The other 1 percent: Malpractice payouts more concentrated than previously thought

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About 1 percent of physicians account for almost one-third (32 percent) of all malpractice claims paid on behalf of physicians, according to an analysis of 10 years' worth of data from the National Practitioner Data Bank published in the New England Journal of Medicine.

What's more, the researchers discovered that many of these claims are tied to a small number of repeat offenders. "In adjusted analyses, the risk of recurrence increased with the number of previous paid claims," the researchers wrote. "For example, as compared with physicians who had one previous paid claim, the 2,160 physicians who had three paid claims had three times the risk of incurring another."

Although some claim concentration can be explained by physicians practicing in riskier specialties or willing to take harder cases, according to STAT News, the findings raise questions about the predictability of claims.

"The policy-relevant question is: Can we identify these guys?" David Studdert, a medical law expert at Stanford Law School and the lead author of the study, told STAT News.

And if such high-risk doctors can be identified, there's the matter of what to do next, Studdert explained to Reuters. "There's a question mark over whether interventions such as peer coaching, supervision, placing conditions on practice and so forth really are capable of returning high-risk physicians to safe practice," he said. "We need to learn a lot more about these programs."

In the meantime, the analysis identified the following noteworthy malpractice trends:

  • The odds of paying out on a subsequent claim were 38 percent higher among male doctors than female physicians
  • Doctors trained outside the United States were 12 percent more likely to have to pay out on more than one claim
  • Compared to general practitioners, malpractice-payout recurrence rates were roughly two times higher in the fields of obstetrics and gynecology, orthopedic surgery, plastic surgery and general surgery

To learn more:
- see the abstract
- read the article from STAT News
- read the article from Reuters

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