GMO2003

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We all know the sky high malpractice premiums certain specialities pay (neurosurgery, ob/gyn, anesthesiology)...but what about radiology?? I've heard here and there that rads is quickly becoming the most litigated of medical specialties?? Is there any truth to this? I have no factual evidence to back up my question...just stuff I've read casually though the media..we all know how accurate and up to date they can be...just curious but interested to know from somebody "in the trenches" so to speak...
 

f_w

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Yep, its true.

> I've heard here and there that rads is quickly becoming the most
> litigated of medical specialties??

While the rates in absolute numbers are not yet in the OB/NS range, the rapid increase is a very worrisome trend. Increases of 30% or more per year are not unheard of in some markets.

Most of the liability exposure in rads stems from the involvement in mammography. The sad truth is, that no matter how good of a mammographer you are, if a reasonably young patient (whoose mammogram you read last year) develops cancer, you WILL get sued. In 60% of 'new' breast cancer, the 'impeccable retrospect-o-scope' will be able to 'clearly see' the abnormality on last years films. Most of these cases could be won in open court as they are patently bogus. However if you loose, 10mio judgements are the rule, not the exception. As a result, insurance companies are very willing to settle these cases for the going rate of 250-500k (of which the shyster gets 40% anyway), regardless of their merit.

Remember, the insurance companies are in the business of selling insurance, not protecting doctors. They have ABSOLUTELY NO INTEREST in curbing frivolous lawsuits. If the claims volumes go up, guess what, they just increase their premiums. And the higher the premium volume, the higher the CEO compensation !!

Some companies in some markets these days offer discounted rates if you promise not to touch any mammograms. I think this is a good start. It will 'thin the herd' and make mammography less and less available. Once women have to wait 9months for their mammogram, maybe they start calling their state legislator to fix the problem. (With the strong political pull of the 'boob lobby' this might backfire. Instead of fixing the problem, they will just make it illegal to discount rates for non-mammographers)
 

Vince

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Here's some excerpts from an article in RSNA News from Jan 05 by Stephen R. Baker, MD:

"Researchers at the University of Medicine and Dentistry of New Jersey in Newark examined the malpractice records of nearly 5,300 radiologists affiliated with One Call Medical, Inc., a preferred provider organization network for MR and CT imaging services that operates in 40 states."

"Fifty-one percent of the radiologists in the network had a history of at least one malpractice suit lodged against them..."

"Among those claims, the highest number, 45 percent, involved failure to diagnose the patient's true condition. The four leading causes of failure to diagnose were:
Missed fractures(29%)
Misinterpretation of breast imaging studies(24%)
Failure to diagnose cancer(15%)
Failure to recognize an acute vascular condition(7%)"

"Failure to diagnose, by far, was the most common cause. Failure to communicate, which is an issue that we worry about, was not a major cause, although the incidence is increasing. The most important result I see is that among the more than 3,000 suits filed, only 21 were the result of a failure to do additional tests, whichi is what we worry about all the time and may be a stimulus for the desire to get further tests to avoid subsequent liability action."

Other findings included:

"The frequency of claims against radiologists is not increasing despite an increase in the number of imaging studies performed."

"9% of claims involved complications of therapeutic interventions performed by radiologists."

"The number of claims varied widely from state to state, with the highest numbers in PA, NV, and OR."

"Claims for failure to diagnose breast disease are not increasing despite a greater number of mammograms performed and interpreted."

"One a case-by-case basis, women radiologists are less likely to be sued for a failure to diagnose breast disease, even though men and women radiologists interpret about equal numbers of mammograms."

"The number of claims for failure to diagnose has remained steady over the last 10 years."

"The number of claims for failure to diagnose lung cancer has increased in the same period."

This article also quoted a malpractice survey by the AMA, RSNA, and ACR....
"The surveys found that the average premium liability insurance in 2003 was $25,200. That compared to $20,000 in 2002 and $16,000 in 2001. In addition, nearly half of the radiologists who responded said they have changed the way they practice because of medical liability issues."


As for me, I hope to match radiology, and I am not worried about the malpractice issues. I think its important for all future physicians to be aware of malpractice concerns, and on the flip-side, asset protection. :D
 

f_w

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> As for me, I hope to match radiology, and I am not worried about
> the malpractice issues.

Well, you should be worried. But I think it shouldn't dissuade you from pursuing rads. Neurosurgeons get sued all the time, they just have the more robust personalities to deal with it.

It is not so much the number on the check to your malpractice carrier. That is just the cost of doing business.
It is more the the 'feeling of impending doom' that grips many radiologists every time they have to touch one of those dreaded mammograms. Without your own wrongdoing, your livelyhood can be taken away from you. A settlement in a mammo case would typically be covered by your insurance, but a year or two later when your group changes malpractice carriers, you might find yourself without coverage, dropped from some of the commercial third party payors and fighting for your hospital priviledges. (after all, by agreeing to the settlement, you have admitted that you are a 'bad doctor', haven't you ?).