Internists are being sued for malpractice for the things they do most often, a study found.
Researchers culled data from a registry of nearly 250,000 closed cases collected by the PIAA (formerly the Physician Insurers Association of America) to find out why internists were being sued. Results appeared in a research letter published April 28 at JAMA Internal Medicine.
From 1985 through 2009, 13.7% of claims were attributed to internists, and 25.1% resulted in claims paid. The most common medical misadventures, defined as alleged departures from the appropriate standard of care, that triggered a claim included:
• errors in diagnosis (26.4%), which involves alleged errors in diagnosing lung cancer, acute myocardial infarction, colon cancer, and breast cancer;
• no misadventure (25.4%);
• improper performance of a procedure (11.1%); and
• medication errors (8.5%).
There was wide variation among claims that resulted in payment. For instance, of claims that resulted in a payment, 40.1% were for a failure to refer and 38.1% were for a failure to perform a procedure. Claims with no medical misadventure resulted in payment in only 4.8% of cases. Median payment was at least $100,000 per paid claim across nearly all categories that the researchers examined.
Frequency and median amount of payout matched those of other reports, the authors noted, and “these data confirm that internists are vulnerable to claims related to what they do commonly—evaluation and management activities (medical histories and physical examinations)—and for the commonly fatal diseases that they are expected to diagnose, such as acute myocardial infarction and lung, colon, and breast cancers.”