One percent of all physicians are responsible for nearly one third of all paid medical malpractice claims according to a recent study in the New England Journal of Medicine. This is a significant finding. For additional perspective on this study, we turned to an article written by Tara Haelle on Medscape.

She suggests that the common risk factors associated with doctors who have paid claims is that they are largely male, older, have already had a previous claim, and are in specialties that are at high-risk for medical malpractice suits, such as neurology and obstetrics.

But one wonders if these high rates of incidence indicate other factors at work? She quotes the author of the study, David M. Studdert, as saying that, “In general, the high-risk specialties tend to be the ones that involve invasive procedures, where risk of adverse outcomes is higher, irrespective of whether the care was appropriate or negligent,” but he also suggests that, “The most important implications of these findings is that ‘frequent flyers’ are a significant problem, and identifying and remediating them early may help improve the quality of the healthcare system.”

The study shows that only 6% of the ~900,000 doctors who were active during the decade which was studied (2004-2015) had a single paid claim. But looking at the 1% with two or more claims, those doctors account for 32% of the number of paid claims. Physicians with 3 paid claims against them (0.2%) account for 12% of all paid claims.

A similar pattern emerges when looking at subspecialties, but several subspecialties had increased incidences of medical malpractice suits across the board. Ms. Haelle quotes a doctor, Lucian Leape MD, based at Harvard who was not involved in the study, “Neurosurgeons are not less careful — they are more careful — than others, but they often get bad results because the surgical techniques have limitations, and the results are devastating. Then anguished families sue.”

The study shows that only 6% of the ~900,000 doctors who were active during the decade which was studied (2004-2015) had a single paid claim.

Those with the lowest risk for an additional paid claim were psychiatrists, followed by pediatricians with a 40% lower and 29% lower risk respectively. Dr. Leape continued, “Their treatments seldom inflict physical harm, and they spend much more time on the personal relationship. Many suits occur because the patient is unhappy with how the doctor treated them, not about the results.”

With that in mind, one can easily imagine why a neurosurgeon is more often sued than, say, a pediatrician for a couple reasons. First, there may be less of an established doctor-patient relationship, as neurosurgeons are often called in to provide a needed surgery. In addition, when the outcome of a neurosurgery is undesirable, it may result in death or a severe disability. These factors combined, along with the emotional weight of the outcome, may often lead the families of the bereaved to sue.

Dr. Studdert, the author of the study concluded, “Our hope is that this study will help motivate regulators, liability insurers, and healthcare organizations to redouble their efforts to address the problems posed by a small number of healthcare practitioners who have troubling malpractice records.”