Do pediatricians face a malpractice crisis?

INDIANAPOLIS -- Do pediatricians face a malpractice crisis? In the first systematic multi-year analysis of malpractice claims solely against pediatricians, researchers from the Indiana University School of Medicine report in the July issue of the journal Pediatrics that the answer is neither yes nor no.

"We studied pediatricians and malpractice because while the medical malpractice issue is extremely stressful and gets a lot of press, and we all have heard numerous horror stories and anecdotes, there is little actual data reported, especially for pediatricians. So we took a retrospective, comprehensive look at malpractice claims against pediatricians. Surprisingly, we found that from 1985-2005 society hasn't become more litigious, at least not vis à vis pediatricians," said Aaron E. Carroll, assistant professor of pediatrics at the IU School of Medicine and a Regenstrief Institute, Inc. affiliated scientist.

Dr. Carroll looked at the two decades of malpractice claims data and found that 68% of malpractice cases against pediatricians were withdrawn or dismissed. Only 5% of malpractice suits against pediatricians went to trial, and of these 4 out of 5 were found in favor of the pediatrician.

During the 20-year period, 214,226 closed malpractice claims were reported to a database maintained by the Physician Insurer Association of America, a trade association of medical malpractice insurance companies. Together, these companies insure approximately 60% of all private practicing physicians and surgeons in the United States.

"While I don't want to minimize the horror of being sued, the numbers don't bear this [malpractice] out as a problem for pediatricians," said Dr. Carroll.

Although children are responsible for a large percentage of healthcare consumption, he found that pediatricians accounted for only 2.97% of all malpractice claims.

Pediatrics ranked 7th in terms of 28 specialties in settlements or awards made directly to plaintiffs as a result of claim-resolution process. Not surprisingly, indemnity payment trended upward between 1985 and 2005. In 1985 the median (50th percentile) payment by pediatricians for a resolved claim was $ 65,000. By 2005 the median payment had risen to $270,000. Both figures are in 2005 dollars.

Slightly more than a quarter of all claims against pediatricians were settled for the plaintiff before going to trial, often because settlement costs less than the median cost of going to trial --$40,000. Settlement is not an admission of guilt.

"Malpractice is a serious issue. Some will read the results of this analysis and draw comfort; others will view the same data with alarm and surprise. Regardless of how one interprets these findings, they are important in truly informing the debate with generalizable facts," the study concluded.

Dr. Carroll and co-author Jennifer Buddenbaum, MHA are with Children's Health Services Research in the IU School of Medicine's Department of Pediatrics.