diagnose a disease, he said.

Seabury and his colleagues examined more than 10,000 claims that closed between 2002 and 2005 from an undisclosed national medical liability insurer. They found that the frequency of claims ending in a trial verdict was low across specialties. For example, only 2% of cases against anesthesiologists ended with a jury decision, compared with 7% of claims against pathologists.

Internists were also among the least likely to face a jury, with only 3% of their cases ending with a verdict. General surgeons were most likely to have a jury find in their favor, while pathologists lost the most.

Eighty percent of cases resolved after trial were in favor of physicians.

The study is consistent with previous studies on medical liability case resolution. Data from the Physician Insurers Assn. of America show that 70% of suits against doctors do not result in payments to patients. At trial, the defense prevails 80% of the time, according to the PIAA.

The Archives analysis showed that doctors spend significant time fighting lawsuits, no matter the cases’ outcomes. The average resolution time for a litigated claim was 25 months. For cases that ended in dismissals, doctors spent 20 months defending the case, while claims resolved at trial took 39 months. Doctors who won at trial spent an average of 44 months in litigation.

“Part of what is surprising is how long this whole process takes,” said Dr. Jena, an internist in the Dept. of Medicine at Massachusetts General Hospital in Boston. “When court cases last a long time, two groups of people are hurt. One is patients. It’s also very difficult for physicians who have this malpractice case looming over their heads.”