Shahed Brown, MD, Daniel D. Dressler, MD, MSc, SFHM, FACP

Hospitalists have a lower rate of malpractice claims than do other physician specialties.

The hospitalist model introduces many care handovers and transient doctor-patient relationships, factors that seemingly would increase risk for malpractice claims. Investigators evaluated >52,000 medical malpractice claims — from 20 different insurance programs covering >3000 U.S. healthcare organizations — representing approximately 30% of closed claims in the U.S. from 1997 to 2011.

Only 272 medical malpractice claims were filed against internal medicine hospitalists (defined as internists who spend >50% of their time on inpatient care), corresponding to a rate of 0.52 claims per 100 physician coverage-years (PCYs). This rate was significantly lower than the rate of claims against nonhospitalist internal medicine physicians (1.91 claims per 100 PCYs), emergency medicine physicians (3.50 claims per 100 PCYs), and general surgeons (4.70 claims per 100 PCYs). Among claims made against hospitalist physicians, one third resulted in payments to plaintiffs (median payment, US$240,000). Researchers found no significant difference by specialty in the percentage of cases that resulted in payments. Although almost half of malpractice claims against hospitalists were related to clinical judgment in diagnosis or consultation, a substantial number of claims were related to clinician communication (36%) or documentation (20%).

Citation(s):

Schaffer AC et al. Liability impact of the hospitalist model of care. J Hosp Med 2014 Oct 21; [e-pub ahead of print].