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

Bob Latino blatino at RELIABILITY.COM
Mon Jan 16 17:36:32 UTC 2017


Thank you.

Is it safe to conclude since these figures are based only on self-reporting, and 'likely' only verdicts (not settlements), the actual numbers would be considerably higher?

This reminds me of the ever increasing number of deaths attributed to medical error, nationally.  When reported in the various Journals, they are based on what is reported and what was interpreted to be a 'medical error'.

From the 1999 IOM Report standpoint, they went one step further and indicated their numbers were based on errors of commission (not omission).  The actual number of deaths due to medical error are very likely to be significantly under-reported for these reasons.

It is hard to accurately measure such metrics, especially on such a large scale.  Especially when just simply defining the terms of 'medical error' and/or 'diagnosis error', are so ambiguous.

Thanks again for your response.

Robert J. Latino, CEO
Reliability Center, Inc.
1.800.457.0645
blatino at reliability.com
www.reliability.com
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From: HM Epstein [mailto:hmepstein at gmail.com]
Sent: Monday, January 16, 2017 12:18 PM
To: Bob Latino <blatino at reliability.com>
Cc: Society to Improve Diagnosis in Medicine <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
Subject: Re: [IMPROVEDX] The Detection, Analysis, and Significance of Physician Clustering in Medical Malpractice Lawsuit Payouts.

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 reliability.com<mailto:blatino at reliability.com>> 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.
1.800.457.0645
blatino at reliability.com<mailto:blatino at reliability.com>
www.reliability.com<http://www.reliability.com>
<image001.jpg><https://www.linkedin.com/company/958495?trk=tyah&trkInfo=clickedVertical%3Acompany%2CclickedEntityId%3A958495%2Cidx%3A1-1-1%2CtarId%3A1464096807851%2Ctas%3Areliability%20center%2C%20inc.>

From: HM Epstein [mailto:hmepstein at GMAIL.COM]
Sent: Monday, January 16, 2017 9:16 AM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
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?

Best,
Helene

"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."
http://mobile.journals.lww.com/journalpatientsafety/_layouts/15/oaks.journals.mobile/articleviewer.aspx?year=9000&issue=00000&article=99553#ath

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