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01
Apr 2016

Just One Bad Apple M.D. Ruins the Malpractice Pool

Will technology help eliminate malpractice? Maybe someday in the near future it will. A recent report in the New England Journal of Medicine found that roughly one percent of all physicians account for 32 percent of malpractice claims. So just one bad doctor out of 100 ruins the fates and rates for patients and physicians alike.

Between 2004 and 2015, researchers from Stanford and the University of Melbourne in Australia looked at 66,426 malpractice claims against 54,099 physicians from the National Practitioner Data Bank, an electronic repository created by Congress in 1986 to improve healthcare quality. The study found that 84 percent of the paid claims were for one-and-done doctors while 16 percent of the physicians had two claims, which accounted for 32 percent of the malpractice claims.

During the study’s 10-year time period, more than $24.6 billion was paid by physicians/medical malpractice insurance plans to satisfy court verdicts and out-of-court settlements of medical malpractice cases. That $24.6 billion does not even include the substantial costs for bringing and defending those claims.

Even more alarming was how many malpractice events were life-altering. Nearly one-third of the claims involved patients who died, while 54 percent were related to “major” or “significant” physical injury. The average payout on a successful malpractice claim was more than $371,000, the study’s research revealed.

The most telling nugget of information was that 4 percent of the physicians had at least three paid claims, accounting for 12 percent of the malpractice claims. Then the number-crunchers dug deeper to see if there were patterns or common characteristics among the offending physicians. Sure enough, there was.

The study found that the physicians who accounted for an outsized share of the claims had a set of distinctive characteristics. The Stanford researchers found that the claim-prone doctors were disproportionately male (82 percent) and were older, rather than younger. More than 50 percent of the claims were by physicians in four areas: internal medicine, obstetrics/gynecology, general surgery and general practice/family medicine.

However, the biggest predictor of all for claim-prone doctors was whether they’d had a prior claim. The Stanford researchers focused on paid (rather than unpaid) claims, stating that those claims were markers for substandard care. Interestingly, approximately only 1 in 3 malpractice claims is ultimately paid. The study noted that only 6 percent of physicians had any paid claims over the study’s 10-year period.

So how can technology help?

The study shows that the bad doctors have been causing a disproportionate amount of malpractice claims. Like a bad driver on the highway with a long list of traffic violations, how does a state get a physician off the proverbial road before injuring yet another patient?

In California, patients are able to review their physician’s record on the state’s medical board website. Depending on the malpractice settlement type, it will be part of the public record if the doctor has had either three or four settlements within a 5-year period. Other information is also available on the website, including whether your physician has had any felony convictions or is on probation. Patients can use the state’s website to determine that a doctor’s license is valid.

There are also websites that rate physicians, such as Healthgrades.com, RateMD.com, Vitals.com, WebMD.com and of course, Yelp.com. Surveying these websites can help patients learn of clinical missteps or issues that may raise an eyebrow or two.

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