Surgical specialties account for most medical malpractice claims. A retrospective observational study to determine the risk for medical malpractice claims for physicians working in hospitals in the Netherlands using anonymized closed malpractice claims between 2007 up to 2021 from two Dutch insurers found that 77% of the claims closed involved surgical specialists. The study was published in December 2024.
A total of 21,845 medical malpractice claims were closed of which 18,649 claims were included in the study. Physicians from surgical specialties accounted for 10,443 (56%) of the closed medical mal[practice claims compared to 3,887 (21%) claims against physicians from specialties with surgical characteristics, and 4,319 (23%) claims against physicians from non-surgical specialties.
Liability was denied in 51% of the claims and the remaining claims were sustained (25%), settled (18%), or closed without decision (6%). Surgical specialists received more claims than their non-surgical colleagues and surgeons faced a higher risk for a claim in general, as well as for a claim with an unfavorable outcome.
Orthopedic surgeons (28%) faced the highest estimated annual risk (EAR) of a medical malpractice claim followed by general surgeons (23%), and plastic surgeons (17%). Those who face the lowest EAR were those practicing in pediatrics ((0.9%), internal medicine (1.8%) and pathology (2.1%).
The study’s authors stated: “Compared to non-surgical specialties, the estimated annual risk for surgical specialties was up to tenfold higher. One possible explanation for this is the relatability between surgical intervention and harm. This relatability may be less noticeable in non-surgical care, resulting in fewer claims. For example, patients may more easily relate adverse events like a subsequent infection or bleeding to surgery than to non-surgical interventions. Additional argumentation for this explanation can be found in the difference in estimated risks between specialties considered entirely surgical (e.g., General Surgeons and Neurosurgeons) and specialties with surgical and non-surgical characteristics (e.g., Urologists, ENT-surgeons, and Dermatologists).”
“The total financial burden was the highest in specialties that faced most claims. Interestingly, the median burden per claim with an unfavorable outcome for the physician and the median payout per unfavorable claim were the highest in Neurology and Cardiology, followed by their surgical counterparts, Neurosurgery and Cardio-Thoracic Surgery. The severity of the injury and the expected duration of experiencing its damage play a vital role in the expected burden.”
“Patients and relatives are the primary victims … It is important to note that the physician(s) involved may also suffer. They may experience guilt, shame, or anxiety, making them ‘second victims’. The term ‘second victim’ has gained interest over the past two decades, with advocates arguing that physicians and their feelings should not be forgotten after adverse events. However, opponents to this phenomenon state that incidents and malpractice claims are part of the job, and physicians should hold a ‘face it and embrace it’ attitude. Although medical litigation should indeed be considered part of the job, negative feelings that come with complaints and claims can negatively influence the day-to-day practice of physicians. For example, physicians who face claims are more prone to severe psychological distress. Claims may also result in defensive behavior. Adequate guidance for individual physicians coping with the negative feelings that come with them, both substantively and interpersonally, is necessary for the well-being of physicians and to decrease the likelihood of practicing defensive medicine.”
If you or a loved one suffered harm due to surgical medical negligence in the United States, you should promptly find a medical malpractice lawyer in your state who may investigate your surgical medical negligence claim for you and represent you or your loved one in a surgical medical malpractice case, if appropriate.
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