Physician Assistant and Nurse Practitioner Malpractice Trends

Abstract

Trends in malpractice awards and adverse actions (e.g., revocation of provider license) following an act or omission constituting medical error or negligence were examined. The National Practitioner Data Bank was used to compare rates of malpractice reports and adverse actions for physicians, physician assistants (PAs), and nurse practitioners (NPs). During 2005 through 2014, there ranged from 11.2 to 19.0 malpractice payment reports per 1,000 physicians, 1.4 to 2.4 per 1,000 PAs, and 1.1 to 1.4 per 1,000 NPs. Physician median payments ranged from 1.3 to 2.3 times higher than PAs or NPs. Diagnosis-related malpractice allegations varied by provider type, with physicians having significantly fewer reports (31.9%) than PAs (52.8%) or NPs (40.6%) over the observation period. Trends in malpractice payment reports may reflect policy enactments to decrease liability.

Effect of state regulatory environments on advanced psychiatric nursing practice

“…One of our psychiatrist informants in North Carolina reported that acting as the supervising physician for a group of PMHNPs put him into a higher risk group and increased his malpractice insurance premiums, which represents a cost to the physician supervisor. We found this surprising since the rate of malpractice payment reports against NPs is only about 10% of those for physicians (Brock et al, 2017).…”

A description of medical malpractice claims involving advanced practice providers

“…Our results with regard to the amount of indemnity paid on behalf of various providers build on previous work. 9,14 Brock et al used the National Practitioner Data Bank to determine the rate over time that PAs, nurse practitioners, and physicians incurred: (1) claims that were paid on their behalf and (2) licensure adverse actions. 9 Of paid claims, our median indemnity of ∼$192,000 that was paid on behalf of physicians was consistent with Brock et al's report of $195,000, the latter of which was normalized to 2014 valuation and projected to decline based on the slope of previous years of data.…”

“…9,14 Brock et al used the National Practitioner Data Bank to determine the rate over time that PAs, nurse practitioners, and physicians incurred: (1) claims that were paid on their behalf and (2) licensure adverse actions. 9 Of paid claims, our median indemnity of ∼$192,000 that was paid on behalf of physicians was consistent with Brock et al's report of $195,000, the latter of which was normalized to 2014 valuation and projected to decline based on the slope of previous years of data. 9 However, our median indemnity of ∼$353,000 that was paid on behalf of PAs and ∼$57,000 that was paid on behalf of APRNs differed from Brock et al's report of $125,000 and $130,000, respectively.…”

“…Prior studies have described malpractice risk for APPs. [8][9][10][11][12][13][14] However, none has used an insurer's database, which includes claims that closed with and without indemnity payment and spans the entire country. We used a unique, national data source to understand how claim characteristics differed depending on whether PAs, APRNs, or physicians were named, including when PAs and APRNs were and were not co-named with physicians.…”

Doctors And Hospitals: A Legal Perspective On Accountability

“…Malpractice study discusses the empirical evidence liability risk of malpractice impact in doctor diagnostic imaging (Li & Brantley, 2015), most often focuses on tabulation and comparison of claims by type of service providers (Brock, Nicholson, & Hooker, 2016;Miller, 2013;Miller, 2012;Miller, 2011), identifying the causes of frequent allegations resulting from diagnosis (Miller, 2013;Miller, 2012;Miller, 2011); Doctors have higher claims rates than assistants and nurses (Brock Nicholson, & Hooker, 2016;Leigh & Flynn, 2013); doctor disciplinary action in practice (Brock Nicholson, & Hooker, 2016;Leigh & Flynn, 2013;Balestra, 2013).…”