Malpractice settlement vs loss in court: Long term implications?

[Norfold]

I’m not sure which forum to put this as there is no legal thread on SDN and this is one of the busiest at the attending physician level. Plus, it may benefit all physicians who read it. If a moderator insists it be moved elsewhere, please let me know which thread would be more appropriate.

Anyway, my question pertains to malpractice outcomes (without any specific legal details): If a malpractice case is “settled” vs “lost in court/held liable”, besides higher malpractice premiums, are there any potential negative implications with one outcome vs the other? e.g. denial of hospital privileges, state medical board licensing problems, hospitals or private practice groups not hiring, etc.

The nature of the lawsuit is key factor. All I can say is there was no intent to harm or negligence by the physicians involved. But, a lack of information and very debatable test results which lead to a wrong dx and subsequently unnecessary treatment (the pt. lived and already had a low 5 yr survival rate).

So, back to the original question: Settlement vs Guilty/Liable. I know the latter of the two sounds worse, but does it actually have a negative impact on one’s career; because either way you didn’t win in court, so what’s the difference?

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[caligas]

Assuming the settlement is more than nominal, both are reportable to National Practioner data base. Both will require reporting for every future application for a job, license, or credentials. Both can effect malpractice premiums. Any difference in implications related to reporting of a settlement vs trial loss pales in comparison to the importance of making the right decision from a financial risk standpoint.

 

[Vandalia]

So, back to the original question: Settlement vs Guilty/Liable. I know the latter of the two sounds worse, but does it actually have a negative impact on one’s career; because either way you didn’t win in court, so what’s the difference?

No one cares.

I have been involved in hiring and credentialing physicians for going on 20 years. No one cares. I cannot remember a single case where anyone paid any attention to a physician's malpractice claims history. Not once. Everyone knows that malpractice claims are basically independently random events that have no relation to quality of care. Even the people who work in the cafeteria know that. Unless you are in the 99th percentile and are generating claims at the rate of one a week.... no one cares.

As mentioned above, the only thing you need to be concerned about is limiting your own liability exposure. This depends on the laws of the state you are in and the precise wording of your malpractice insurance contract. A carrier has the duty to negotiate a settlement within policy limits if at all possible. If they do that, and you insist on going to trial (as is your right), you might be liable for anything above the settlement amount. In addition, in some states, if a party rejects a settlement offer, and goes to trial and receives a less favorable judgement, they are liable for the other parties attorney fees. Again, depending on the precise wording of the contract and the laws of the state, if you reject a settlement offer, you may be on the hook for those.

Don't let your ego get involved, that is always a prescription for disaster. I personally do not care what non-physicians, and "people so stupid they couldn't figure out a way to get out of jury duty" think about my work.

As for things like the NPDB and a "record", once again, no one cares.

EDIT: There are occasions where a malpractice claim has resulted in action by the state medical board. However, these are usually not the "run of the mill" cases. For example, I remember one about 20 years ago involving a radiologist (probably about 70 at the time) who had a number of claims involving his interpretation of CT/MRI. It came out that he had no training in these modalities and was obviously deficient. Therefore, the state board restricted his license to plain-film imaging. I think he simply surrendered his license and retired. Or a claim where a surgeon was unavailable to provide his patients follow-up care due to severe substance abuse issues.

So it is possible for a malpractice claim to result in action against a medical license, but these generally involve a long-pattern of behavior or other serious issues that directly relate to the "ability to practice medicine with a reasonable degree of skill."

 

[coroner]

Not an expert in this by any means, but to echo the above post, I would think there would only be significant consequences down the road if there were multiple lawsuits and/or the nature was something egregious e.g. intent to harm or an obvious ethical violation e.g. falsifying credentials as in the above example.