Top 3 Medical Specialties with Highest Malpractice Risk

Malpractice lawsuits are much more than a common occurrence in medicine; they are practically a fixture of the medical profession.  If you practice long enough, you will eventually be sued.  According to the American Medical Association, five percent of physicians are the subject of malpractice suits each year.  There is however significant variation in the likelihood of a malpractice claim based on specialty. While neurosurgery has the highest malpractice risk, with a 19.1 percent risk annually, the lowest risk specialty was psychiatry with just a 2.6 percent annual risk. These figures were taken from a RAND study of 41,000 physicians from 1991 to 2005.

There are many legal justifications for these lawsuits, but the most common included:

1. Improper diagnosis- 31%
2. Abnormal injury to patient- 31%
3. Failure to treat- 12%

Neurosurgery

Neurosurgery leads all specialties with an annual malpractice risk of 19.1 percent. In a study published in PLOS ONE, researchers found that there was a strong correlation between malpractice risk and the size of hospitalization charges rather than mortality rates. This may suggest that this specialty is often seen as a lucrative target, more so than as a poorly performing profession. The study examined the outcomes of 189,000 patients with cranial neurosurgical procedures from 2005 to 2010.

Thoracic-cardiovascular Surgery

Just behind neurosurgery in highest malpractice risk is thoracic-cardiovascular surgery with an annual risk of 19 percent. While there are many reasons why heart surgeons may face a malpractice lawsuit, the most predominant is the failure to diagnose a myocardial infarction. The Doctors Company examined 429 cardiology claims from 2007 to 2013 and found that 25 percent were due to the physician’s inability to distinguish a MI from other similar conditions like an aortic dissection.

Other common lawsuit causes included improper management of treatment (14 percent), Improper treatment (12 percent) and improper surgical performance (11 percent). Many cardiovascular procedures develop complications—which should and usually are disclosed at the time of consent—but most of these lawsuits arise when the physician mishandles the response to the complication.

General Surgery

With a 15 percent chance of being sued each year, General Surgeons have the third highest malpractice risk. According to one Medscape survey of 4,000 physicians, the leading cause of malpractice lawsuits against general surgeons at 44 percent of the time was the occurrence of an abnormal injury.  Twenty-one percent of lawsuits were based on a failure to diagnose, with other causes taking up less than ten percent of lawsuits.

In response to these claims, many surgeons pointed to infections, bleeding, pain or injury to other physiological systems.  In some cases, patients failed to obtain follow-up treatment. There were often comorbidities when a death occurred.

Effects of Malpractice Claims

For many medical specialists, a malpractice claim is almost an inevitability, but there is some good news.  Almost 54 percent are dismissed by the court and only 4.5 percent go to trial. If it does go to trial, the verdict is in the favor of the physician 79.3 percent of the time.