Docs win most malpractice suits, but road is long

• Public Health • May 23, 12

Malpractice claims against U.S. doctors are often dismissed, and when they go to trial, the verdict is usually in the doctor’s favor, according to a new study.

But even when a case is dismissed, the road is typically long for both doctors and the patients suing, researchers said.

“Most claims go in favor of the physician, and they take a long time to resolve,” said lead researcher Dr. Anupam B. Jena, of Massachusetts General Hospital and Harvard Medical School in Boston.

Medical malpractice claims have become a hot-button issue in the U.S., coming up repeatedly in debates about healthcare reform. Some specialists must pay a couple hundred thousand dollars a year in premiums for insurance against malpractice claims—though rates vary by state.

But not much has been known about how long malpractice claims take to resolve, or what proportion of them actually end in a payment to patients, according to Jena.

For their study, he and his colleagues looked at more than 10,000 malpractice claims against U.S. doctors closed between 2002 and 2005.

They found that of all claims, about 55 percent resulted in an actual lawsuit.

Of those litigated claims, more than half were dismissed by the court. And out of the rest, most were resolved before a verdict; less than five percent ended up being decided by a trial verdict.

When there was a verdict, it went in favor of the doctor 80 percent of the time, Jena’s team reported in the Archives of Internal Medicine.

What stands out in the findings, Jena said, was the length of time cases took to resolve—even when they were dismissed.

On average, lawsuits dismissed in court took more than 20 months, and those resolved before a verdict took over 28 months.

Cases that went all the way to a trial verdict typically lasted a few years: 39 months, on average, when it went in favor of the doctor, and close to 44 months when the patient won.

“It is hard on everyone,” Jena told Reuters Health.

For doctors, the outcomes of claims varied by specialty—which is not surprising, Jena noted.

For example, internists were among the most likely to have cases against them dismissed in court. Pathologists and pediatricians were least likely: about 36 percent of cases against pathologists, and a little over 40 percent against pediatricians, were dismissed.

That makes sense, according to Jena. Pathologists study lab test samples and are key in diagnosing diseases. If they seem to have missed something, there is going to be more scrutiny. The same may be true in cases against pediatricians because a child is involved.

DEALING WITH ERRORS

“Medical malpractice is necessary,” Jena said, “because there are clearly cases where patients are harmed by negligent care.”

But, he added, the lengthy legal process, even in cases that are dismissed before trial, is an issue.

For doctors, Jena said, “there’s anxiety, and the potential for damage to their reputation.”

And for patients, those that have suffered real harm often end up in a long battle. “We need better ways of identifying those patients and making sure they are compensated more quickly,” Jena said.

He pointed to some measures that already exist. Some hospitals and healthcare systems have started “early disclosure” programs, where they try to spot medical errors and proactively tell patients about them and offer compensation.

And a majority of U.S. states now have so-called “apology” laws. Under those, doctors who have made an error can own up to it, without having that apology used as evidence against them if there is a lawsuit.

The goal of those laws has been to curb malpractice claims, because litigants often cite anger over a doctor’s perceived lack of remorse as a reason for suing.

And a recent study hinted that apology laws may be working as intended. Researchers estimated that in states with apology laws, cases involving the most severe injuries settled about 20 percent faster, and payments in those cases were lower.

SOURCE: Archives of Internal Medicine, online May 14, 2012.

###

Outcomes of Medical Malpractice Litigation Against US Physicians

There are few estimates of the rates and outcomes of malpractice litigation according to physician specialty as well as of the time required to resolve litigated claims of varying types. In our study, approximately 50% of all claims involved litigation, with half of these litigated claims being dismissed in court. A large percentage of litigated claims were resolved before verdict. Outcomes of litigation varied substantially according to specialty. The length of time required to resolve claims was twice as great for litigated than for nonlitigated claims, and time to resolution was considerable even among claims that were dismissed in court. While most claims were ultimately decided in a physician’s favor, that resolution came only after months or years. The substantial portion of litigated claims that are not dismissed in court and the length of time required to resolve litigated claims more generally may help explain why malpractice claims undergoing litigation are an important source of concern to physicians.

Anupam B. Jena, MD, PhD; Amitabh Chandra, PhD; Darius Lakdawalla, PhD; Seth Seabury, PhD

Print Version
Tell-a-Friend