A recent database study conducted at Brigham and Women’s Hospital found that the rate of medical malpractice claims paid on behalf of physicians in the United States declined substantially from 1992 to 2014. The study analyzed data from the National Practitioner Data Bank (NPDB), a centralized database of paid malpractice claims that was created by Congress in 1986. Researchers found an overall drop in the amount of paid claims across all specialties, but the extent of the decline was markedly different by specialty, according to Adam Schaffer, MD, lead author of the paper. The findings are published in the March 27, 2017 issue of the JAMA Internal Medicine journal.

Researchers report that the overall rate of claims paid on behalf of all physicians dropped by 55.7 percent. Pediatricians had the largest decline, at 75.8 percent, and cardiologists had the smallest, at 13.5 percent. Mean compensation amounts and the percentage of payments exceeding $1 million increased, with wide differences in rates and characteristics across specialties. After adjusting for inflation, the amount of the paid claims increased by 23.3 percent. Neurosurgery had the highest mean payment, and dermatology had the lowest.

The authors report that the most common type of allegation underlying all paid claims was an error in diagnosis (31.8 percent), followed by errors related to surgery (26.9 percent) and errors related to medication or treatment (24.5 percent). Thirty-two percent of paid claims were related to a patient death. Pulmonologists were most likely to be involved in a claim that involved a patient death.

The authors of the study note that a better understanding of the causes of variation among specialties in paid medical malpractice claims may help inform decisions about the approaches needed to improve patient safety and reduce liability.