Specialists, particularly surgeons (85%) and Ob/Gyns (85%), were far more likely to be sued than primary care doctors. Psychiatrists (29%) and dermatologists (28%) were the specialists named least frequently in lawsuits.
More than half (55%) of physicians responding to a Medscape survey say they’ve been sued for malpractice at least once in their career, and many say that experience changed their attitudes toward their patients.
The findings represent a 15% increase in malpractice suits over Medscape’s 2013 Malpractice Report.
“We really need to do something about this,” said Hansa Bhargava, MD, senior medical correspondent for Medscape. “We’re talking about the costs of medicine, and we know how much healthcare costs per capita, but we still have this system where there are a lot of lawsuits.”
Failure to diagnose a patient’s condition or complications arising from treatment were the most common reasons that patients sued, the survey found.
Medscape received more than 4,000 responses from physicians across 25 specialties and found that specialists, particularly surgeons (85%) and Ob/Gyns (85%), were far more likely to be sued than primary care doctors. Psychiatrists (29%) and dermatologists (28%) were the specialists named least frequently in lawsuits.
Accordingly, malpractice insurance premiums range from nearly $200,000 annually for a New York City Ob-Gyn, to about $38,000 for an internist.
Being the subject of a malpractice suit took 58% of physicians by surprise and 51% said the experience changed their attitudes towards patients; 26% say they no longer trust patients or treat them differently, such as practicing defensive medicine; 6% left the practice setting, and 3% changed insurers, the survey found.
“I was surprised with how only 26% of doctors say they no longer trust patients,” Bhargava said. “Being sued, and especially since a lot of these lawsuits are either dismissed or settled out of court, can be a very scarring experience, especially if you aren’t at fault, which speaks to the fact that most physicians go into the profession because they truly want to help patients.”
Most suits were dismissed or settled before trial but the experience takes its toll on physicians, one-third of whom said they spent more than 40 hours preparing their defense. The same percentage said it took three to five years to resolve their case.
Fifty-eight percent of physicians said they were either encouraged or required to settle by their hospital or malpractice insurer.
“I could tell you stories of colleagues who have been sued and more than often the hospital or insurer just wants to settle,” Bhargava said. “They don’t want to incur charges, and it is time consuming for everyone involved.”
“The other issue is that if patient sues, the attorney will go through the chart and sue every single doctor and nurse on the chart because they want to cover all the bases,” she said. “That creates a lot of negativity toward the system and the patient.”
The majority of physicians cited better communication with patients as a way to reduce the number of malpractice suits, along with medical screening panels to determine the merits of a suit and caps on non-economic damages.
“We’re not just saying ‘doctors communicating better with patients,’ but perhaps putting less emphasis on RVUs or how many patients you see each hour or you have to document this and that,” Bhargava said. “Giving time to speak with the patient, which is so essential in healthcare, I’d like to see that more.”
That better communication, apparently, does not involve an apology. Only 2% of physicians said that “saying ‘I’m sorry’ would have made a difference.” Eighty-three percent said it made no difference.
“It probably speaks to the larger issue of the patient/physician relationship,” Bhargava said. “Physicians are feeling boxed in, especially with the requirements around documentation and billing, and that time for the patient/physician interaction has decreased. So, perhaps physicians feel there is no room to build a relationship because they don’t have time for it, so what is the point of saying ‘I’m sorry.’”
John Commins is the news editor for HealthLeaders.