By Dennis Thompson
WEDNESDAY, March 27, 2019 (HealthDay News) -- A bad doctor bedeviled by malpractice claims closes up shop in the dead of night and slips away to another state, hoping to leave his soiled reputation behind.
That's a common scenario many imagine. But the reality is almost as scary, a new study finds.
More than 9 out of 10 doctors who've racked up five or more successful malpractice claims against them continue to see patients as usual, and they're in no particular rush to set up shop far away, said lead researcher David Studdert, a professor of medicine and law at Stanford Law School.
"We find that, contrary to popular wisdom, they're no more likely than other physicians to pick up and relocate for a fresh start somewhere else," Studdert said.
The chances that malpractice-prone doctors will quit medicine altogether are higher than those of doctors with unblemished records, the study results showed. They are about 45 percent more likely to give up and try their hand at something else.
That would be "somewhat reassuring from a patient safety standpoint," Studdert said, except that "the fact is most of these 'frequent flyers' continue to practice, and I wouldn't want to be one of their patients."
Studdert and his colleagues examined malpractice trends by linking a federal database that tracks successful malpractice claims with a national Medicare database of physicians, which tracks where the doctors are practicing in any given year.
Between 2003 and 2015, 89 percent of physicians had no successful malpractice claims filed against them, researchers found. About 9 percent had one successful claim on their record, and the remaining 2 percent had two or more claims, the results revealed.
"We find that about 2 percent of practicing physicians account for about 40 percent of malpractice claims," Studdert said.
The findings were published March 28 in the New England Journal of Medicine.
That only 1 of 10 physicians had a successful claim against them is "perhaps the most striking fact" in the study, said Dr. Richard Anderson, chairman and chief executive officer of The Doctors Company, the nation's largest physician-owned medical malpractice insurer.
"Although not measured by the study, it is certain that a significant percentage of these physicians were nonetheless targets in fruitless malpractice litigation that resulted in no indemnity payments," Anderson said.
The researchers focused on the trouble-prone 2 percent because paid malpractice claims provide a "pretty strong quality signal," given that only about a third of malpractice claims are successful, Studdert said.
The research team specifically wanted to find out how those physicians and the people in their communities react to such a troubled medical practice.
Not much really happens, as it turns out. Most malpractice-prone doctors keep practicing right where they are, and it doesn't appear that they suffer any substantial loss of business, results showed.
Doctors with multiple successful claims did not appear to suffer any heavy decline in the number of patients they saw. Docs with four claims treated about 5 percent fewer Medicare patients than those with no claims, and physicians with five claims treated 11 percent fewer.
"Even though you're accumulating claims and there's some flashing red lights about quality, you don't seem to treat fewer patients," Studdert said.
On the other hand, doctors with five or more claims are more than twice as likely to move into a solo practice, which Studdert finds worrying from a patient safety perspective.
"Physicians with multiple claims are more likely to switch into small practice groups or solo practice, and that professional isolation could increase the risk they pose to patients," Studdert said. "In a hospital setting or a larger practice, there's more oversight on what you're doing. There's also more opportunity to seek advice and get help from colleagues."
Doctors are likely able to maintain successful practices despite racking up a lot of malpractice claims because many states provide little to no access to information regarding claims against physicians, Studdert said.
"The available evidence suggests that referring physicians aren't paying much attention to that information, nor are patients," Studdert said.
The RAND Corp. has more about medical malpractice.
SOURCES: David Studdert, LLB, Sc.D., professor, medicine and law, Stanford Law School, Stanford, Calif.; Richard Anderson, M.D., chairman and chief executive officer, The Doctors Company; March 28, 2019, New England Journal of Medicine
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