What types of doctors are most likely to get sued?

Talk to a doctor about medical malpractice, and he or she is likely to tell you this: Patients don’t necessarily sue because a doctor made a mistake, they sue because they got a bad outcome.

A report released today by the New England Journal of Medicine bears this out. It finds that in a given year, 7.4% of doctors (on average) get sued by patients, but only 20% of those claims (on average) result in some sort of payment.

Researchers from Harvard, USC and the Rand Corp. in Santa Monica examined malpractice claims against nearly 41,000 doctors who were covered by a single insurance company from 1991 to 2005. They found that claims against doctors in low-risk specialties (such as pediatrics and psychiatry) fell over the course of the study, while claims against doctors in high-risk specialties (mainly surgeons) peaked from 1995 to 2000.

So, which doctors were most likely to be sued? Neurosurgeons topped the list, with 19.1% of them facing a claim each year. They were followed by thoracic-cardiovascular surgeons (18.9%) and general surgery (15.3%). Rounding out the top 10 specialties were orthopedic surgery, plastic surgery, gastroenterology, obstetrics & gynecology, urology, pulmonary medicine and oncology.

At the other end of the spectrum, only 2.6% of psychiatrists got sued in a given year, followed by 3.1% of pediatricians and 5.2% of family practice physicians. The other kinds of specialists least likely to be sued were dermatologists, pathologists, nephrologists, ophthalmologists, diagnostic radiologists, anesthesiologists and emergency medicine doctors.

But the likelihood of being sued didn’t necessarily correlate to the likelihood of having to make a payment to a patient – either a jury award or a settlement reached out of court. The researchers found that gynecologists (considered separately from obstetricians) were the most likely to make a payment when sued, though they were only 12th most likely to be sued in the first place. And though neurosurgeons were most likely to be sued, thoracic-cardiovascular surgeons, general surgeons and orthopedic surgeons were all more likely to have to pay a malpractice claim over the course of a year.

When payments were made, they averaged just under $275,000 per claim. For pediatricians, the average claim was nearly twice as high, at $520,924, and for pathologists it was $383,509. Both of those figures were higher than the average claim paid by neurosurgeons – $344,811 – despite the fact the neurosurgeons faced the most lawsuits.

Those averages were pushed up by the very small number of settlements and jury awards that exceeded $1 million – only 66 over the entire study period. Eleven of those payments were made by OB/GYNs, 10 were made by pathologists, seven by anesthesiologists and seven by pediatricians.

Though it’s clear that some doctors faced a higher risk of lawsuits than others, almost all doctors could expect to get sued at least once over the course of their careers. Among physicians in high-risk specialties, 88% were projected to be hit with their first lawsuit by the age of 45, and 99% would be sued at least once by the time they were 65, the researchers calculated. Among physicians in low-risk specialties, 36% were projected to be named in a lawsuit by age 45, but by the age of 65 that proportion was expected to climb to 75%, according to the report.

You can read the entire study on the New England Journal of Medicine’s website.