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Medscape Radiologist Malpractice Report 2021
Batya Swift Yasgur, MA, LSW | January 27, 2022
| Contributor Information
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Medscape Radiologist Malpractice Report 2021
Batya Swift Yasgur, MA, LSW | January 27, 2022 | Contributor Information
Being named in a malpractice suit is one of the most difficult and traumatic experiences of any physician's career. Medscape's Malpractice Report 2021 surveyed more than 4300 physicians in 29 specialties who described why they were sued, how the lawsuit worked out, and the impact of their ordeal on their practice and their relationship with patients. In this slideshow, radiologists share their experiences with lawsuits.
(Note: Some totals in this presentation do not equal 100% due to rounding.)
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Medscape Radiologist Malpractice Report 2021
Batya Swift Yasgur, MA, LSW | January 27, 2022 | Contributor Information
The percentage of radiologists who reported being sued was higher than the number of overall physician respondents who went through a malpractice suit (51%). Of the 29 specialties, radiologists ranked ninth in percentage of respondents who reported being sued. Radiologists reported fewer lawsuits in 2021 than they did in 2019, when they ranked sixth among the other specialties surveyed, with 76% of respondents reporting a lawsuit. (Respondents could choose more than one answer.)
The reason, for this, however, may not be connected with more favorable circumstances for radiologists but rather with the COVID-19 pandemic. "Many states had COVID-related immunities for providers treating patients with COVID," says Evan Lyman, associate attorney at Vouté, Lohrfink, McAndrew, Meisner & Roberts, LLP, White Plains, New York. "And especially during the first months of the pandemic, only the most urgent cases were being seen, so preventive imaging or elective procedures were not being conducted." Indeed, Medscape's 2021 Radiologist Compensation Report confirmed that the volume of patients seen by radiologists has dropped considerably as a result of the pandemic.
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Medscape Radiologist Malpractice Report 2021
Batya Swift Yasgur, MA, LSW | January 27, 2022 | Contributor Information
Among radiologists, by far the most common reason for the lawsuit was failure to diagnose/delayed diagnosis — a percentage more than twice that of overall physician respondents (31%). Similar to other physicians, the second most common reason was complications from treatment/surgery, but it was less common compared with the larger physician population (14% in radiologists vs 29% among physicians overall).
"The suit was filed because of alleged failure to communicate CT findings in an inpatient, although I correctly diagnosed abnormal findings, in an appropriate time frame," one respondent wrote.
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Medscape Radiologist Malpractice Report 2021
Batya Swift Yasgur, MA, LSW | January 27, 2022 | Contributor Information
This year, about a quarter of PCPs and close to one fifth of specialists paid between $5000 and $9999 annually for coverage. By contrast, less than a tenth of radiologists paid that amount and close to a fifth paid $20,000-$24,999. The largest percentage of radiologist respondents didn't know how much they paid.
Many respondents expressed resentment that their malpractice insurance premiums went up considerably after having been sued, regardless of the outcome of the suit.
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Medscape Radiologist Malpractice Report 2021
Batya Swift Yasgur, MA, LSW | January 27, 2022 | Contributor Information
Most radiologists were surprised by being sued, and a larger percentage than general physician respondents reported being "very" surprised (60% vs 54%).
"One of the most common reasons for lawsuits is that patients are lost to follow-up," says Lyman. "A patient whose radiologist detects a concerning finding but is not properly informed of that finding by the referring physician might have a bad outcome and a resulting lawsuit might name the radiologist. The fact that the referring physician might not have received or read the radiologist's findings will not necessarily let the radiologist off the hook. Thus, a radiologist may be surprised when named in a lawsuit."
"I documented and noted my concerns in the patient's chart, but the pulmonologist and cardiologist failed to read/act. They then implicated me for lack of direct communication," one radiologist respondent wrote.
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Medscape Radiologist Malpractice Report 2021
Batya Swift Yasgur, MA, LSW | January 27, 2022 | Contributor Information
The ability of radiologists to predict who might bring a suit was comparable to that of overall physician respondents, of whom 54% said they could have identified the patient and 46% said they couldn't.
Many respondents reported that they were included in the lawsuit because all providers involved in the patient's care were named. "A young patient died because the ER doctor failed to follow up on critical findings on a CT scan," one respondent wrote. Another said, "The diagnosis was made correctly but another physician gave the patient medication they were allergic to, and the patient died. Everyone on the chart was sued." Other respondents, however, recognized that they had missed a key finding that led to the adverse outcome.
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Medscape Radiologist Malpractice Report 2021
Batya Swift Yasgur, MA, LSW | January 27, 2022 | Contributor Information
Similar to the overall sample of physician respondents, most radiologists felt that the lawsuit was not warranted.
"I'm sure there is actual malpractice occurring out there in the world of medicine, because physicians are human and mistakes do occur; but in many clients I've had, some of these cases border on the ridiculous," said Paul Walker, a New York City–based malpractice attorney at Walker Medical Law, who represents physicians and other healthcare professionals.
"The plaintiff blanket-included the entire medical staff," one respondent wrote. Another said, "My involvement took place after the injury took place. The lawsuit against me was totally unjustified."
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Medscape Radiologist Malpractice Report 2021
Batya Swift Yasgur, MA, LSW | January 27, 2022 | Contributor Information
Similar to the overall physician sample, most radiologists reported that the lawsuit never went to trial. However, more radiologists than physicians at large reported that it was settled before trial (42% vs 33%).
Many resented the settlement and felt that it was foisted on them. "All expert witnesses agreed that I did nothing wrong, but the insurance company, not needing my consent, elected to settle the case. That left a blemish on my professional career," wrote one respondent. Some would have preferred not to settle but felt that it was less onerous than continuing with the process of the lawsuit and its defense. "Most malpractice suits are unfounded but get settled because it is a cost-benefit approach that is taken more frequently than not," a respondent summarized.
One respondent wrote, "Physicians should have the absolute right to defend themselves without being forced to settle, either in court or at the hands of arbitration panels."
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Medscape Radiologist Malpractice Report 2021
Batya Swift Yasgur, MA, LSW | January 27, 2022 | Contributor Information
Over a quarter of radiologists spent upward of 40 hours preparing for their defense, with several respondents bemoaning the time "wasted" through the process, from preparation to appearances at depositions or in court. One respondent took off a full 2 weeks from work to be present at trial, only to face further postponement. He chose to settle, calling the process "legal blackmail." Another considered the "lengthy time commitment" involved to be one of the worst aspects of the having been sued.
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Medscape Radiologist Malpractice Report 2021
Batya Swift Yasgur, MA, LSW | January 27, 2022 | Contributor Information
The duration of lawsuits for radiologists was virtually identical to the survey responses of physicians in other specialties, with the most common duration lasting 1-2 years. The second most common time frames were less than 1 year and 3-5 years, at a quarter of responses each.
"It was a long, drawn-out process," wrote a radiologist. Another described going through 2 years of depositions, followed by a trial. One respondent considered the length of time the lawsuit dragged out to be one of the most stressful components of the entire ordeal, particularly "constantly thinking about a possible trial and outcome for almost 3 years."
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Medscape Radiologist Malpractice Report 2021
Batya Swift Yasgur, MA, LSW | January 27, 2022 | Contributor Information
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Medscape Radiologist Malpractice Report 2021
Batya Swift Yasgur, MA, LSW | January 27, 2022 | Contributor Information
Over half of respondents stated that they wouldn't have done anything differently, higher than the 43% of overall physicians with that response.
Although some studies have found no significant correlation between speed-reading of imaging studies and increased error rates, "it is intuitive to believe that the faster one reads, the more likely an error will be committed," according to an article by Leonard Berlin, MD, of the Department of Radiology at Rush University, Chicago, Illinois.
"Some radiologists are fast readers and other are slow readers. However, all radiologists must spend what they honestly believe to be adequate time for interpretation," Berlin writes.
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Medscape Radiologist Malpractice Report 2021
Batya Swift Yasgur, MA, LSW | January 27, 2022 | Contributor Information
Fewer radiologists than physicians overall felt that the outcome of the lawsuit was fair (53% vs 61%, respectively).
One respondent said what was unfair was "the knowledge that I did everything correctly and was still sued; and having to settle the case because the insurer insisted seemed unfair to the doctors involved."
One respondent thought the outcome was both fair and unfair. "I think the outcome was okay for a family that was angry and hurt. However, it was not fair to me or the urologist, as we took the hit for a situation that we neither caused nor worsened."
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Medscape Radiologist Malpractice Report 2021
Batya Swift Yasgur, MA, LSW | January 27, 2022 | Contributor Information
The monetary payments that plaintiffs received were higher in radiology-related lawsuits than among the general physicians, among whom 40% received a payout of up to $100,000 and 15% received a payout of up to $1 million.
According to a study by Baker and colleagues, the percentage of cases in which radiologists were sued and payment was made to the plaintiff differ "markedly" by state, as do median and mean award amount.
One of the largest cases against a radiologist took place in New York. It went to trial and the plaintiff was awarded $11.6 million that included past, present, and future pain and suffering damages of $8.5 million.
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Medscape Radiologist Malpractice Report 2021
Batya Swift Yasgur, MA, LSW | January 27, 2022 | Contributor Information
A slightly lower percentage of radiologists than physicians in general thought that apologizing would be ineffective in averting a potential lawsuit (71% vs 79%), but a considerably higher percentage weren't sure (29% vs 19%). No radiologists thought that saying "I'm sorry" would have made a difference.
"I have often been told that being completely honest with a patient when an accident or error occurs is the best route. In this case, that is what I did. I feel like if I had not spoken with the patient, she would not have directly implicated me," one respondent said.
Berlin advises radiologists who have committed an error to "first discuss the matter of disclosing it to the patient with the department chair or the hospital's risk management or legal staff." For radiologists in private practice, he advises seeking advice from the professional liability insurance representative.
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Medscape Radiologist Malpractice Report 2021
Batya Swift Yasgur, MA, LSW | January 27, 2022 | Contributor Information
Similar to members of other specialties, most radiologists did not feel that a lawsuit negatively affected their overall medical career, although some did report negative sequelae. "You always have to disclose and answer for having had a lawsuit, and it makes people suspicious," one radiologist respondent wrote. Another said, "I had to explain the unwarranted case for the last 20 years."
"The insurance company a lot of times will reassess and possibly drop the coverage of a physician after a malpractice suit. Other times, when applying for a job, the topic comes up and has to be explained, which can be especially hurtful, especially if your actions have really had nothing to do with the outcome," a respondent said.
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Medscape Radiologist Malpractice Report 2021
Batya Swift Yasgur, MA, LSW | January 27, 2022 | Contributor Information
More radiologists than physicians in general reported being unchanged as a result of the lawsuit (64% vs 52%), and fewer radiologists than overall physicians reported that they have lost trust in their patients (16% vs 24%).
"I trust the system less."
"I left the practice years earlier, with fear of litigation as a significant reason."
"I considered leaving medicine."
"I have better communication of results to referring docs."
"I have stopped reading all OB ultrasound exams even though I am quite proficient at it."
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Medscape Radiologist Malpractice Report 2021
Batya Swift Yasgur, MA, LSW | January 27, 2022 | Contributor Information
Similar to other physicians, nearly no radiologists reported being sued for a COVID-19-related allegation. "The US has seen an enormous number of COVID-19 infections and a terrible number of COVID-19 deaths, but we have not seen a lot of lawsuits specifically around COVID-19 so far," says Peter A. Kolbert, JD, senior vice president, Claim and Litigation Services, Healthcare Risk Advisors, a division of TDC Group.
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Medscape Radiologist Malpractice Report 2021
Batya Swift Yasgur, MA, LSW | January 27, 2022 | Contributor Information
Similar to other physicians, the vast majority of radiologists have not been sued in relation to the action of NPs and PAs. However, they should remain on their toes, because the number and role of these nonphysician clinicians has been increasing and evolving, both within and outside of radiology practices.
"One recent development is that CMS modified the longstanding rules related to supervision of level 2 diagnostic tests to allow role for NPs, PAs, and even nurse midwives to perform supervision, as of 2021," says Thomas Greeson, a partner with Reed Smith LLP, located in Northern Virginia, and former general counsel for the American College of Radiology.
Laws regarding the role of these clinicians differ from state to state, cautioned Greeson, who is a member of the Life Sciences Health Industry Group. His practice focuses on representing radiologists and diagnostic imaging providers. "I encourage radiologic groups considering using NPs or PAs to be aware of their state laws before allowing these providers to supervise level 2 diagnostic tests."
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Medscape Radiologist Malpractice Report 2021
Batya Swift Yasgur, MA, LSW | January 27, 2022 | Contributor Information
Similar to physicians in general, most radiologists are not worried about being named in a malpractice suit because of an issue that arose during the pandemic. However, several raised concerns.
"There may be increased errors due to stress on physicians during COVID and more errors due to high volumes during the post-COVID rebound."
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Medscape Radiologist Malpractice Report 2021
Batya Swift Yasgur, MA, LSW | January 27, 2022 | Contributor Information
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Medscape Radiologist Malpractice Report 2021
Batya Swift Yasgur, MA, LSW | January 27, 2022 | Contributor Information
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Medscape Radiologist Malpractice Report 2021
Batya Swift Yasgur, MA, LSW | January 27, 2022 | Contributor Information
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Medscape Radiologist Malpractice Report 2021
Batya Swift Yasgur, MA, LSW | January 27, 2022 | Contributor Information
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Batya Swift Yasgur, MA, LSW
Reporter, Medscape Business of Medicine
Disclosure: Batya Swift Yasgur, MA, LSW, has disclosed no relevant financial relationships.
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