AMA: Almost half of older physicians have been sued

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 - Malpractice

In a trio of reports, the American Medical Association (AMA) attacked what it called a “broken” medical liability system, finding that getting sued isn’t uncommon for physicians and can cost tens of thousands of dollars even if a case is dismissed. 

The reports largely backed up the AMA’s advocacy for medical liability reforms, such as calling for limitations on noneconomic damages in malpractice cases through state and federal legislation.

“Information in this new research paints a bleak picture of physicians’ experiences with medical liability claims and the associated cost burdens on the health system,” AMA President David O. Barbe, MD, MHA, said in a statement. “The reports validate the fact that preserving quality and access in medicine, while reducing cost, requires fairness in the civil justice system. Every dollar spent on the broken medical liability system is a dollar that cannot be used to improve patient care.”

The first report examined how frequently physicians have a medical liability claim filed against them. Thirty-four percent of physicians responding to the AMA’s 2016 survey have been sued. The longer a physician has been in practice, the likelihood for getting sued appeared to grow, as 49.2 percent of physicians aged 55 and over reported having a claim filed against them—with 28 percent of older doctors reported being sued two or more times—compared to the 8.2 percent of physicians under the age of 40 who have ever been sued. More male physicians (39.2 percent) reported being sued than female physicians (22.8 percent).

Broken down by specialty, the most commonly sued physicians worked in obstetrics and gynecology (63.6 percent), general surgery (63.2 percent) and emergency medicine (51.7 percent). Those numbers all increased among doctors older than 55, led by 76.5 percent of those more experienced OB-GYNs being sued. Psychiatrists (16.1 percent) and pediatricians (17.8 percent) reported being sued the least.

Getting sued isn’t indicative of any medical error or improper care, wrote AMA economist Jose Guardado, PhD, who authored all three reports. 68 percent of malpractice claims closed in 2015 were dropped, dismissed or withdrawn.

The expense involved with these claims was the focus of the second report. Between 2006 and 2015, the average expense incurred on medical liability claims climbed 64.5 percent, hitting $54,165. Even for the 68 percent of claims which were dropped, there was an average cost of $30,475.

“Even though the vast majority of claims are dropped, dismissed or withdrawn, the heavy cost associated with a litigious climate takes a significant financial toll on our health care system when the nation is working to reduce unnecessary health care costs,” Barbe said in a statement.

Another 23 percent of claims closed in 2015 resulted in settlements, with an average expense of nearly $79,000. The highest average expense came from plaintiff verdicts ($262,141)—but only 7 percent of all claims were decided by a trial and 87.5 percent of those were won by the physician defendants. Overall, verdicts in favor of the plaintiff made up less than 1 percent of all closed claims in 2015.

Payments for losses or other compensation, gathered together under “indemnity payments” were shown to be on the rise. For the 25 percent of claims with an indemnity payment in 2015, the average paid out was $365,503, 11.5 percent higher than in 2013.

The third report looked at changes in premiums for medical liability insurance between 2008 and 2017. While the AMA noted “increasing stability” in those costs, it noted since 2015, more premiums have increased than decreased, reversing a trend seen in the earlier part of the study period.

Additionally, physicians practicing in different states can expect a wide variation in the cost of insurance. For example, a general surgery practitioner in Nassau and Suffolk Counties in New York would be charged an average of $134,923 in 2017. In neighboring New Jersey, however, the price would drop to $60,810.

Despite industry concerns about overly litigious patients, the rate of liability claims paid on behalf of U.S. physicians actually dropped 55.7 percent between 1992 and 2014, though the mean compensation payment increased 23.3 percent over the same time period.

Some providers have tackled the problem with communication-and-resolution programs, which involve talking to patients and their families about adverse outcomes which weren’t caused by substandard care. Rather than motivating more patients to sue, it has been shown to lower hospitals’ liability costs.