Physicians with Multiple Paid Medical Malpractice Claims: Are They Outliers or Just Unlucky?

30 Pages Posted: 24 Jun 2018 Last revised: 9 Apr 2019

Date Written: March 1, 2019

Abstract

We extend Studdert et al. (NEJM, 2016). We examine to what extent a physician who has past paid medical malpractice (“med mal”) claims in a defined prior period is more likely to have additional paid claims in a defined future period, relative to a physician with no prior-period claims. Our simulation implements a null hypothesis that paid claims are random events, with arrival risk depending on state and specialty, but not on physician-specific factors (such as technical ability, bedside manner, and communication skills). We show that even a single paid claim in the prior five years nearly quadruples the likelihood of a paid claim in the next five years, and dramatically increases the likelihood of 2+ future paid claims. More generally, the number of prior paid claims strongly predicts both the likelihood of having future paid claims and the expected number of future claims. By comparing actual to simulated probabilities, we can predict the likelihood that having a given number of paid claims is attributable to chance. We find that even for physicians in high-risk specialties in high-risk states, bad luck is unlikely to explain having two paid claims in five years, and highly unlikely to explain three or more claims in 5 years. Hospitals and state medical boards can use our approach to identify physicians that are likely to benefit from graduated interventions aimed at reducing future claims and patient harm.

The Online Appendix for this paper is available at https://ssrn.com/abstract=3057095.

Keywords: medical malpractice, outliers, bad doctors, simulation

JEL Classification: K13, K41

Suggested Citation

Black, Bernard S. and Hyman, David A. and Lerner, Joshua Y., Physicians with Multiple Paid Medical Malpractice Claims: Are They Outliers or Just Unlucky? (March 1, 2019). International Review of Law and Economics, 2019. Available at SSRN: https://ssrn.com/abstract=3201919 or http://dx.doi.org/10.2139/ssrn.3201919

Bernard S. Black

Northwestern University - Pritzker School of Law ( email )

375 E. Chicago Ave
Chicago, IL 60611
United States
312-503-2784 (Phone)

Northwestern University - Kellogg School of Management

2001 Sheridan Road
Evanston, IL 60208
United States
847-491-5049 (Phone)

European Corporate Governance Institute (ECGI)

Brussels
Belgium

David A. Hyman

Georgetown University Law Center ( email )

600 New Jersey Avenue, NW
Washington, DC 20001
United States

Joshua Y. Lerner (Contact Author)

Northwestern University - Pritzker School of Law ( email )

375 E. Chicago Ave
Chicago, IL 60611
United States

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