Study: One-third of all paid malpractice claims attributed to 1% of doctors

A small portion of physicians—about 1 percent—accounted for nearly a third of all malpractice claims paid in the U.S. over a recent 10-year period, according to results of a study published online Jan. 28 in the New England Journal of Medicine.

Concerns about claim-prone doctors are nothing new in healthcare, as substantial research has been devoted to identifying possible risk factors such as physician age, specialty, claim history and quality of care.

But solidifying a risk profile for physician malpractice remains a work in progress, according to lead author David Studdert, LLB, of Stanford University School of Medicine, and colleagues.

“The distribution of malpractice claims among physicians is not well understood,” they wrote. “If claim-prone physicians account for a substantial share of all claims, the ability to reliably identify them at an early stage could guide efforts to improve care.”

Studdert and his team used data from the National Practitioner Data Bank to analyze 66,426 claims paid against 54,099 physicians between 2005 and 2014. Concentrations of claims among physicians were calculated and risk factors associated with recurrent claims against individual physicians were identified.

Their results showed that roughly 1 percent of all physicians accounted for 32 percent of total paid malpractice claims. Additionally, specific physician characteristics including claim history and medical specialty were indicated as underlying risk factors for recurrent paid malpractice claims.

“In adjusted analyses, the risk of recurrence increased with the number of previous paid claims,” the researchers wrote. “Risks of recurrence also varied widely according to specialty—for example, the risk among neurosurgeons was four times as great as the risk among psychiatrists.”

The finding could prove useful in limiting future claims by identifying doctors who fit the malpractice risk profile and supplying them with training and other resources before a major medical mistake occurs, said Studdert and his colleagues.

“In an environment in which a small minority of physicians with multiple claims accounts for a substantial share of all claims, an ability to reliably predict who is at high risk for further claims could be very useful,” the authors concluded. “It could present an exciting opportunity for the liability and risk-management enterprises to join the mainstream of efforts to improve quality.”