Unresolved liability suits cast long shadow over physicians

In addition to an average of nearly two years a claim remains open is the time between an incident and when a suit is filed.

By — Posted Jan. 23, 2013

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The average physician spends nearly 11% of his or her career with an unresolved medical liability claim, says a study in the January Health Affairs.

Speciality plays a significant role in how long a claim remains open, according to the study, which examined claims data for about 40,000 physicians covered by an unidentified national insurer.

Neurosurgeons spent 27% of their careers with an open claim — the longest of the specialties studied. Psychiatrists had the shortest span — 3% of their careers with an unresolved claim.

Internists had an open claim for 10% of their career, while family/general physicians had one for 8%. A doctor's average career is 40 years (link).

The findings are unfortunate, considering that the majority of medical liability claims end in favor of physicians, said Richard E. Anderson, MD, chair and CEO of The Doctors Company, a physician-owned liability insurer in Napa, Calif.

“It is a national disgrace that physicians must bear the enormous cost and disruption of protracted litigation when the vast majority of cases are without merit,” Dr. Anderson said. “This is powerful evidence of the need for national tort reform.”

An American Medical Association analysis of 2011 Physician Insurers Assn. of America data found that 65% of medical liability claims are dropped, dismissed or withdrawn, while just under a quarter result in settlements. Of the 8% that go to trial, 90% of those claims end in a doctor's favor, the AMA analysis showed.

“The litigious climate hurts patients' access to physician care at a time when the nation is working to improve access to health care and reduce unnecessary health care costs,” said AMA President Jeremy A. Lazarus, MD. “Every dollar spent on the broken medical liability system is a dollar that cannot be used to improve patient care.

“The AMA supports proven medical liability reforms like those working in California to preserve access to physicians while providing patients who have been harmed with quicker compensation. Evidence shows that medical negligence claims in California are settled about 30% faster than the national average.”

How long claims linger

On average, a medical liability lawsuit takes 20 months to be resolved from the time of filing, the study found. Claims against pediatricians took an average of 25 months to resolve, while nephrologists resolved legal challenges in 14 months. Internists spent 22 months resolving claims, and physicians in family/general practice needed 20 months.

Although these time frames are substantial, it's important to note how much time passes from the date of the incident to the lawsuit being filed, said study co-author Seth Seabury, a researcher with the RAND Corp. Plaintiffs typically take nearly two years to sue doctors after alleged negligence, the study found.

“That's a long time after an event happens before the actual” lawsuit, Seabury said. “In some cases, physicians have knowledge this might be an event that could lead to a malpractice event. It shows how long these cases spread out from their perspective.”

The study findings provide the public and others a better understanding of why physicians are concerned about the possibility of being sued, said study co-author Anupam B. Jena, MD, PhD, an assistant professor of health care policy at Harvard Medical School in Boston.

Physicians “spend a substantial portion of their careers dealing with malpractice,” he said. “We should be investing in ways to figure out how to streamline the [legal] process and how to distinguish between claims that are meritorious and claims in which malpractice clearly did not occur.”

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How much time doctors spend facing unresolved cases

The percentage of physicians' time over a career marked by open medical liability claims varies by specialty. Neurosurgeons spent the most time on unresolved lawsuits, and psychiatrists spent the least.

Specialists All claims Claims with patient payment Claims without patient payment
Neurosurgeons 27.2% 5.9% 21.3%
Orthopedic surgeons 18.4% 6.8% 11.6%
General surgeons 18.3% 6.6% 11.6%
Obstetrician-gynecologists 15.7% 5.8% 10.0%
Emergency physicians 12.8% 4.9% 7.8%
Cardiologists 11.0% 2.4% 8.6%
Internists 10.3% 2.6% 7.7%
Family/general practice physicians 7.6% 2.1% 5.4%
Pediatricians 6.8% 2.1% 4.7%
Psychiatrists 3.3% 1.2% 2.1%
All physicians 10.6% 3.3% 7.3%

Source: “On Average, Physicians Spend Nearly 11% Of Their 40-Year Careers With An Open, Unresolved Malpractice Claim,” Health Affairs, January (link)

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