February 5, 2013

162017_132140396847214_292624_nIn a study from 1997, the researchers reported on the differences in characteristics among surgeons in the United States who had no medical malpractice claims filed against them, low rates of medical malpractice claims, and high medical malpractice claim rates. The study involved the malpractice claims experience of 427 surgeons: 148 orthopedic surgeons, 115 obstetrician-gynecologists, and 164 other surgeons (“other surgeons”), all of whom were members of the California-based liability-protection trust, Cooperative of American Physicians (“Cooperative”).

The study defined medical malpractice claims as malpractice claims that had been filed, had been in litigation, and which had been closed by settlement or otherwise. The claims rate was determined by dividing the number of medical malpractice claims (lawsuits) by the number of years as a member of the Cooperative. The medical malpractice claim rates were separated into four categories: no claims, low claim rates (less than 0.13 mean claims per year), high claim rates (between 0.54 and 0.61 mean claims per year), and surgeons who had been terminated from membership in the Cooperative but remained in active practice (between 0.90 to 1.4 mean claims per year).

Surgeon Characteristics Affecting Medical Malpractice Claim Rates

The study found that orthopedic surgeons who had been terminated by the Cooperative were significantly younger (49 years old) than those in the other two surgeon groups.

Orthopedic surgeons who were born in the United States were significantly more likely to be in the no claims or low claims groups when compared to surgeons in the high claims group (no matter which claims group obstetrician-gynecologists were in, they were less likely to have been born in the United States than surgeons in the other two groups).

Marital status had no effect on which claims rate group the surgeons were in.

More of the orthopedic surgeons and “other surgeons” who had been terminated from the Cooperative attended a medical school outside of the United States or Canada than those with no claims or low claims.

The surgeons who had been terminated from the Cooperative tended to have been less likely to have completed a fellowship than those with no claims or few claims.

All surgeons who had been terminated from the Cooperative were less likely to be board-certified than those surgeons with no claims or few clams.

The study found no significant influence in medical malpractice claim rates based on undergraduate college major, medical school prestige score, membership in honor societies, or years of specialty training.

When compared with surgeons with no claims or few claims, all surgeons terminated from the Cooperative were more likely to be in a solo medical practice.

All surgeons who had been terminated from the Cooperative were significantly less likely to have a clinical faculty appointment than surgeons with no claims or few claims.

Orthopedic surgeons who had been terminated from the Cooperative belonged to a significantly lower number of professional societies than their peers. The “other surgeons” who had been terminated from the Cooperative were less likely to be members of the American College of Surgeons than their peers with no claims or few claims.

The study’s authors stated, “Our data suggest that lower rates of malpractice may be associated with greater collegial interaction, such as an increased opportunity for formal and informal consultations in group practices and the awareness of new therapeutic advances through membership in professional societies, clinical faculty teaching, and for orthopedists, higher levels of moral reasoning …. The findings reported in this study generally support the view that personal, educational, and professional characteristics of physicians themselves (in this case surgeons) may contribute substantially to the incidence and outcome of malpractice claims.”

Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1303954/pdf/westjmed00341-0039.pdf

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