Is there a set of traits that identify malpractice claim-prone providers? Or at least that identify complaint-prone trends? A recent study(1) presented findings that may help industry experts identify and mitigate future risk based on historical data. For example, in that study, approximately 1% of all physicians accounted for 32% of paid claims. Additionally, the risk of recurrence increased with the number of previously paid claims. For example, providers who already had three paid claims had three times the risk of incurring another. In other words, they have a 24% chance of acquiring another paid claim within two years.
Generally speaking, male physicians over age 35 were in the greatest risk category. Additionally, these specialties were at higher risk for litigation(2):
- Orthopedic Surgeons
- General Surgeons
- Plastic Surgeons
However, the issue isn’t simply a matter of being a male neurosurgeon who graduated from medical school at least five years ago. If other factors can be isolated, then providers and healthcare organizations need to develop programs to reduce the likelihood of adverse incidents that lead to malpractice litigation.
Algorithms and risk assessments are already in place for insurers, with underwriters and actuaries studying data and trends every day. Actuarial analysis for liability coverage creates specific, cost-aligned policies and programs. But data isn’t a person. And malpractice is not always a measurable action. A patient’s propensity to sue is based on many factors, not the least of which is their perceived relationship with their provider(3).
While an evidence-driven trend may exist, the real question is how to harness this data into actionable future risk mitigation. Does the defense of malpractice suits only play a reactive role in the healthcare industry? Certainly, more research is needed to determine whether statistics can be used for quality improvement efforts, including counseling, training, and supervision.
Contact us if you are interested in learning more about how actuarial analysis aids us in forecasting your practice’s litigation potential.