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Surgeons Face Higher Risks for Malpractice Compared to Their Non-Surgical Colleagues
21 Pages Posted: 7 Apr 2023
More...Abstract
Background: Malpractice claims can negatively influence the careers of physicians, contributing to the increased physician drop-out rates. It is assumed that surgeons face higher risks for a claim although this is not yet objectively determined. The objective of the present study was to determine the risk for malpractice claims for physicians from surgical specialties, specialties with surgical characteristics and non-surgical specialties.
Methods: A retrospective observational study using anonymized closed malpractice claims between 2007 up to 2021 from Dutch insurers (Centramed and MediRisk) that currently insure >85% of Dutch hospitals was carried out with an emphasis on surgical specialties. Main outcomes involved claim volume & outcome, and the estimated annual risk (EAR) for a claim per year for the individual physician from a particular specialty. Sustained or settled claims were considered unfavorable for the physician (UOP).
Results: Surgical specialties and specialties with surgical characteristics accounted for 77% (14,330/18,649) of the claims closed. Liability was denied in 51% of the claims (n=9,487). The remaining claims were sustained (n=4,600; 25%), settled (n=3,444; 18%) or closed without decision (n=1118; 6%). Surgeons faced an average EAR of 21.6% (range 6.5% - 28%) which was higher compared to colleagues from specialties with surgical characteristics (EAR 7.3%; range 2.9% - 10.1%) and non-surgical specialties (EAR 2.5%; range 0.9% - 4.4%). The average risk for an UOP was 9.3% per year for surgeons. Orthopedic- (EAR 28.3%; UOP 10.9%), General- (EAR 22.6%; 10.6%), and Plastic Surgeons (EAR 16.6%; UOP 5.7%) were most at risk for a claim, annually.
Conclusions: The present study is the first study to compare the risk for a malpractice claim for all major medical specialties over a fifteen-year period on a nationwide scale. Surgeons received more claims than their non-surgical colleagues. Relative to specialty size, surgeons faced a higher risk for a claim in general, as well as for a claim with an unfavorable outcome.
Funding: No external funding was received for this research.
Declaration of Interest: Clemens Dirven and Peter Vandertop gave independent medical advice in some of the claims that were included in the present study. Quirine Amelink contributed to the present study in a personal capacity, not in relationship with her current affiliation through the Dutch Health and Youth Care Inspectorate. Wouter Dronkers, Jan van Rees, Désirée Klemann, Dennis Buis, Dirk Grünhagen, Marike Broekman, Aart Hendriks, Eric Boersma, Markus Klimek, and Jochem Spoor have no disclosures.
Ethical Approval: The present study was approved by the Institutional Review Board of the Erasmus University Medical Centre, Rotterdam, (METC 2020-0972) and was performed in accordance with the Declaration of Helsinki.
Keywords: claim, error, health law, malpractice, medical litigation, negligence, second victim, surgery
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