Forty-one percent of U.S. psychiatrists have been sued for malpractice at least once, findings from the newly released Medscape Psychiatrist Malpractice Report 2019 show.
The top reason for the legal action was wrongful death (31%), followed by poor outcome/disease progression (23%), failure to treat/delayed treatment (11%), errors in medication administration (10%), and complications from treatment/surgery (8%).
Only 7% of psychiatrists said failure to treat/delayed treatment was the reason for the lawsuit, whereas this was the top reason for physicians overall (33%) in the report.
Medscape surveyed 4,360 physician members in more than 25 specialties about whether they have been sued for malpractice, reasons for a lawsuit, what happened, and how the experience affected the way they practice medicine and interact with patients.
Among psychiatrists named in a lawsuit, 44% said they were very surprised to be the subject of litigation. A similar percentage reported they were somewhat surprised (41%), while 15% were not at all surprised.
The vast majority of psychiatrists (87%) believed the lawsuit was not warranted, while 11% were unsure. Only a small percentage (2%) believed that legal action was justified, the lowest percentage of all physicians (6%).
Among psychiatrists who were sued, 42% were able to identify the incident that sparked the lawsuit. A slightly higher percentage (47%) said there was no specific incident that spurred legal action; 11% couldn’t recall.
Psychological factors
“There’s a whole host of what you could call psychological factors that can contribute to the filing of a claim,” David S. Szabo, a malpractice defense attorney with Locke Lord LLP, Boston, said in an interview.
“These can occur when a patient perceives a breakdown in the doctor-patient relationship or is pretty certain that there’s been a mistake and they feel like they’ve been shut out of productive conversation with their health care provider or providers,” said Mr. Szabo.
Legal action eats up time. A total of 43% of psychiatrists reported spending more than 40 hours on their defense, which involved gathering records, meeting with attorneys, and preparing for depositions.
Forty-six percent reported that the entire process took 1-2 years to resolve, but nearly a quarter (23%) said the process dragged on for 3-5 years.
One-third of psychiatrists who were named in a malpractice lawsuit said the case was settled out of court. Of the cases that went to trial, 12% of psychiatrists reported that the verdict was in their favor; 3% reported that the outcome of the case was in the plaintiff’s favor.
Asked why they think most malpractice lawsuits occurred, 61% of psychiatrists said that patients don’t understand medical risks and blame the doctor for bad outcomes even if the doctor does everything right.
A similar percentage of psychiatrists recognized that if a true medical error has occurred, patients wanted to seek restitution and/or assign blame. Only 29% of psychiatrists felt that constant advertising by lawyers to get new clients was the reason for most malpractice cases.
The overwhelming majority of psychiatrists (93%) who responded to the survey carry malpractice insurance, about the same as physicians overall (94%).
Among those with malpractice coverage who either settled or went to trial, about half were either encouraged by their insurer to settle the case or were required by their insurer to do so.
“Generally, if a physician senses that he or she is heading toward a difference of opinion with the insurer about settlement, they probably ought to invest a little time in having personal counsel look at the case,” Mr. Szabo said.