By age 65, 75% of physicians in low-risk, and 99% in high risk, categories will have at least one medical professional liability claim. What is your risk?
Even amongst the best and brightest physicians, it is commonly accepted that adverse patient outcomes happen. Statistically it’s not a matter of if, but when. An adverse event could be due to potential complications from surgery or prescription medicine interactions, human error, or negligence. And sometimes the human body responds differently than expected, even when physicians apply consistent standards of care.
In a study reported by the RAND Institute for Civil Justice and RAND Health, on average 7.4% of all physicians (regardless of specialty) had a claim annually, of which 1.6% made an indemnity payment. In addition, the study reports that by age 45, 36% percent of physicians in low-risk specialties are likely to have at least one medical professional liability claim compared to 88% of those in high-risk categories. By age 65, however, those numbers skyrocket: 75% of physicians in lowrisk, and 99% in high-risk, categories will have at least one medical professional liability claim.
Physicians Insurance A Mutual Company’s recent study of claims data compared a ten-year window of claims and lawsuits by specialty, analyzing each and finding out how many claims eventually ended up in litigation (see sidebar). In some cases, when the data pool was not large enough to create a statistically reliable percentage, the study results provide a sense of likelihood—responding to a common question physicians ask: “What’s the likelihood I am going to get sued?”
SOLUTIONS TO DECREASING RISK
In an article in Medical Economics, author Susan Kreimer highlights six practices for mitigating common risks in office-based practices. They include being open and honest in communications, offering explanations that make sense to patients who are facing decisions or unanticipated outcomes, ensuring informed consent, keeping up on standards and training, and following up on diagnostic tests and referrals. She also notes that variances in procedures and policies, and physicians’ avoidance behaviors after an event, contribute to increased risk and should be addressed.†
Medical chart documentation standards are also key to improving patient safety and reducing risk. Providers who have scored high on compliance of these standards have had fewer medical professional liability claims. Ten standards have been identified as best practices in patient care chart documentation:
- Use of problem and medication lists
- Prominent notation of allergies/adverse reactions
- Use/documentation of telephone triage
- Effective on-call after-hours coverage
- Legible medical records with correct notation of errors and additions
- Informed consent documentation
- Use/documentation of patient follow-up tracking system
- Use/documentation of test tracking system
- Use/documentation of consultant tracking system
- Signing of incoming reports
YOU ARE NOT ALONE
If and when a claim happens, Physicians Insurance works alongside the physicians, clinic, and hospital to navigate the process effectively and efficiently. Since every claim is unique, and each claim will develop in its own way, we use professional and experienced claims staff and attorneys who specialize in the defense of medical professional liability litigation. In other words, you’re not alone. For more information about how we approach claims, please feel free to call Physicians Insurance to speak with a claims representative.
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†Susan Kreimer, “Six Ways Physicians Can Prevent Patient Injury and Avoid Lawsuits,” Medical Economics, December 10, 2013, accessed March 7, 2014, http://medicaleconomics.modernmedicine.com/medical-economics/news/six-ways-physicianscan-prevent-patient-injury-and-avoid-lawsuits.