- Joined
- Jul 3, 2004
- Messages
- 5,573
- Reaction score
- 9
Alright, so I know specialists in OB/GYN, neurosurg, etc get sued a lot...but what would you say are the specialties (non-primary care) that have the lowest rates of malpractice suits?
Docs that don't get sued
- Thread starter velo
- Start date
- Joined
- Jul 10, 2003
- Messages
- 1,261
- Reaction score
- 4
Academic research types... 😉
- Joined
- Apr 16, 2004
- Messages
- 4,923
- Reaction score
- 6,117
The bottom line is, be nice to your patients and treat them with the respect and dignity that they deserve. Your malpractice rates are virtually guaranteed to be lower.
But Salty is right. Academic medicine is the place to be if you want to avoid prohibitively expensive malpractice insurance premiums.
But Salty is right. Academic medicine is the place to be if you want to avoid prohibitively expensive malpractice insurance premiums.
- Joined
- May 3, 2004
- Messages
- 12,808
- Reaction score
- 3,658
Bottom line is all docs get sued. I agree with SaltySquegee he is RIGHT!!!
- Joined
- Jul 10, 2003
- Messages
- 1,261
- Reaction score
- 4
Postgrad Med J. 2004 Mar;80(941):165-8.
"How to avoid being sued in clinical practice."
Panting G.
Medical Protection Society, 33 Cavendish Square, London W1G 0PS, UK. [email protected]
Abstract:
"Challenges to clinical management are a fact of professional life. Every doctor must expect to become embroiled in complaints and claims from time to time and be prepared to justify why they managed a particular case in the way that they did. Good medical practice is defensible practice, which depends upon staying within the limits of your own expertise, keeping up to date and conducting audit, ensuring your administration is effective and that patients are not allowed to slip through the net, that you communicate effectively with patients, their carers and colleagues, and that medical records recall all salient facts relating to the patient. If things go wrong, be open, investigate the facts, explain the situation fully to the patient, and do not be afraid to apologise."
"How to avoid being sued in clinical practice."
Panting G.
Medical Protection Society, 33 Cavendish Square, London W1G 0PS, UK. [email protected]
Abstract:
"Challenges to clinical management are a fact of professional life. Every doctor must expect to become embroiled in complaints and claims from time to time and be prepared to justify why they managed a particular case in the way that they did. Good medical practice is defensible practice, which depends upon staying within the limits of your own expertise, keeping up to date and conducting audit, ensuring your administration is effective and that patients are not allowed to slip through the net, that you communicate effectively with patients, their carers and colleagues, and that medical records recall all salient facts relating to the patient. If things go wrong, be open, investigate the facts, explain the situation fully to the patient, and do not be afraid to apologise."
- Joined
- Jul 10, 2003
- Messages
- 1,261
- Reaction score
- 4
JAMA. 2002 Jun 12;287(22):2951-7.
Patient complaints and malpractice risk.
Hickson GB, Federspiel CF, Pichert JW, Miller CS, Gauld-Jaeger J, Bost P.
Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN 37232, USA. [email protected]
"CONTEXT: A small number of physicians experience a disproportionate share of malpractice claims and expenses. If malpractice risk is related in large measure to factors such as patient dissatisfaction with interpersonal behaviors, care and treatment, and access, it might be possible to monitor physicians' risk of being sued. OBJECTIVE: To examine the association between physicians' patient complaint records and their risk management experiences. DESIGN, SETTING, AND PARTICIPANTS: Retrospective longitudinal cohort study of 645 general and specialist physicians in a large US medical group between January 1992 and March 1998, accounting for 2546 physician-years of care. MAIN OUTCOME MEASURES: Computerized records of all unsolicited patient complaints were recorded by the medical center's patient affairs office, coded to characterize the nature of the problem and alleged offender, and compared with each physician's risk management records for the same period. RESULTS: Both patient complaints and risk management events were higher for surgeons than nonsurgeons. Specifically, 137 (32%) of the 426 nonsurgeons had at least 1 risk management file compared with nearly two thirds (137 [63%] of 219) of all surgeons (chi2(1)= 54.7, P<.001). Both complaint and risk management data were positively correlated with physicians' volume of clinical activity. Logistic regression revealed that risk management file openings, file openings with expenditures, and lawsuits were significantly related to total numbers of patient complaints, even when data were adjusted for clinical activity. Predictive concordance of specialty group, complaint count, clinical activity, and sex for risk management file openings was 84%; file openings with expenditures, 83%; lawsuits, 81%; and multiple lawsuits, 87%. CONCLUSIONS: Unsolicited patient complaints captured and recorded by a medical group are positively associated with physicians' risk management experiences."
Patient complaints and malpractice risk.
Hickson GB, Federspiel CF, Pichert JW, Miller CS, Gauld-Jaeger J, Bost P.
Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN 37232, USA. [email protected]
"CONTEXT: A small number of physicians experience a disproportionate share of malpractice claims and expenses. If malpractice risk is related in large measure to factors such as patient dissatisfaction with interpersonal behaviors, care and treatment, and access, it might be possible to monitor physicians' risk of being sued. OBJECTIVE: To examine the association between physicians' patient complaint records and their risk management experiences. DESIGN, SETTING, AND PARTICIPANTS: Retrospective longitudinal cohort study of 645 general and specialist physicians in a large US medical group between January 1992 and March 1998, accounting for 2546 physician-years of care. MAIN OUTCOME MEASURES: Computerized records of all unsolicited patient complaints were recorded by the medical center's patient affairs office, coded to characterize the nature of the problem and alleged offender, and compared with each physician's risk management records for the same period. RESULTS: Both patient complaints and risk management events were higher for surgeons than nonsurgeons. Specifically, 137 (32%) of the 426 nonsurgeons had at least 1 risk management file compared with nearly two thirds (137 [63%] of 219) of all surgeons (chi2(1)= 54.7, P<.001). Both complaint and risk management data were positively correlated with physicians' volume of clinical activity. Logistic regression revealed that risk management file openings, file openings with expenditures, and lawsuits were significantly related to total numbers of patient complaints, even when data were adjusted for clinical activity. Predictive concordance of specialty group, complaint count, clinical activity, and sex for risk management file openings was 84%; file openings with expenditures, 83%; lawsuits, 81%; and multiple lawsuits, 87%. CONCLUSIONS: Unsolicited patient complaints captured and recorded by a medical group are positively associated with physicians' risk management experiences."
- Joined
- Jul 10, 2003
- Messages
- 1,261
- Reaction score
- 4
J Fam Pract. 1999 Jan;48(1):23-30.
Malpractice claims against family physicians are the best doctors sued more?
Ely JW, Dawson JD, Young PR, Doebbeling BN, Goerdt CJ, Elder NC, Olick RS.
Department of Family Medicine, University of Iowa College of Medicine, Iowa City, USA.
"BACKGROUND: Physicians who have been sued multiple times for malpractice are assumed to be less competent than those who have never been sued. However, there is a lack of data to support this assumption. Competence includes both knowledge and performance, and there are theoretical reasons to suspect that the most knowledgeable physicians may be sued the most. METHODS: We conducted a retrospective cohort study of family physicians who were included in the Florida section of the 1996 American Medical Association's Physician Masterfile and who practiced in Florida at any time between 1971 and 1994 (N = 3686). The main outcome was the number of malpractice claims per physician adjusted for time in practice. Using regression methods, we analyzed associations between malpractice claims and measures of physician knowledge. RESULTS: Risk factors for malpractice claims included graduation from a medical school in the United States or Canada (incidence rate ratio [IRR] 1.8; 95% confidence interval [CI], 1.6-2.1), specialty board certification (IRR 1.8; 95% CI, 1.6-2.1), holding the American Medical Association Physician's Recognition Award (IRR 1.4; 95% CI, 1.2-1.7), and Alpha Omega Alpha Honor Society membership (IRR 1.8; 95% CI, 1.1-3.0). Among board-certified family physicians, sued physicians who made no payments to a plaintiff had higher certification examination scores than nonsued physicians (53.48 vs 51.38, P < .01). The scores of sued physicians who made payments were similar to those of nonsued physicians (51.05 vs 51.38, P = .93). CONCLUSIONS: Among Florida family physicians, the frequency of malpractice claims increased with evidence of greater medical knowledge."
Malpractice claims against family physicians are the best doctors sued more?
Ely JW, Dawson JD, Young PR, Doebbeling BN, Goerdt CJ, Elder NC, Olick RS.
Department of Family Medicine, University of Iowa College of Medicine, Iowa City, USA.
"BACKGROUND: Physicians who have been sued multiple times for malpractice are assumed to be less competent than those who have never been sued. However, there is a lack of data to support this assumption. Competence includes both knowledge and performance, and there are theoretical reasons to suspect that the most knowledgeable physicians may be sued the most. METHODS: We conducted a retrospective cohort study of family physicians who were included in the Florida section of the 1996 American Medical Association's Physician Masterfile and who practiced in Florida at any time between 1971 and 1994 (N = 3686). The main outcome was the number of malpractice claims per physician adjusted for time in practice. Using regression methods, we analyzed associations between malpractice claims and measures of physician knowledge. RESULTS: Risk factors for malpractice claims included graduation from a medical school in the United States or Canada (incidence rate ratio [IRR] 1.8; 95% confidence interval [CI], 1.6-2.1), specialty board certification (IRR 1.8; 95% CI, 1.6-2.1), holding the American Medical Association Physician's Recognition Award (IRR 1.4; 95% CI, 1.2-1.7), and Alpha Omega Alpha Honor Society membership (IRR 1.8; 95% CI, 1.1-3.0). Among board-certified family physicians, sued physicians who made no payments to a plaintiff had higher certification examination scores than nonsued physicians (53.48 vs 51.38, P < .01). The scores of sued physicians who made payments were similar to those of nonsued physicians (51.05 vs 51.38, P = .93). CONCLUSIONS: Among Florida family physicians, the frequency of malpractice claims increased with evidence of greater medical knowledge."
- Joined
- Jul 10, 2003
- Messages
- 1,261
- Reaction score
- 4
JAMA. 1997 Feb 19;277(7):553-9
Physician-patient communication. The relationship with malpractice claims among primary care physicians and surgeons.
Levinson W, Roter DL, Mullooly JP, Dull VT, Frankel RM.
Department of Medicine, Oregon Health Sciences University, Portland, USA.
OBJECTIVE: To identify specific communication behaviors associated with malpractice history in primary care physicians and surgeons. DESIGN: Comparison of communication behaviors of "claims" vs "no-claims" physicians using audiotapes of 10 routine office visits per physician. SETTINGS: One hundred twenty-four physician offices in Oregon and Colorado. PARTICIPANTS: Fifty-nine primary care physicians (general internists and family practitioners) and 65 general and orthopedic surgeons and their patients. Physicians were classified into no-claims or claims (> or =2 lifetime claims) groups based on insurance company records and were stratified by years in practice and specialty. MAIN OUTCOME MEASURES: Audiotape analysis using the Roter Interaction Analysis System. RESULTS: Significant differences in communication behaviors of no-claims and claims physicians were identified in primary care physicians but not in surgeons. Compared with claims primary care physicians, no-claims primary care physicians used more statements of orientation (educating patients about what to expect and the flow of a visit), laughed and used humor more, and tended to use more facilitation (soliciting patients' opinions, checking understanding, and encouraging patients to talk). No-claims primary care physicians spent longer in routine visits than claims primary care physicians (mean, 18.3 vs 15.0 minutes), and the length of the visit had an independent effect in predicting claims status. The multivariable model for primary care improved the prediction of claims status by 57% above chance (90% confidence interval, 33%-73%). Multivariable models did not significantly improve prediction of claims status for surgeons. CONCLUSIONS: Routine physician-patient communication differs in primary care physicians with vs without prior malpractice claims. In contrast, the study did not find communication behaviors to distinguish between claims vs no-claims surgeons. The study identifies specific and teachable communication behaviors associated with fewer malpractice claims for primary care physicians. Physicians can use these findings as they seek to improve communication and decrease malpractice risk. Malpractice insurers can use this information to guide malpractice risk prevention and education for primary care physicians but should not assume that it is appropriate to teach similar behaviors to other specialty groups.
Physician-patient communication. The relationship with malpractice claims among primary care physicians and surgeons.
Levinson W, Roter DL, Mullooly JP, Dull VT, Frankel RM.
Department of Medicine, Oregon Health Sciences University, Portland, USA.
OBJECTIVE: To identify specific communication behaviors associated with malpractice history in primary care physicians and surgeons. DESIGN: Comparison of communication behaviors of "claims" vs "no-claims" physicians using audiotapes of 10 routine office visits per physician. SETTINGS: One hundred twenty-four physician offices in Oregon and Colorado. PARTICIPANTS: Fifty-nine primary care physicians (general internists and family practitioners) and 65 general and orthopedic surgeons and their patients. Physicians were classified into no-claims or claims (> or =2 lifetime claims) groups based on insurance company records and were stratified by years in practice and specialty. MAIN OUTCOME MEASURES: Audiotape analysis using the Roter Interaction Analysis System. RESULTS: Significant differences in communication behaviors of no-claims and claims physicians were identified in primary care physicians but not in surgeons. Compared with claims primary care physicians, no-claims primary care physicians used more statements of orientation (educating patients about what to expect and the flow of a visit), laughed and used humor more, and tended to use more facilitation (soliciting patients' opinions, checking understanding, and encouraging patients to talk). No-claims primary care physicians spent longer in routine visits than claims primary care physicians (mean, 18.3 vs 15.0 minutes), and the length of the visit had an independent effect in predicting claims status. The multivariable model for primary care improved the prediction of claims status by 57% above chance (90% confidence interval, 33%-73%). Multivariable models did not significantly improve prediction of claims status for surgeons. CONCLUSIONS: Routine physician-patient communication differs in primary care physicians with vs without prior malpractice claims. In contrast, the study did not find communication behaviors to distinguish between claims vs no-claims surgeons. The study identifies specific and teachable communication behaviors associated with fewer malpractice claims for primary care physicians. Physicians can use these findings as they seek to improve communication and decrease malpractice risk. Malpractice insurers can use this information to guide malpractice risk prevention and education for primary care physicians but should not assume that it is appropriate to teach similar behaviors to other specialty groups.
- Joined
- Jul 10, 2003
- Messages
- 1,261
- Reaction score
- 4
So what have we all learned.
2nd to Academic research:
Pick a non-surgical specialty, don't be a MoFo when communicating with your patients, be less informed than your collegues, and spend on average 3.3 minutes more with your patient asking them how their day has been; if you don't want to get sued. 👍
Gotta love pubmed.
2nd to Academic research:
Pick a non-surgical specialty, don't be a MoFo when communicating with your patients, be less informed than your collegues, and spend on average 3.3 minutes more with your patient asking them how their day has been; if you don't want to get sued. 👍
Gotta love pubmed.
- Joined
- Jun 26, 2003
- Messages
- 1,191
- Reaction score
- 4
all docs have the chance to get sued..it's just how much they get sued that's different
- Joined
- Jul 3, 2004
- Messages
- 5,573
- Reaction score
- 9
ericdamiansean said:
First of all I want to thank everyone for their input, and especially to SS, those pubmed abstracts were quite interesting.
I don't think I titled this thread very well though. I am aware that all docs have a chance to get sued, and that if you are personable with your patients and they "like you" your chances of getting sued go down. But what I was trying to ask wasn't what can an individual do to avoid litigation. I'm trying to find out what specialties have high/low rates of malpractice claims.
So, statistically speaking, does anybody know which specialties are least often sued? just curious
- Joined
- Jul 7, 2004
- Messages
- 265
- Reaction score
- 0
Millitary doctors don't get sued. One of my Dad's friends is an extremely risk averse fellow, and he works a relatively low paying job at a VA hospital on Long Island for that very reason.
- Joined
- Jul 10, 2003
- Messages
- 1,261
- Reaction score
- 4
Me too, but neither Pubmed or google turned up much of substance.velocypedalist said:
??? 😕
- Joined
- Jun 26, 2004
- Messages
- 49
- Reaction score
- 0
fun for actuaries
table 2
so nothing spelled out, but general indications. these were in the first page of google hits; there's probaby something better (and more recent) out there.
table 2
so nothing spelled out, but general indications. these were in the first page of google hits; there's probaby something better (and more recent) out there.
- Joined
- Jun 26, 2003
- Messages
- 1,191
- Reaction score
- 4
velocypedalist said:
There are many factors that contribute to whether one gets sued or not. BAsically, one of the main factors is where you are practising. if you are saying the US or the UK, the chances of you getting sued there are higher, mainly because the people there are more well educated and they know their rights. If you are working in a third world/developing country, the likelihood is far less, because patients are less educated and they have this god-like respect for doctors.
Secondly, the doctor patient relationship matters. The nicer you are to patients, even if you screw up and are willing to admit the mistake, I guess they'll be more likely to sue you for less or to settle out of court. MAny doctors and even medical students alike do not like admitting their faults, due to their egos etc, but this mentality should change.
Next, which specialty gets sued the least? Basically, take into account all the factors involved, I think that any specialty is least likely to be sued if the doctor, staff etc are caring, careful, have a good relationship with the patient etc.
But, relatively speaking, without all these factors in place, I think the following are the least likely:
aerospace medicine, psychiatry, forensic pathology, occupational med, com med, and rehab
But then, look at them closely, it's either they don't deal with real patients directly (forensics) or they are more of primary prevention
- Joined
- Dec 11, 2003
- Messages
- 6,617
- Reaction score
- 14
ericdamiansean said:
What they lack in getting sued, they make up for in death threats.
- Joined
- Jun 26, 2003
- Messages
- 1,191
- Reaction score
- 4
Fermata said:
seriously? WHy? Is this a case of: Hey doc, if you don't get off my construction site, I'm gona offload a ton of brick on you
- Joined
- Dec 11, 2003
- Messages
- 6,617
- Reaction score
- 14
ericdamiansean said:
Occupational med docs are involved in telling people that they can't work any more.
Figure it out.
- Joined
- Jun 26, 2003
- Messages
- 1,191
- Reaction score
- 4
and they'll kill me for that? man..some people are sensitive
but why? I can tell a patient he/she can't work, but non-adherence comes to play, he/she goes and work, UNLESS I am a busybody and tell the patient's employer, which is unethical and i'll get slapped with a big fat legal issue
but why? I can tell a patient he/she can't work, but non-adherence comes to play, he/she goes and work, UNLESS I am a busybody and tell the patient's employer, which is unethical and i'll get slapped with a big fat legal issue
Similar threads
