Only 1% of U.S. doctors are responsible for 32% of the malpractice claims that result in payments to patients, according to an analysis of 15 years’ worth of cases. And when a doctor has to pay out on one claim, the chances are good that the same physician will soon be paying out on another, researchers report in the New England Journal of Medicine.
Using data from the National Practitioner Data Bank, investigators at the Stanford University School of Medicine and other institutions analyzed 66,426 claims paid against 54,099 physicians from 2005 through 2014. They found that approximately 1% of all physicians accounted for 32% of paid claims. Among physicians with paid claims, 84% incurred only one during the study period (accounting for 68% of all paid claims); 16% had at least two paid claims (accounting for 32% of the claims); and 4% had at least three paid claims (accounting for 12% of the claims). A total of 126 doctors had more than five paid claims against them.
In adjusted analyses, the risk of recurrence increased with the number of previous paid claims. For example, 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 one (hazard ratio, 3.11); this corresponded to a 24% chance of another paid claim within two years.
Risks of claims recurrence varied widely according to specialty. For example, the risk among neurosurgeons was four times greater than the risk among psychiatrists.
The median payment among all claims was nearly $205,000.
“I think people will be surprised about the extent to which the claims are concentrated within a relatively small group of practitioners. It’s actually more concentrated than in earlier studies,” lead author Dr. David Studdert told Reuters Health. The result, he said, demonstrates that there are practitioners who can accumulate large numbers of claims and continue to practice.