An Examination of Medical Malpractice Claims Involving Physician Trainees

Myers, Laura C.; Gartland, Rajshri M.; Skillings, Jillian; Heard, Lisa; Bittner, Edward A.; Einbinder, Jonathan S.; Metlay, Joshua P.; Mort, Elizabeth

doi:10.1097/acm.0000000000003117

Cited by 22 publications

(20 citation statements)

References 27 publications

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“…Overall, general surgery had higher risk of malpractice when compared with other surgical subspecialties, 18 54 however, agreement was not universal. 55 Grey literature and published academic papers reported GPs and family medicine specialists comprise a large proportion of total claims (34%–62%) and were up to three times as likely to be subject to claims. 33 50 55 56 Other high-risk specialties include psychiatry, obstetrics and gynaecology, which were noted to be between four and 17 times as likely to be subject to malpractice claims compared with GPs.…”

Section: Resultsmentioning

confidence: 99%

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Systematic review of the factors and the key indicators that identify doctors at risk of complaints, malpractice claims or impaired performance

Austin

Nullwala

et al. 2021

BMJ Open

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ObjectiveTo identify the risk factors associated with complaints, malpractice claims and impaired performance in medical practitioners.DesignSystematic review.Data sourcesOvid-Medline, Ovid Embase, Scopus and Cochrane Central Register of Controlled Trials were searched from 2011 until March 2020. Reference lists and Google were also handsearched.ResultsSixty-seven peer-reviewed papers and three grey literature publications from 2011 to March 2020 were reviewed by pairs of independent reviewers. Twenty-three key factors identified, which were categorised as demographic or workplace related. Gender, age, years spent in practice and greater number of patient lists were associated with higher risk of malpractice claim or complaint. Risk factors associated with physician impaired performance included substance abuse and burn-out.ConclusionsIt is likely that risk factors are interdependent with no single factor as a strong predictor of a doctor’s risk to the public. Risk factors for malpractice claim or complaint are likely to be country specific due to differences in governance structures, processes and funding. Risk factors for impaired performance are likely to be specialty specific due to differences in work culture and access to substances. New ways of supporting doctors might be developed, using risk factor data to reduce adverse events and patient harm.PROSPERO registration numberPROSPERO registration number: CRD42020182045.

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Section: Resultsmentioning

confidence: 99%

“… 39 51 60 61 64 In contrast, three studies reported practitioners with fewer years in practice had higher odds of a malpractice claim or medical litigation. 55 65 66 …”

Section: Resultsmentioning

confidence: 99%

Systematic review of the factors and the key indicators that identify doctors at risk of complaints, malpractice claims or impaired performance

Austin

Nullwala

et al. 2021

BMJ Open

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“…There is robust quality assurance, including biweekly coder conference calls, annual conferences, and auditing processes where 15% of claims are reviewed quarterly. Previous scholarly work has been published using these data 9–12 …”

Section: Methodsmentioning

confidence: 99%

Characteristics of medical malpractice claims involving emergency medicine physicians

Myers

Einbinder

Camargo

et al. 2020

J of Healthc Risk Manag

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Background: Identifying characteristics of malpractice claims involving emergency medicine (EM) physicians allows leaders to develop patient safety initiatives to prevent future harm events. Methods: A retrospective study was performed of paid/unpaid claims closed 2007 to 2016 from Comparative Benchmarking System. Claims were identified by physician specialty involved (EM, internal medicine, general surgery). Various characteristics were compared by physician specialty. Multivariable regression was performed to identify factors associated with claim payment, in which (1) physician specialty was included as a predictor and (2) only the subset involving EM physicians was analyzed. Results: Of 54,772 claims, 2760 involved EM physicians, 5886 involved internists, and 3207 involved surgeons. Death was the most common severity among EM claims (34%). Diagnosis-related allegations accounted for 58%, higher than 42% and 11% of claims involving internists and surgeons, respectively (P < 0.0001). Thirty-one percent was paid. The median indemnity paid on behalf of any defendant was $206,261 (interquartile range $55,065-527,651). The most common final diagnoses were myocardial infarction (2%), pulmonary embolus (2%), and cardiac arrest (2%). Procedure-related claims were associated with increased payment likelihood (odds ratio 1.21, 95% confidence interval 1.10-1.34). Conclusion: Malpractice claims in EM are often diagnosis-or procedure related. Our findings suggest that diagnostic accuracy and procedural competency should shape future quality improvement work.

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“…There is robust quality assurance, including biweekly coder conference calls, annual conferences, and auditing processes whereby 15% of the claims are reviewed quarterly. Several studies have been published using the database 15‐18 …”

Section: Methodsmentioning

confidence: 99%

“…Several studies have been published using the database. [15][16][17][18] The Institutional Review Board provided an exemption (2019P001490).…”

Section: E T H O D S Study Design and Data Sourcementioning

confidence: 99%

A description of medical malpractice claims involving advanced practice providers

Myers

Sawicki

Heard

et al. 2020

J of Healthc Risk Manag

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This article is ASHRM CE eligible. Earn 1.0 credit hours of Continuing Education by passing an online quiz based on your reading at ASHRM.org/JournalCE. [This article is updated on November 10, 2020, after first online publication, to identify it as a CE article.] Background: The number of physician assistants (PAs) and advanced practice registered nurses (APRNs), together known as advanced practice providers (APPs), has risen dramatically. The goal is identifying characteristics of paid medical malpractice claims, in which APPs are defendants. Methods: Retrospective cohort study using Harvard's malpractice insurer's national database. Closed claims (2007-2016) with PAs, APRNs, or physicians as defendants. The primary analysis compared claims by role group by patient-, provider-, and claim-level characteristics. Supplemental analyses compared claims naming APPs with and without physicians. Multivariable logistic regression identified variables associated with claim payment. Results: Of 54,772 claims, PAs were defendants without APRNs or physicians in 26 claims; APRNs were defendants without PAs or physicians in 63; physicians were defendants without PAs or APRNs in 37,354. Approximately 75% of claims naming APPs co-named physicians. More claims naming PAs and APRNs were paid on behalf of the hospital/practice (38% and 32%, respectively) compared with physicians (8%, P < 0.001). Payment was less likely for inpatient care (OR 0.89, 95% CI 0.85-0.93, P < 0.001) but higher when APRNs were defendants (1.82, 1.09-3.03), when procedure-related (1.31, 1.25-1.38, P < 0.001) or patients died (1.09, 1.03-1.16, P = 0.003). Conclusions: These results can inform patient safety initiatives to prevent future harms. The target is outpatient airway procedures performed by APRNs.

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An Examination of Medical Malpractice Claims Involving Physician Trainees

Cited by 22 publications

References 27 publications

Systematic review of the factors and the key indicators that identify doctors at risk of complaints, malpractice claims or impaired performance

Systematic review of the factors and the key indicators that identify doctors at risk of complaints, malpractice claims or impaired performance

Characteristics of medical malpractice claims involving emergency medicine physicians

A description of medical malpractice claims involving advanced practice providers

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