McKinley Glover1, Glen W McGee, Derek S Wilkinson, Harnam Singh, Alexis Bolick, Rebecca A Betensky, H Benjamin Harvey, Debra Weinstein, Adam Schaffer. 1. M. Glover is radiologist and assistant professor, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; ORCID: http://orcid.org/0000-0002-5711-8937. G.W. McGee is postdoctoral researcher, Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts; ORCID: http://orcid.org/0000-0002-6133-9169. D.S. Wilkinson is data scientist, National Practitioner Data Bank, Bureau of Health Workforce, Health Resources and Services Administration, Rockville, Maryland. H. Singh is chief data and research officer, National Practitioner Data Bank, Bureau of Health Workforce, Health Resources and Services Administration, Rockville, Maryland. A. Bolick was an MPH student at the Harvard T. H. Chan School of Public Health, Boston, Massachusetts, at the time this article was written. R.A. Betensky is professor, Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts. H.B. Harvey is radiologist and assistant professor, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; ORCID: http://orcid.org/0000-0001-9550-1876. D. Weinstein is vice president for graduate medical education, Partners Healthcare, and associate professor of medicine, Harvard Medical School, Boston, Massachusetts. A. Schaffer is associate physician, Department of Medicine, Brigham and Women's Hospital, assistant professor of medicine, Harvard Medical School, and senior clinical analytics specialist, Controlled Risk Insurance Company/Risk Management Foundation of the Harvard Medical Institutions, Boston, Massachusetts.
Abstract
PURPOSE: Limited information exists about medical malpractice claims against physicians-in-training. Data on residents' involvement in malpractice actions may inform perceptions about medicolegal liability and influence clinical decision-making at a formative stage. This study aimed to characterize rates and payment amounts of paid malpractice claims on behalf of resident physicians in the United States. METHOD: Using data from the National Practitioner Data Bank, 1,248 paid malpractice claims against resident physicians (interns, residents, and fellows) from 2001 to 2015, representing 1,632,471 residents-years, were analyzed. Temporal trends in overall and specialty-specific paid claim rates, payment amounts, catastrophic (> $1 million) and small (< $100,000) payments, and other claim characteristics were assessed. Payment amounts were compared with attending physicians during the same time period. RESULTS: The overall paid malpractice claim rate was 0.76 per 1,000 resident-years from 2001 to 2015. Among 1,194 unique residents with paid claims, 95.7% had exactly 1 claim, while 4.3% had 2-4 claims during training. Specialty-specific paid claim rates ranged from 0.12 per 1,000 resident-years (pathology) to 2.96 (obstetrics and gynecology). Overall paid claim rates decreased by 52% from 2001-2005 to 2011-2015 (95% confidence interval [CI]: 0.45, 0.59). Median inflation-adjusted payment amount was $199,024 (2015 dollars), not significantly different from payments made on behalf of attending physicians during the same period. Proportions of catastrophic (11.2%) and small (33.1%) claims did not significantly change over the study period. CONCLUSIONS: From 2001 to 2015, paid malpractice claim rates on behalf of resident physicians decreased by 52%, while median payment amounts were stable. Resident paid claim rates were lower than attending physicians, while payment amounts were similar.
PURPOSE: Limited information exists about medical malpractice claims against physicians-in-training. Data on residents' involvement in malpractice actions may inform perceptions about medicolegal liability and influence clinical decision-making at a formative stage. This study aimed to characterize rates and payment amounts of paid malpractice claims on behalf of resident physicians in the United States. METHOD: Using data from the National Practitioner Data Bank, 1,248 paid malpractice claims against resident physicians (interns, residents, and fellows) from 2001 to 2015, representing 1,632,471 residents-years, were analyzed. Temporal trends in overall and specialty-specific paid claim rates, payment amounts, catastrophic (> $1 million) and small (< $100,000) payments, and other claim characteristics were assessed. Payment amounts were compared with attending physicians during the same time period. RESULTS: The overall paid malpractice claim rate was 0.76 per 1,000 resident-years from 2001 to 2015. Among 1,194 unique residents with paid claims, 95.7% had exactly 1 claim, while 4.3% had 2-4 claims during training. Specialty-specific paid claim rates ranged from 0.12 per 1,000 resident-years (pathology) to 2.96 (obstetrics and gynecology). Overall paid claim rates decreased by 52% from 2001-2005 to 2011-2015 (95% confidence interval [CI]: 0.45, 0.59). Median inflation-adjusted payment amount was $199,024 (2015 dollars), not significantly different from payments made on behalf of attending physicians during the same period. Proportions of catastrophic (11.2%) and small (33.1%) claims did not significantly change over the study period. CONCLUSIONS: From 2001 to 2015, paid malpractice claim rates on behalf of resident physicians decreased by 52%, while median payment amounts were stable. Resident paid claim rates were lower than attending physicians, while payment amounts were similar.