A new study conducted by researchers at Brigham and Women’s Hospital, an affiliate of Harvard Medical School, has found that the number of medical malpractice claims paid by physicians have substantially decreased over the last two decades. However, the payout amounts on successful claims, adjusted for inflation, have increased over the years. The study, entitled “Rates and Characteristics of Paid Malpractice Claims Among U.S. Physicians by Specialty, 1992-2014,” is one of the first of its kind, as it analyzes and categorizes the data by medical specialty. But what does this mean for the average litigant, attorney, or expert? Because the study breaks down its findings by specialty, it can be a helpful tool in ascertaining the likelihood of success on a particular claim. As the study remarks, “Specialty-specific information about paid claims may help inform decisions about the approaches needed to simultaneously improve patient safety and reduce liability.”
The Study’s Data and Analysis
The study, published online by the American Medical Association’s medical journal, JAMA Internal Medicine, was conducted for the purpose of characterizing by specialty the trends in medical malpractice claims paid on behalf of United States physicians. The study noted that there is scarce data categorizing the specialty of the doctors in medical malpractice cases. As explained by Allen Kachalia, M.D., chief quality officer at Brigham and Women’s Hospital and senior author of the study, “Previous research has shown that physicians’ perceptions of their risk of liability can influence their clinical decision making, and a better understanding of the causes of variation among specialties in paid malpractice claims may both improve patient safety and reduce liability risk.” The National Practitioner Data Bank, a centralized database of paid medical malpractice claims, was utilized by the researchers to gather data from 1992 to 2014. All dollar amounts were adjusted to 2014 dollars using the Consumer Price Index.
The researchers found that over the course of the twenty-two year time period, the overall rate of medical malpractice claims paid on behalf of all United States physicians decreased by 55.7 percent. As the lead author, Adam Schaffer, M.D., stated, “We’ve found that there was an overall drop in the amount of paid claim across all specialties, but that the magnitude of the decline was markedly different by specialty.” Pediatricians experienced the greatest decline, with a decrease in claims by 75.8 percent, while cardiologists only saw a 13.5 percent decrease.
Despite the overall 55.7 percent drop in cases, the average amount of payment increased by 23.3 percent after adjusting for inflation. The mean compensation amount was $329,565, which varied widely across specialties. Neurosurgery had the highest mean payment of claims, about $470,000, while dermatology claims had the lowest average payout of about $189,000. Gastroenterologists and pathologists experienced the greatest spike in mean payments, averaging an increased $114,000 and $138,000, respectively. General practitioners saw the smallest rise in average payouts, increasing by $17,000. In addition, payments exceeding $1 million also increased during the same time period.
The research indicated that the most common allegations of malpractice were misdiagnosis (31.8 percent of all claims), errors related to surgical procedures (26.9 percent), and treatment-related mistakes (24.5 percent). Approximately 32 percent of all paid claims involved the death of a patient. Pulmonologists were found to be most likely involved in patient death claims. In contrast, plastic surgeons and dermatologists had the highest percentage of “low-severity” claims that resulted in minor physical or emotional injuries.
What Do These Findings Mean for Experts?
These findings are a useful guiding post for experts, attorneys, and litigants alike. While the study does not surmise the exact causes of the 55.7 percent drop in successful medical malpractice claims over the past two decades, it can be assumed that these cases have become more difficult to win. At the same time, because the average payout has increased by 23.3 percent, medical malpractice claims are far from a poor bet. Generally, these findings can be interpreted to mean that the cases that are strong enough to win, will often win big (either at trial or during settlement negotiations).
As stated in the study, its purpose was to gain a “better understanding of the causes of variation among specialties in paid malpractice claims may help reduce patient injury and physicians’ risk of liability.” In the same regard, these variations can be helpful to all involved in the litigation process, particularly experts. Knowing the trends of a certain specialty can help both attorneys and experts formulate their case strategy accordingly. For example, if a specialty has seen a sharp increase in payouts over the past two decades, a plaintiff’s medical expert may be able to testify to the cause of such trends and how it relates specifically to the doctor’s alleged negligence. A plaintiff’s damages expert could likewise use payout increase trends (found in case law and awards statistics) as a foundation for accessing the appropriate monetary damages.
Because the general decline in successful claims may create the assumption that medical malpractice cases are more difficult to win, it is only more of a reason to obtain an expert as soon as possible. The utilization of a medical expert from the inception of litigation can help craft a strategy based on the specific practice area at issue.