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Monday, June 10, 2019

A Missed Opportunity for the Malpractice System to Improve Health Care

Aaron Carroll
The New York Times
Originally posted May 27, 2019

Here are two excerpts:

First, the good news: These doctors quit at higher rates than other physicians. And they also tend not to pick up and move somewhere else to start fresh (which many thought they’d do given that licenses and malpractice are regulated at the state level).

But the overwhelming majority of doctors who had five or more paid claims kept on going. And they also moved to solo practice and small groups more often, where there’s even less oversight, so those problematic doctors may produce even worse outcomes.

We have long known that some doctors are likelier than others to be sued. Those who practice in certain higher-risk specialties — like surgery, obstetrics and gynecology, and emergency medicine — are more likely to be sued than those in lower-risk specialties like family medicine, pediatrics and psychiatry. Men are more likely to be sued than women. Lawsuits seem to peak when doctors are around 40.

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Those who accumulated more claims were more likely to stop practicing medicine. Even though they were more likely to retire, more than 90 percent of doctors who had at least five claims were still in practice.

Physicians with more claims were also not any more likely than those with fewer or no complaints to move to another state and continue practicing. This is actually one of the reasons the practitioner data bank was created — to prevent doctors from running away from their history by moving between states. In that respect, it appears to be working.

What’s worrisome, though, is that physicians with more claims shifted their type of practice. Those with five or more claims had more than twice the odds of moving into solo practice.

The info is here.

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