Although you may think so given the craziness of some of our PopTort posts, the topic of “weed” doesn’t often appear in ThePopTort. Except weed can mean lots of things. There’s also the “bad apple” kind of “weed," which is actually part of our regular vocabulary over here! (No, this is not a disguised vegetation blog, although we have occasionally gone that route.) “Weed” tends to show up this way:
- Here’s how to reduce malpractice, injuries, claims and lawsuits: Weed out the small number of doctors responsible for most malpractice, especially repeat offenders who should not be practicing at all.
- If state agencies would do their job and weed out the small number of doctors committing the most malpractice, everyone wins.
Finally, this notion is getting some respect. The New England Journal of Medicine has just published a new study finding that:
Just 1 percent of active U.S. physicians are responsible for nearly a third of the nation's paid malpractice claims.
And, the more paid claims doctors incurred, the higher their risk of future paid claims, the study found.
What’s more, “[O]nly 6 percent of all active U.S. physicians had a paid claim.” Say the authors,
The results suggest it may be possible to identify “claim-prone” physicians and intervene before they encounter additional claims, said study lead author David Studdert, professor of medicine and law at Stanford University in Palo Alto, Calif.
"I think a lot of liability insurers and health care organizations have not taken that analytical step to really understand who these folks are,” he said.
They also confirm that certain specialties have the highest claims. Say the researchers:
Neurosurgeons, orthopedic surgeons, general surgeons and obstetrician-gynecologists were among those who faced double the risk of future claims, compared with internal medicine physicians, the study showed.
That's partly due to the nature of the work, [David Sousa, chief operating officer and general counsel of Medical Mutual in Raleigh, N.C., which insures some 13,000 doctors in 22 states] explained. “OBs [obstetricians] forever in this country have been the prime target, because if something goes wrong in the delivery of a newborn child, the injuries are devastating,” he said.
True. Brain injuries in newborns can be catastrophic, requiring a lifetime of care. But the study found that a physician’s specialty or even the nature of the injuries they cause, is not “the most important predictor of a claim.” Instead,
The most important predictor of a claim appeared to be a physician's past claims history. Compared with doctors with one previous paid claim, those with two paid claims had almost twice the risk of having another. Physicians with three paid claims had three times the risk. Those with six or more had more than 12 times the risk, the study found.
Are they bad doctors or just more likely to attract claims?
“It is a very reasonable question to ask why it's possible to accumulate four or five paid claims in a 10-year period and continue to practice [medicine],"” Studdert said. “We don't know the answer to that question.”
Yet we do know one answer: state disciplinary boards do nothing to weed out this small number of bad doctors responsible for this large chunk of malpractice payouts. We know this from Public Citizen’s work (see the Center for Justice & Democracy briefing book beginning on page 8), which is why we do take exception to the comment from lead author Studdert, who said, “there's never been a national study of how malpractice claims are distributed among physicians.” Public Citizen has been doing such studies for years, which is why we’ve been talking about it for years. And it may have led to this dismissive comment from Dr. Sousa, who said, “I don't believe that they discovered anything new.”
But that may be the scariest comment of all.
Comments