The Detection, Analysis, and Significance of Physician Clustering in Medical Malpractice Lawsuit Payouts.

HM Epstein hmepstein at GMAIL.COM
Mon Jan 16 17:17:33 UTC 2017

I don't know. They surveyed only the public use files on what the physicians self reported as malpractice payments to the NPDB. The article did not break it down into settlements and verdict payments. As far as I understand, it does not represent everything because it's dependent on self reporting. They weren't even able to break it down by specialty or state. 

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On Jan 16, 2017, at 12:09 PM, Bob Latino <blatino at> wrote:

For the laymen of the group, does 'malpractice payouts' include verdicts and settlements?  Since settlements are normally sealed, I wanted to see what that number encompassed.
Robert J. Latino, CEO
Reliability Center, Inc.
blatino at
From: HM Epstein [mailto:hmepstein at GMAIL.COM] 
Sent: Monday, January 16, 2017 9:16 AM
Subject: [IMPROVEDX] The Detection, Analysis, and Significance of Physician Clustering in Medical Malpractice Lawsuit Payouts.
Reviewing 25 years of National Practitioner Data Bank malpractice records, this study determined that half of the malpractice payouts were made by 1.8% of the doctors who reported it to the NPDB. I've quoted the results from the abstract below. 
From a improving diagnostics and patient safety point of view, if such a small percentage of "outlier" physicians are responsible for so much of the harm, shouldn't physicians be clamoring for their medical boards to be stricter on doctors with more than one malpractice claim? Only 18.9% had any sort of action against them regarding their license to practice or their clinical privileges. 
Of course, this is based on malpractice payouts that were reported. How many are not? And if the GOP Congress are able to pass some of their rules adding more layers between malpractice and reporting it, what does that mean for patients?
"Approximately 1.8% of physicians were responsible for half of the $83,368,588,200 reported to the NPDB over 25 years. Within that group, 12.6% had an adverse licensure action reported to the NPDB, and 6.3% had a clinical privileges action reported. Physicians who were in the high dollar payout category and had one malpractice claim payout had a 74.5% chance of another payout, more than twice the rate for all physicians who had a single payout (chi-square, P < 0.0001). The likelihood that that physician would have additional payments increased as the number of previous payments increased. Total dollar payouts per physician better predicted future payouts than numbers of payouts."

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