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Medscape Primary Care Malpractice Report 2017: Real Physicians. Real Lawsuits.

Sandra Levy; Leslie Kane, MA | December 5, 2017 | Contributor Information

Primary care physicians (PCPs) confront many challenges—among them, malpractice lawsuits. In a recent survey, more than 4000 physicians, including PCPs, told Medscape how malpractice lawsuits affected their lives, why they were sued, what happened with the case, and how it has affected the way they practice medicine. Here are the results.

Medscape Primary Care Malpractice Report 2017: Real Physicians. Real Lawsuits.

Sandra Levy; Leslie Kane, MA | December 5, 2017 | Contributor Information

Malpractice lawsuits are pervasive. Almost half (49%) of PCPs have been named in a lawsuit. Forty-one percent were involved in suits where other parties were also named, while 11% were involved in suits where they were the only person named.

Numbers in charts may not add up to 100% due to rounding.

Medscape Primary Care Malpractice Report 2017: Real Physicians. Real Lawsuits.

Sandra Levy; Leslie Kane, MA | December 5, 2017 | Contributor Information

The majority (58%) of PCPs who were sued have been named in one lawsuit. However, among PCPs sued, 39% have been sued two to five times.

Medscape Primary Care Malpractice Report 2017: Real Physicians. Real Lawsuits.

Sandra Levy; Leslie Kane, MA | December 5, 2017 | Contributor Information

Malpractice lawsuits typically catch PCPs off-guard. Among PCPs sued, 69% were surprised by the suit, 22% were somewhat surprised, and 9% weren't surprised at all.

Medscape Primary Care Malpractice Report 2017: Real Physicians. Real Lawsuits.

Sandra Levy; Leslie Kane, MA | December 5, 2017 | Contributor Information

Among PCPs, the top reasons for a lawsuit were failure to diagnose or a delayed diagnosis (43%), followed by a poor outcome or disease progression (25%), failure to treat or delayed treatment (20%), and wrongful death (20%).

Medscape Primary Care Malpractice Report 2017: Real Physicians. Real Lawsuits.

Sandra Levy; Leslie Kane, MA | December 5, 2017 | Contributor Information

Among PCPs named in a malpractice lawsuit, 89% felt that the suit was unwarranted. Seven percent weren't sure and 4% agreed that the suit had merit.

Medscape Primary Care Malpractice Report 2017: Real Physicians. Real Lawsuits.

Sandra Levy; Leslie Kane, MA | December 5, 2017 | Contributor Information

What helps make the specter of malpractice so distressing is that in many situations, there is no forewarning. Half of PCPs said that they knew of no event that sparked the lawsuit or would have alerted them to expect a suit. Slightly over one third (34%) of PCPs said there was such an incident, while 16% said they didn't recall the circumstance.

Medscape Primary Care Malpractice Report 2017: Real Physicians. Real Lawsuits.

Sandra Levy; Leslie Kane, MA | December 5, 2017 | Contributor Information

Besides worrying about the outcome of a lawsuit, PCPs have to lose work time to prepare. Almost one third (31%) of PCPs spent more than 40 hours on their defense, including getting records together, meeting with their attorney, and preparing for depositions and discussions. Almost one fifth (18%) of PCPs devoted 6 to 10 hours to these and other tasks, and another 16% allocated 11 to 20 hours of their time.

Medscape Primary Care Malpractice Report 2017: Real Physicians. Real Lawsuits.

Sandra Levy; Leslie Kane, MA | December 5, 2017 | Contributor Information

For more than a quarter (28%) of PCPs, their cases were resolved early enough that they never went to court or a trial-related meeting. Still, nearly 1 in 5 were in court or meetings for more than 50 hours.

Medscape Primary Care Malpractice Report 2017: Real Physicians. Real Lawsuits.

Sandra Levy; Leslie Kane, MA | December 5, 2017 | Contributor Information

Giving sworn evidence is an integral process in seeking the facts of the case. The information gained at depositions is often used to decide how to proceed with the case. The majority of PCPs (82%) named in a malpractice lawsuit were involved in giving depositions.

Medscape Primary Care Malpractice Report 2017: Real Physicians. Real Lawsuits.

Sandra Levy; Leslie Kane, MA | December 5, 2017 | Contributor Information

Defendant attorneys say that PCPs sometimes get themselves into trouble during depositions by volunteering information that the plaintiff attorney can use to trip them up. PCPs who have been through depositions provided the advice above for other physicians.

Medscape Primary Care Malpractice Report 2017: Real Physicians. Real Lawsuits.

Sandra Levy; Leslie Kane, MA | December 5, 2017 | Contributor Information

One fourth (25%) of lawsuits were resolved in under a year. Six percent of the lawsuits dragged on for over 5 years, and for about a third of physicians, the lawsuit lasted 3 to 5 years.

Medscape Primary Care Malpractice Report 2017: Real Physicians. Real Lawsuits.

Sandra Levy; Leslie Kane, MA | December 5, 2017 | Contributor Information

Almost one third (29%) of PCPs in our survey said that their lawsuit was settled before trial. Covering all types of lawsuits, the vast majority of cases do settle.[1] Of note, only 1% of respondents said the case went to trial and the judge or jury decided against them. For 11% of PCPs, the judge or jury returned a verdict in their favor.

Medscape Primary Care Malpractice Report 2017: Real Physicians. Real Lawsuits.

Sandra Levy; Leslie Kane, MA | December 5, 2017 | Contributor Information

Losing a lawsuit can be financially devastating to both the practice and the physician's personal finances. Not surprisingly, almost all PCPs (96%) said they have malpractice coverage. In a number of states, physicians are not required to carry malpractice insurance. In the first decade of the 2000s, "going bare" was an option chosen by a number of physicians; that option has since become less popular.

Medscape Primary Care Malpractice Report 2017: Real Physicians. Real Lawsuits.

Sandra Levy; Leslie Kane, MA | December 5, 2017 | Contributor Information

PCPs' insurers often exert influence over malpractice cases. Many policies have a "hammer clause" which gives the insurer power to enforce a settlement. In recent case law, however, the clause has been shown to rest on whether the insured's refusal to settle is unreasonable.[2]

Medscape Primary Care Malpractice Report 2017: Real Physicians. Real Lawsuits.

Sandra Levy; Leslie Kane, MA | December 5, 2017 | Contributor Information

Plaintiffs in malpractice cases often walk away with a substantial financial award. Almost one third of PCPs (29%) said that in their cases, the plaintiff received up to $500,000; 21% said the plaintiff was awarded up to $1 million.

Medscape Primary Care Malpractice Report 2017: Real Physicians. Real Lawsuits.

Sandra Levy; Leslie Kane, MA | December 5, 2017 | Contributor Information

Of note, almost two thirds (63%) of PCPs think that the outcome of their malpractice suit was fair. Over one third (37%) hold the opposite opinion.

Medscape Primary Care Malpractice Report 2017: Real Physicians. Real Lawsuits.

Sandra Levy; Leslie Kane, MA | December 5, 2017 | Contributor Information

A malpractice lawsuit can change a PCP's view on patients and healthcare. Over one fourth (28%) of PCPs no longer trust patients and now treat them differently. Going through a lawsuit prompted 6% of PCPs to leave their practice setting, while 3% of PCPs decided to change their insurer.

Medscape Primary Care Malpractice Report 2017: Real Physicians. Real Lawsuits.

Sandra Levy; Leslie Kane, MA | December 5, 2017 | Contributor Information

Malpractice lawsuits can be challenging and difficult, but only one third (33%) of PCPs feel that the lawsuit negatively affected their overall medical career. About two thirds (67%) said the lawsuit had no negative effect.

Medscape Primary Care Malpractice Report 2017: Real Physicians. Real Lawsuits.

Sandra Levy; Leslie Kane, MA | December 5, 2017 | Contributor Information

Hindsight is 20/20, and looking back, physicians who were sued say they would have done things differently to avoid the suit. Better chart documentation was cited most often (26%), followed by ordering tests that would have "covered" PCPs in case a malpractice lawsuit was brought against them (14%).

Medscape Primary Care Malpractice Report 2017: Real Physicians. Real Lawsuits.

Sandra Levy; Leslie Kane, MA | December 5, 2017 | Contributor Information

In 36 states, certain statements concerning disclosure or apologies are prohibited from being admissible in a medical malpractice lawsuit. PCPs are still skeptical. The majority of PCPs in our survey (84%) do not believe that saying "I'm sorry" to the plaintiff earlier, or at all, would have made a difference in whether they were sued. Only 1% believe that it would have made a difference.

Medscape Primary Care Malpractice Report 2017: Real Physicians. Real Lawsuits.

Sandra Levy; Leslie Kane, MA | December 5, 2017 | Contributor Information

For almost half of PCPs (46%), the threat of lawsuits is on their minds all or most of the time. Many say that this is the motivation for so many physicians practicing defensive medicine. But 14% of PCPs said they rarely have these thoughts.

Medscape Primary Care Malpractice Report 2017: Real Physicians. Real Lawsuits.

Sandra Levy; Leslie Kane, MA | December 5, 2017 | Contributor Information

Almost two fifths of PCPs (39%) indicated that the threat of malpractice influences their actions all or most of the time. A similar percentage (38%) said that it occasionally influences their actions. Only 3% said that it never does.

Medscape Primary Care Malpractice Report 2017: Real Physicians. Real Lawsuits.

Sandra Levy; Leslie Kane, MA | December 5, 2017 | Contributor Information

Although the potential for a malpractice suit is greater when dealing with high-risk patients, most PCPs in our survey (86%) have not turned away such patients.

Medscape Primary Care Malpractice Report 2017: Real Physicians. Real Lawsuits.

Sandra Levy; Leslie Kane, MA | December 5, 2017 | Contributor Information

Many malpractice insurers offer a risk audit to help PCPs lessen their chances for a lawsuit. Still, two thirds of PCPs (66%) have not had nor plan to have a risk assessment. Almost one fourth (24%) of PCPs said that they have done so, and 10% expect to do so in the future.

Medscape Primary Care Malpractice Report 2017: Real Physicians. Real Lawsuits.

Sandra Levy; Leslie Kane, MA | December 5, 2017 | Contributor Information

While 16% of PCPs would not sue another physician, 81% said that if they were harmed by another physician they would consider suing, depending on the situation. Only 3% said that they would definitely sue another physician.

Medscape Primary Care Malpractice Report 2017: Real Physicians. Real Lawsuits.

Sandra Levy; Leslie Kane, MA | December 5, 2017 | Contributor Information

Politicians and medical organizations have promoted various ways to reduce the number of malpractice lawsuits. Over half (56%) of PCPs cited better communication and rapport with patients as the most effective way to discourage malpractice lawsuits, followed by having a medical panel screen cases for merit (51%) and placing caps on noneconomic damages (50%).

Medscape Primary Care Malpractice Report 2017: Real Physicians. Real Lawsuits.

Sandra Levy; Leslie Kane, MA | December 5, 2017 | Contributor Information

Medscape Primary Care Malpractice Report 2017: Real Physicians. Real Lawsuits.

Sandra Levy; Leslie Kane, MA | December 5, 2017 | Contributor Information

Two thirds of PCPs gave a thumbs-down to major medical organizations' or state societies' efforts to reduce the number of malpractice lawsuits. Only 6% felt that these organizations were active enough in working to improve the malpractice environment.

Medscape Primary Care Malpractice Report 2017: Real Physicians. Real Lawsuits.

Sandra Levy; Leslie Kane, MA | December 5, 2017 | Contributor Information

Medscape Primary Care Malpractice Report 2017: Real Physicians. Real Lawsuits.

Sandra Levy; Leslie Kane, MA | December 5, 2017 | Contributor Information

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Medscape Physician Compensation Report 2017

More than 19,200 physicians in over 27 specialties responded to this year's Medscape compensation survey and told about their compensation, productivity, challenges, and more.Medscape Features Slideshows, April 2017
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