Two recent studies of medical malpractice claims highlight how patient complaints may identify those surgeons at greater risk for complications, a significant decrease in paid medical malpractice claims since 1992, and the need for greater understanding of the causes of differences in claims experience across medical specialties.A study published in the February 15, 2017 online issue of JAMA Surgery found that prior “unsolicited patient observations” or patient complaints for a surgeon were “significantly associated” with the risk of the patient having an increased risk of surgical and medical complications. The researchers found some patient complaints described behavior that might intimidate or prevent effective communication between physician and patient. Other complaints included patients’ observations of a surgeon’s disrespectful or rude behavior with other healthcare providers. The study’s authors recommend that, “[E]fforts to promote patient safety and address risk of malpractice claims should continue to focus on surgeon’s ability to communicate respectfully and effectively with patients and other medical professionals.” A question yet to be addressed is whether the behavior that causes patient dissatisfaction might also contribute to the origin of adverse outcomes. That said, the study showed that surgeons who statistically were in the highest quartile of having received unsolicited patient observations in the two years prior to the involved surgery were 13.9 percent more likely to have patients with surgical complications than the surgeons in the lowest quartile. When extrapolating these findings to the entire U.S. healthcare system, the surgeons’ behaviors could lead to more than 350,000 post-surgical complications, at a cost of over $3 billion to the healthcare system each year.

Another study published in the May 2017 issue of JAMA Internal Medicine found that although there was a significant decrease in the rate of paid medical malpractice claims between 1992 and 2014, there was an increase in the mean payment amounts and the rate of catastrophic payments. Also, there were significant differences in rates of paid claims and characteristics of alleged injuries across specialties. Across all paid claims, the most common type of allegation was an error in diagnosis at 31.8 percent of paid claims, followed by errors related to surgery at 26.9 percent of paid claims. The study further showed that while the rate of claims paid to claimants substantially decreased, the amounts and percentage of claims exceeding $1 million increased. There was also a wide disparity in number of claims paid among the different medical specialties. The researchers noted that understanding the reason for the differences in paid malpractice claims among specialties may help reduce patient injury and decrease physicians’ risk of liability.

While these new studies offer insight into additional ways that healthcare systems and physicians may improve patient outcomes and reduce healthcare provider liability, they are also a reminder that there is much yet to learn.

In the meantime, it appears to be very prudent to:

• Ensure open lines of communication between patient and practitioner, both in person, in writing, and in electronic media.
• Provide background information regarding a physician.
• Lastly, to make an informed decision regarding care, review the public practitioner profile that many states require physicians to maintain. In Florida, practitioner profiles are available here.