Physician Survey Reports: 4.5% of Medical Liability Cases Resolved by ADR

By Holly Hayes

An August American Medical Association (AMA) survey of 5,825 physicians illustrates a need for medical liability state and federal reforms. Survey responses indicated:

42.2% of physicians were sued, with 22.4% sued twice or more. Rates varied by specialty, but general surgeons and obstetrician-gynecologists were most likely to be sued (69.2%). Family physicians and general internists had similar rates (38.9% and 34%). Pediatricians and psychiatrists were sued the least.

Physicians who had an ownership interest in a practice were at greater risk, with 47.5% reporting being sued, compared with 33.4% for those with no ownership interest.

The majority of lawsuits never made it to the courtroom, according to 2008 data from the Physician Insurers Assn. of America, a trade group representing liability insurance companies owned or operated by physicians, hospitals and other health care professionals.

Sixty-five percent were dropped, dismissed or withdrawn. About one in four claims was settled, and 4.5% were decided by alternative dispute mechanism. Of the 5% that went to trial, defendants won in 90% of cases, the PIAA said.

But fighting a claim is costly. Defense against a claim averaged $22,163 for suits dropped, dismissed or withdrawn, and more than $100,000 for cases that went to trial, according to PIAA data.

The frequency of medical liability lawsuits documented in the report illustrates the need for reforms at the state and federal levels, said AMA Immediate Past President J. James Rohack, MD.

“Even though the vast majority of claims are dropped or decided in favor of physicians, the understandable fear of meritless lawsuits can influence what specialty of medicine physicians practice, where they practice and when they retire,” Dr. Rohack said in a statement. “This litigious climate hurts patients’ access to physician care at a time when the nation is working to reduce unnecessary health care costs.”

In June, The Agency for Healthcare Research and Quality (AHRQ) announced that seven demonstration grants for the Medical Liability Reform and Patient Safety initiative have been funded for a total amount of $19.7 million. Thirteen planning grants have also been funded for a total amount of $3.5 million. The grants support the implementation and evaluation of evidence-based patient safety and medical liability projects. See more here.

The seven demonstration grants include models that meet one or more of the medical liability reform and patient safety initiative goals, including: “Reducing preventable harms. Informing injured patients promptly, and making efforts to provide prompt compensation. Promoting early disclosures and settlement, through a court-directed alternative dispute resolution model.”

Dr. Rohack said the AMA will continue to push for reforms, including tort reform that has proven effective in Texas. “‘We’re committed to lowering health care costs to make it affordable to all Americans, and ending defensive medicine is a big part of that,'” he said.

We welcome your comments on the use of ADR in medical liability lawsuits.

Holly Hayes is a mediator at Karl Bayer, Dispute Resolution Expert where she focuses on mediation of health care disputes. Holly holds a B.A. from Southern Methodist University and a Masters in Health Administration from Duke University. She can be reached at holly@karlbayer.com.