Experiences of neurological surgeons with malpractice lawsuits

OBJECTIVEAs a specialty that treats acute pathology and refractory pain, neurosurgery is at risk for high liability, making the practice of defensive medicine quite common. The extent to which the practice of defensive medicine is linked to experience with malpractice lawsuits remains unclear. The aims of this study were to clarify this by surveying neurosurgeons about the frequency of experiencing medical lawsuits and to show how neurosurgeons reflect on facing such lawsuits.METHODSA survey consisting of 24 questions was distributed among members of the Congress of Neurological Surgeons. The survey consisted of four parts: 1) demographics of participants; 2) the way malpractice lawsuits affect the way respondents practice medicine; 3) experiences with medical malpractice lawsuits; and 4) the effect of the medical malpractice environment on one’s own practice of medicine.RESULTSThere were a total of 490 survey respondents, 83.5% of whom were employed in the US. Of the respondents, 39.5% stated they were frequently or always concerned about being sued, and 77.4% stated their fear had led to a change in how they practice medicine. For 58.4%, this change led to the practice of defensive medicine, while for others it led to more extensive documentation (14.3%) and/or to referring or dropping complex cases (12.4%).Among the respondents, 80.9% at some time were named in a medical malpractice lawsuit and 12.3% more than 10 times. The main concerns expressed about being sued included losing confidence and practicing defensive medicine (17.8%), personal assets being at risk (16.9%), and being named in the National Practitioner Data Bank (15.6%). Given the medical malpractice environment, 58.7% of respondents considered referring complex patient cases, whereas 36.5% considered leaving the practice of medicine. The fear of being sued (OR 4.06, 95% CI 2.53–6.51) and the consideration of limiting the scope of practice (OR 3.08, 1.80–5.20) were both independently associated with higher odds of considering leaving the practice of medicine.CONCLUSIONSThe current medicolegal landscape has a profound impact on neurosurgical practice. The fear of being sued, the financial aspects of practicing defensive medicine, and the proportion of neurosurgeons who are considering leaving the practice of medicine emphasize the need for a shift in the medicolegal landscape to a system in which fear of being sued does not play a dominant role and the interests of patients are protected.

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An Analysis of Otolaryngology Medical Malpractice Payments From the National Practitioner Data Bank

Otolaryngology ◽

10.1177/0194599820942498 ◽

2020 ◽

pp. 019459982094249

Author(s):

Christopher T. Breen ◽

Saral Mehra

Keyword(s):

Medical Malpractice ◽

Kendall Test ◽

Data Bank ◽

Annual Number ◽

Patient Age ◽

Cross Sectional ◽

Patient Âgé ◽

Trends Over Time ◽

National Practitioner Data Bank ◽

Sectional Analysis

Objective To describe malpractice payments made on behalf of otolaryngologists, analyze trends over time, and test the association of payment amount with severity of alleged malpractice and patient age. Study Design Retrospective cross-sectional analysis. Setting National Practitioner Data Bank. Subjects and Methods This study comprised all payments made on behalf of otolaryngologists from 1991 to 2018 that were reported to the National Practitioner Data Bank. Descriptive statistics were calculated within and across years. Trends in payments were analyzed with the Mann-Kendall test. Generalized linear regression was utilized to test for association of payment amount with severity of the alleged injury and patient age. Results From 1991 to 2018, there was a significant decrease in the number of payments (272 to 81) and number of otolaryngologists on whose behalf payments were made (250 to 77). Mean and median payments increased significantly from $248,848 to $420,386 and from $96,813 to $275,000, respectively. By severity of alleged injury, mean payments ranged from $39,755 (95% CI, $20,957-$75,412) for insignificant injury to $754,349 (95% CI, $624,847-$910,692) for patients who were left quadriplegic, sustained brain damage, or required lifelong care. By patient age, mean payments for patients ≥60 years old were $191,465 (95% CI, $159,880-$229,292) versus $247,878 (95% CI, $209,416-$293,402) for patients aged 20 to 39 years and $232,225 (95% CI, $197,691-$272,793) for patients aged 40 to 59 years. Conclusion The annual number and total value of malpractice payments decreased, while the annual mean and median payments increased. Payment amount was associated with severity of alleged malpractice and patient age.

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The Growth Of Physician Medical Malpractice Payments: Evidence From The National Practitioner Data Bank

Health Affairs ◽

10.1377/hlthaff.w5.240 ◽

2005 ◽

Vol 24 (Suppl1) ◽

pp. W5-240-W5-249 ◽

Cited By ~ 49

Author(s):

Amitabh Chandra ◽

Shantanu Nundy ◽

Seth A. Seabury

Keyword(s):

Medical Malpractice ◽

Data Bank ◽

National Practitioner Data Bank

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Clinical Judgment Revisited

Methods of Information in Medicine ◽

10.1055/s-0038-1634415 ◽

1999 ◽

Vol 38 (04/05) ◽

pp. 279-286 ◽

Cited By ~ 5

Author(s):

L. L. Weed

Keyword(s):

Decision Making ◽

Medical Practice ◽

Clinical Judgment ◽

Medical Information ◽

Patient Records ◽

Practice Of Medicine ◽

The Way

AbstractIt is widely recognised that accessing and processing medical information in libraries and patient records is a burden beyond the capacities of the physician’s unaided mind in the conditions of medical practice. Physicians are quite capable of tremendous intellectual feats but cannot possibly do it all. The way ahead requires the development of a framework in which the brilliant pieces of understanding are routinely assembled into a working unit of social machinery that is coherent and as error free as possible – a challenge in which we ourselves are among the working parts to be organized and brought under control.Such a framework of intellectual rigor and discipline in the practice of medicine can only be achieved if knowledge is embedded in tools; the system requiring the routine use of those tools in all decision making by both providers and patients.

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