Malpractice in pediatrics

[crazyhands]

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hey everyone,

I really hate to bring up this topic but I could not find much on the search engine. Here goes anyway: I am a 4th year med student applying for a peds residency this year. I feel really excited to begin my 4th year since I am doing alot of peds rotations and really do feel like this is the field for me. However, I recently was looking up some information about malpractice in different fields and found some scary numbers. I posted the links below.

from NEJM (2011) http://www.nejm.org/doi/full/10.1056/NEJMsa1012370#t=articleTop

good: peds is almost the least sued field
bad: if they get sued, they are paying out much more on average than any other field

My concern is this: I'm not quite sure how malpratice premiums work, or how much they increase after a person has been sued, or how much a person actually pays. But it seems like if they get sued for quite a bit, I would figure their premiums would go up so high that now they have to see tons of patients a day just make much money at all.

Another concern: This article: http://www.pediatricsdigest.mobi/content/122/6/e1282.full
talks about the most common conditions involved in malpractice. One of them is the failure to dx pneumonia leading to almost $400,000 indemnity. Really?

And I also read about how the average defense cost is around $28,000 in which no indeminty was paid.

Any thoughts on this?

 

[oldbearprofessor]

My concern is this: I'm not quite sure how malpratice premiums work, or how much they increase after a person has been sued, or how much a person actually pays. But it seems like if they get sued for quite a bit, I would figure their premiums would go up so high that now they have to see tons of patients a day just make much money at all.

Since no one else responded, here are a few quick pointers...

1. Payout per case is higher in pediatrics, especially in states with malpractice reform as this decreases non-economic but usually not economic (costs of care) payout. In other words, lifetime care costs are generally not limited by malpractice reform and are thus higher in pediatrics than in adult medicine. Classic case was the recent birth related case in Maryland that has been widely discussed on SDN and elsewhere where the very large settlement was related to estimated long-term care needs and the other aspects of the jury verdict were quickly reduced due to malpractice reform laws, but not the long-term care costs.

2. How your malpractice insurance is paid and what happens if you get sued and have to make a payment are highly variable based on type of practice. Many are covered by institutional or large group policies and this wouldn't be markedly affected if at all by one or two cases. It is extremely uncommon for a pediatrician to get sued frequently.

3. In general, malpractice issues are of less concern in pediatrics than many other fields, but risks are certainly real and arguably, malpractice reform has had a somewhat less effect on pediatrics as explained above. They would not be a reason to avoid pediatrics as we are not at especially high risk and taking care of children is worth it, IMHO.

 

[crazyhands]

Thanks alot OBP. That was helpful!