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In Case You Were Wondering About Malpractice Data

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In Case You Were Wondering About Malpractice Data

By Jock Hoffman, CRICO

Related to: Claims, Publications

CRICO’s national Comparative Benchmarking System (CBS), with 360,000 cases, can tell you a lot about malpractice event tendencies and trends. How much you rely on such information depends on your confidence in the analytics behind the numbers, and your understanding of what MPL cases represent. Indeed, without faith in the basic premise that malpractice cases offer actionable insights, the numbers are just numbers. To test your conviction that those numbers have value, consider these questions.

 

Do good doctors get sued?

Yes.

Essentially, all physicians are at risk of being named in an MPL claim or lawsuit because they are human (thus prone to mistakes), and they practice in complex (and imperfect) systems. Against the backdrop of all patient encounters, an allegation of malpractice is extremely rare, but within the community of clinicians, being named at least once is not rare, and is not a measure of clinical ability.

2

Should I care about malpractice cases that are closed without payment?

Yes.

About 70 percent of cases close without an indemnity payment. All allegations of malpractice are motivated by either a sense that substandard care should be compensated, or a need to better understand an adverse outcome. The inclusion of zero-indemnity cases in the database helps identify factors that set them apart from paid cases. Analysis of zero-payment cases can also identify opportunities for providers to pre-empt litigation and avoid multiple years of stress while waiting for a resolution.

3

Is the payment amount a reflection of the degree of malpractice?

No.

Financial severity is not a gauge of clinical practice or medical error. The amounts of indemnity payments are most directly aligned with the severity of the injury involved and the patient’s age. Egregious errors can be non-injurious, and severe care-related injuries (including deaths) can be the result of an unfortunate misunderstanding by a highly conscientious caregiver.

4

Is malpractice experience a good indicator for business decisions?

Maybe.

One highly-visible malpractice case may not reflect an organization’s safety culture. Even the very best institutions experience bad outcomes in the practice setting and in the courtroom. More reliable indicators of business compatibility include how a given entity identifies risk (including the use of MPL data) and how it responds to outliers, evidence-based trends, and emerging risks.

5

Do malpractice cases change how care is delivered?

Yes.

Malpractice cases often bring to light systemic problems that led to substandard care and point to the need for process improvement. In some cases, change is driven by a single event, but comprehensive analysis of the factors that contributed to a broader set of events can help uncover more subtle problems.

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November 29, 2018
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