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Jane A is a 35-year-old emergency physician who has practiced for 7 years since completing her residency. She loves medicine, especially the opportunity to help complete strangers in their time of greatest need, and prides herself on her attention to detail, her conscientious care, and her meticulous documentation. She is generally regarded as one of the best physicians in the practice, both for her clinical acumen and for her empathic approach to patient care.

Jane is stunned when in the middle of a busy shift a process server accosts her with a medical malpractice claim in which she is named as defendant. Her concentration is broken, and she takes a break to review the claim. She does not remember the patient, whom she saw for a very few minutes at the end of a shift before transferring care to the oncoming shift. When Jane later obtains the medical records, she discovers that the physician who assumed care of the patient from her did not sign the chart. This physician is not named in the suit, nor are other physicians who were consulted during the disposition of the patient.

Over the next 4 years, Jane defends herself admirably but ultimately is found to be negligent because she does not handle testimony well and her lawyer cannot prove to the jury that substantial decisions were made by other physicians involved in the case. Her health suffers and she seriously contemplates the difficult decision to leave medicine.

Until recently, estimates regarding the frequency of malpractice claims against emergency physicians were sheer guesswork. Physicians have been reluctant to share their personal experience with malpractice litigation due to fear of repercussions in the community and loss of professional reputation. Although liability insurers have had access to accurate figures, even those statistics that they were willing to share were flawed because of the failure to aggregate data, and difficulty in parsing out those claims that actually resulted from emergency physician care.

Claim Frequency

In 2010 several studies shed more light on this matter. The American Medical Association (AMA) determined in a comprehensive cross-specialty survey of 5282 physicians that 42% had been sued for malpractice at some time in their careers, with an average of 95 claims for every 100 physicians surveyed.1 There were dramatic variations in claims frequency among specialties. Emergency physicians ranked fifth in claims frequency, with 109 claims per 100 physicians. Nearly half the EPs reported experiencing at least 1 claim, and 30.9% had been sued several times. In the year covered by the survey (2007-2008), 8.7% of the EPs surveyed had been sued. Over 75% of EPs over age 55 had experienced claims.

Aggregate outcomes data for emergency medicine malpractice claims from 1985 to 2007 were reported in a separate study done at Johns Hopkins, using PIAA (Physician Insurers Association of America, whose members insure 60% of physicians ...

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