Doctors love to complain that they are the victims of a legal system gone haywire. To hear them tell it, they practice great medicine, but are deluged with frivolous lawsuits provoked by greedy lawyers. In point of actual fact, the number of malpractice claims is far, far less than the instances of medical malpractice that seriously injure patients. Only a small fraction of the victims of medical malpractice ever make a claim, much less file suit.
The curtain was pulled back on the subject of medical malpractice by a group of respected researchers for the New England Journal of Medicine in 1991. They were encouraged to undertake their study by a major insurer of doctors and hospitals in the hopes of developing information that would promote patient safety and reduce the number of claims the company had to pay.
Through a review of thousands of hospital charts from New York patients, the researchers, many of whom were physicians themselves, discovered that there were many adverse events during hospitalizations and that almost 25% of them were the result of medical malpractice. They defined an adverse event as one caused by medical management which resulted in a longer hospital stay or a disabling injury at the time of discharge, or both. They found that about 4% of all hospitalizations involved an adverse event, with medication events constituting the largest share. Among their other significant findings was that the more serious the injury suffered by the patient, the more likely it was to have been the result of medical malpractice. Older patients were at higher risk of an adverse event and more likely to be victims of medical malpractice. They called for changes in the delivery of health care to improve patient safety.
Thirty years later, other researchers, encouraged and supported by the same insurance company, wanted to see if there had been any improvements in patient safety in light of the many changes in medicine. They undertook a similar study of hospital admissions looking for the presence of adverse events and determining how many of them were the result of medical malpractice. Their results were also published in the New England Journal of Medicine. Surprisingly or unsurprisingly, depending on your point of view, they found a lot of medical malpractice and many injured patients.
The study involved a review of almost 3,000 hospital admissions at 11 hospitals of various sizes in the state of Massachusetts in calendar year 2018. This time there was at least one adverse event in almost 24% of the admissions. In the earlier study, the rate of adverse events had only been 3.7%. One figure which had changed little was the percentage of adverse events which were the result of medical malpractice. It was still around 23%. A preventable adverse event occurred in almost 7% of all admissions and patients had a 1% chance of being the victim of a serious or fatal adverse event resulting from medical malpractice. As before, drug reactions were the most common adverse event. Also as before, the risk of being the victim of medical negligence was higher for older patients.
In the interim between the two studies discussed here, similar studies in California, Utah and Colorado found rates of adverse events and medical negligence very much in line with the findings here.
Arizona had 652,651 hospital admissions in 2021. Assuming the rates of adverse events and medical malpractice are even roughly similar between Arizona and the hospitals in New York and Massachusetts, there were around 156,000 adverse hospital events in Arizona in 2021, of which approximately 36,000 were the result of medical malpractice. Over 6,500 patients suffered a serious or fatal injury due to medical malpractice. Now consider that there were only 170 medical malpractice cases filed in the entire state of Arizona in 2024. This number is close to the usual number of malpractice cases filed.
Rather than feeling sorry for themselves for being sued on occasion, doctors ought to be thanking their lucky stars that the rate of malpractice claims is so low. In another post, I will discuss my thoughts about why there is such a big difference between the large number of patients seriously injured or killed by malpractice and the very tiny number of malpractice lawsuits filed.
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