Just the Cost of Doing Business

Good news, everyone!

In the past two decades, for virtually every specialty, the number of paid medical malpractice claims has decreased. Overall, for all specialties, the rate of payment has been halved, compared with the 1992-1996 timeframe. Neurosurgery, unfortunately, is still the “winner”, followed by plastic surgery, thoracic surgery, and obstetrics. The lowest rates were seen in psychiatry and pediatrics. Emergency medicine sits right in the middle, with 18.8 paid claims per 1,000 physician years.

The bad news, unfortunately, was that the claim amounts – including paid claims greater than $1 million – increased. Emergency Medicine paid claim amounts increased 26.1% to a mean of $314,052 in the most recent time period of analysis, an increase in line with the overall mean for all specialties. The largest jump in payout amounts was essentially a tie between dermatology, gastroenterology, pathology, and urology. Neurosurgery actually had one of the lowest payout increases – probably because they started from such lofty heights, already.

Types of malpractice alleged varied by specialty, with the expected variation between diagnostic error, surgical error, and treatment errors between the diagnostic and surgical specialties. Most (63.6%) of malpractice alleged in emergency medicine fell into alleged diagnostic error, while logically 73.3% of alleged error in plastic surgery fell under surgical error.

These data, from the National Provider Data Bank, only document payments made for written claims and do not include settlements or monies paid out by institutions. Whether these actually represent a friendlier environment for physicians, more aggressive approaches to settling claims, or a shifting of liability to corporate proxy is not clear. Regardless, even if it is a little of all three, the trend is probably moving in the right direction.

“Rates and Characteristics of Paid Malpractice Claims Among US Physicians by Specialty, 1992-2014”