Provider and Practice Factors Associated With Emergency Physicians’ Being Named in a Malpractice Claim

Abstract

Objective We examine the association between emergency physician characteristics and practice factors with the risk of being named in a malpractice claim. Methods We used malpractice claims along with provider, operational, and jurisdictional data from a national emergency medicine group (87 emergency departments (EDs) in 15 states from 1/1/2010 to 6/30/2014) to assess the relationship between individual physician and practice variables and being named in a malpractice claim. Individual and practice factors included: years in practice, emergency medicine Board Certification, visit admission rate, Relative Value Units/hour generated, total visits seen as attending physician of record, working at multiple facilities, working primarily overnight shifts, patient experience data percentile, and state malpractice environment. We assessed the relationship between emergency physician and practice variables and malpractice claims using logistic regression. Results In 9,477,150 ED visits seen by 1,029 emergency physicians, there were 98 malpractice claims against 90 physicians (9%). Increasing total number of years in practice (adjusted odds ratio 1.04, 95% CI 1.02–1.06) and higher visit volume (adjusted odds ratio 1.09 per 1000 visits, 95% CI 1.05–1.12) were associated with being named in a malpractice claim. No other factors were associated with malpractice claims. Conclusion In this sample of emergency physicians, one in 11 were named in a malpractice claim over 4.5 years. Total number of years in practice and visit volume were the only identified factors associated with being named, suggesting that exposure to higher patient volumes and longer practice experience are the primary contributors to malpractice risk.

The Effect of Shared Decisionmaking on Patients’ Likelihood of Filing a Complaint or Lawsuit: A Simulation Study

“…[37][38][39][40][41][42] Recent studies in EM have failed to find physician characteristics that lead to increased litigation, other than simply volume of patients seen. 11 While this study is by no means conclusive regarding the relationship between SDM and malpractice, high-quality empiric data is not likely to be forthcoming, as SDM is variably used and variably documented. Rather than focusing on the effects of SDM on liability, physicians and researchers should work to promote clinical care that is rational and inclusive of patients' preferences.…”

“…This is quite a bit higher than reported rates of lawsuits, which have been estimated to be related to 0.001 and 0.03% of all hospital visits, suggesting that this group of participants was an appropriate cohort for testing whether an intervention changed litigiousness. 11,31…”

“…10 Emergency medicine has high malpractice risk because of the undifferentiated patient population, limited time, and high medical acuity. 11 Most EPs admit to ordering medically unnecessary imaging and cite fear of malpractice as a main reason, but also recognize that involving patients in SDM could help decrease the amount of medically unnecessary tests ordered. 7 However, no clear evidence exists regarding the effect of SDM on malpractice risk, and physicians have cited this as a barrier to implementation of SDM.…”

Age and professional experience increase the risk of encountering legal malpractice claims among emergency service physicians

“…Both Studdert et al (9) and carlson et al (10) reported >10 years as the average duration of professional experience in their studies. The times indicated in these two studies differed from those in the present study, which found that 84% of the emergency physicians had <10 years of professional experience.…”

“…Studdert et al reported that 96% of the physicians had >10 years of professional experience and the malpractice-related investigation rate was 88% (9). carlson et al reported that the average duration of professional experience of physicians was 15.7 years and malpractice rates increased by 4% each year (10).…”