The rate of malpractice claims paid on behalf of U.S. physicians “declined substantially”  between 1992–2014, however the characteristics of these paid claims differed greatly with respect to physician specialty, according to results from a study published in JAMA Internal Medicine.

“Previous research has shown that physicians’ perceptions of their risk of liability can influence their clinical decision making,” said Allen Kachalia, MD, chief quality officer at  Brigham and Women’s Hospital and senior author of the study, however data characterizing the rate of claims paid on behalf of physicians according to specialty is lacking. In order to understand these malpractice claims better, the researchers conducted a comprehensive analysis of all paid malpractice claims linked to physician specialty from the National Practitioner Data Bank (1/1/1992–12/31/2014). 

The main outcomes of the study were the rates of malpractice claims per physician-year, mean compensation amounts, the concentration of paid claims among a limited number of physicians, the proportion of paid claims that were >$1 million, severity of injury, and type of malpractice alleged for the malpractice claims (n=280,368) paid on behalf of physicians.  

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From 1992–1996 to 2009–2014, the rate of paid claims reduced by 55.7% (from 20.1 to 8.9 per 1000 physician-years; P<0.001). This ranged from a 13.5% reduction in cardiology (P=0.15) to a 75.8% reduction in pediatrics (P<0.001). 

The mean compensation payment was $329,565, reflecting a 23.3% increase from $286,751 in 1992–1996 to $353,473 in 2009–2014 (P<0.001). This ranged from $17,431 in general practice (P=0.36) to $114,410 in gastroenterology (P<0.001) and $138,708 in pathology (P=0.005). 

Of the total paid claims, 7.6% (n=21,271) were >$1 million and 32.1% (n=35,293) involved a patient death. The most common type of allegation was diagnostic error, which was seen in 31.8% of paid claims. This ranged from 3.5% in anesthesiology to 87.0% in pathology. 

Overall, study authors noted a substantial decrease in the rate of malpractice claims between 1992–2014 with “wide differences in rates and characteristics across specialties.” The authors concluded that more knowledge about the causes of variation across the specialties may help lower patient injury and physicians’ liability risk.

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