Targeting Bad Doctors: Lessons from Indiana, 1975–2015

Liu, Jing; Hyman, David A.

doi:10.1111/jels.12214

Cited by 10 publications

(11 citation statements)

References 18 publications

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“…Are these physicians truly worse at the things that discipline can address, or simply more likely to face patient complaints? In other work using Indiana data, we find that psychiatrists and ob‐gyns are substantially more likely to face disciplinary action for sexual misconduct than other specialties (Liu & Hyman 2019).…”

Section: Performance and Overlap Of The Med Mal And Disciplinary Systemsmentioning

confidence: 52%

“…Although there is a significant repeat‐player effect (so not all physicians will have paid claims), that is still a substantial likelihood of having a paid claim. Physicians are also sued four to five times for every claim that results in a payout (Jena et al 2011; Liu & Hyman 2019). Thus, although there is a relatively low risk of being sued each year—and a low risk that any given suit or claim will result in a payout—those risks still accumulate over a practice lifetime.…”

Section: Discussionmentioning

confidence: 99%

“…Also, some physicians educated in non‐U.S. medical schools may practice in settings (rural areas, low‐income areas) where finding a replacement could be hard, which the licensing board might take into account in deciding whether to take disciplinary action (Liu & Hyman 2019). Yet those places tend to have lower overall med mal risk, so this can at most be a partial explanation.…”

Section: Discussionmentioning

confidence: 99%

“…The closest study to ours is Liu and Hyman (2019). They use data from 1977–2015 for almost 30,000 Indiana‐licensed physicians to study the degree of overlap of the med mal and disciplinary systems.…”

Section: Literature Review Data Sources and Analytical Strategymentioning

confidence: 91%

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Medical Malpractice and Physician Discipline: The Good, The Bad and The Ugly

Hyman¹,

Rahmati²,

Black³

2021

J Empirical Legal Studies

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We study the overlap between the medical malpractice (med mal) and medical disciplinary systems using the records of almost 90,000 Illinois physicians who held an active license at any point from 1990–2016. We quantify the specialty‐specific risk of having a paid med mal claim or a disciplinary action; how many physicians have both; and the extent to which physicians with two or more paid claims or two or more disciplinary actions account for a disproportionate share of the activity of both systems. We also examine which factors are associated with paid claims and disciplinary actions, and whether physicians with multiple paid claims or disciplinary actions are concentrated at particular hospitals. Physicians with two or more paid claims account for only 2.37 percent of all licensed physicians, but they account for 53 percent of paid claims and payouts. Physicians with two or more disciplinary actions account for only 0.47 percent of physicians but 28 percent of all disciplinary actions. The risk of paid claims and disciplinary actions varies greatly by specialty. Physicians who attended non‐U.S. medical schools are more likely to have paid claims but (except for high‐disciplinary‐risk specialties) are not more likely to be subject to disciplinary action. Physicians with prior paid claims are more likely to be the target of disciplinary action—but not vice versa. A small number of Illinois hospitals are staffed by physicians with unusually high numbers of paid med mal claims, disciplinary actions, or both.

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Section: Performance and Overlap Of The Med Mal And Disciplinary Systemsmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Literature Review Data Sources and Analytical Strategymentioning

confidence: 91%

See 2 more Smart Citations

Medical Malpractice and Physician Discipline: The Good, The Bad and The Ugly

Hyman¹,

Rahmati²,

Black³

2021

J Empirical Legal Studies

Self Cite

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“…32 In Indiana, USA, drug or alcohol abuse and drug diversion were the most common reasons for a disciplinary complaint. 45…”

Section: Substance Use Complaintsmentioning

confidence: 99%

Systematic review of the factors and the key indicators that identify doctors at risk of complaints, malpractice claims or impaired performance

Austin

Nullwala

et al. 2021

BMJ Open

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ObjectiveTo identify the risk factors associated with complaints, malpractice claims and impaired performance in medical practitioners.DesignSystematic review.Data sourcesOvid-Medline, Ovid Embase, Scopus and Cochrane Central Register of Controlled Trials were searched from 2011 until March 2020. Reference lists and Google were also handsearched.ResultsSixty-seven peer-reviewed papers and three grey literature publications from 2011 to March 2020 were reviewed by pairs of independent reviewers. Twenty-three key factors identified, which were categorised as demographic or workplace related. Gender, age, years spent in practice and greater number of patient lists were associated with higher risk of malpractice claim or complaint. Risk factors associated with physician impaired performance included substance abuse and burn-out.ConclusionsIt is likely that risk factors are interdependent with no single factor as a strong predictor of a doctor’s risk to the public. Risk factors for malpractice claim or complaint are likely to be country specific due to differences in governance structures, processes and funding. Risk factors for impaired performance are likely to be specialty specific due to differences in work culture and access to substances. New ways of supporting doctors might be developed, using risk factor data to reduce adverse events and patient harm.PROSPERO registration numberPROSPERO registration number: CRD42020182045.

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Association of Past and Future Paid Medical Malpractice Claims

Hyman

Lerner

Magid³

et al. 2023

JAMA Health Forum

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ImportanceMany physicians believe that most medical malpractice claims are random events. This study assessed the association of prior paid claims (including a single prior claim) with future paid claims; whether public disclosure of prior paid claims affects future paid claims; and whether the association of prior and future paid claims decayed over time.ObjectiveTo examine the association of 1 or more prior paid medical malpractice claims with future paid claims.Design, Setting, and ParticipantsThis study assessed the association between prior paid claims (including a single prior claim) with future claims; whether public disclosure of prior claims affects future paid claims; and whether the association of prior and future paid claims decayed over time. This retrospective case-control study included all 881 876 licensed physicians in the US. All data analysis took place between July, 2018 and January, 2023.ExposurePaid medical malpractice claims.Main Outcome and MeasuresAssociation between a prior paid medical malpractice claim and likelihood of a paid claim in a future period, compared with simulated results expected if paid claims are random events. Using the same outcomes, we also assessed whether public disclosure of paid claims affects future paid claim rates.ResultsThis study included all 881 876 physicians licensed to practice in the US at the time of the study. Overall, 3.3% of the 841 961 physicians with 0 paid claims in the prior period had 1 or more claims in the future period vs 12.4% of the 34 512 physicians with 1 paid claim in the prior period; 22.4% of the 4189 physicians with 2 paid claims in the prior period; and 37% of the 1214 physicians with 3 paid claims in the prior period. The association between prior claims and future claims was similar for high-medical-malpractice-risk and lower-risk specialties; 1 prior-period claim was associated with a 3.1 times higher likelihood of a future-period claim for high-risk specialties (95% CI, 2.8-3.4) vs a 4.2 times higher likelihood for lower-risk specialties (95% CI, 3.8-4.6). The predictive power of a prior paid claim for future claims declined gradually as the time since the prior claim increased, for prior or future periods up to 10 years. Public disclosure did not affect the association between prior and future paid claims.Conclusions and RelevanceIn this study of paid medical malpractice claims for all US physicians, a single prior paid claim was associated with substantial, long-lived higher future claim risk, independent of whether a physician was practicing in a high- or low-risk specialty, or whether a state publicly disclosed paid claims. Timely, noncoercive intervention, including education, has the potential to reduce future claims.

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Targeting Bad Doctors: Lessons from Indiana, 1975–2015

Cited by 10 publications

References 18 publications

Medical Malpractice and Physician Discipline: The Good, The Bad and The Ugly

Medical Malpractice and Physician Discipline: The Good, The Bad and The Ugly

Systematic review of the factors and the key indicators that identify doctors at risk of complaints, malpractice claims or impaired performance

Association of Past and Future Paid Medical Malpractice Claims

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