General and Plastic Surgeons Are the Most-Sued Specialists

Lucy Hicks

February 03, 2022

More than three fourths (77%) of surgeons report being named in a malpractice lawsuit, according to the Medscape Surgeon Malpractice Report 2021.

General and plastic surgeons tied as the specialists most likely to be sued (both 83%), and specialized surgeons ranked sixth among all specialties, with 74% reporting at least one lawsuit during their career. The top reason for being sued was complications from treatment/surgery (65%), a percentage more than twice that of physicians overall (29%).

This new report was compiled from an online survey including more than 4300 physicians from 29 specialties. The survey was available from May 21 to August 28, 2021, and included 382 general, specialized, and transplant surgeons. More than four fifths of respondents (82%) were male and 58% had practiced surgery for more than 25 years. Over half (57%) were aged 60 years or older, and 25% reported being at least years old.

The second most common reason for being sued among surgeons was poor outcome/disease progression (21%), followed by wrongful death (17%), failure to diagnosis/delayed diagnosis (16%), failure to treat/delayed treatment (16%), and abnormal injury to the patient (15%).

One third of surgeons (33%) said they paid $30,000 or more in malpractice insurance every year, compared with just 4% of primary care physicians and 11% of other specialists. Both primary care physicians and all specialists most commonly reported paying under $10,000 in malpractice insurance premiums (40% and 30%, respectively), whereas just 7% of surgeons said the same. The second most common response among surgeons (17%) was that they did not know how much their practice spent on malpractice insurance.

Four fifths of surgeons (80%) reported being "very surprised" or "somewhat surprised" by the malpractice suit. Slightly more surgeons said they were not surprised (20%) by suit compared with physicians overall (14%). Similar to other specialties, the vast majority of surgeons (82%) believed that the malpractice lawsuit was not warranted. Less than one tenth of surgeons (9%) thought the suit was warranted, and 9% were unsure.

A larger proportion of surgeons (44%) reported spending more than 40 hours on their defense in comparison to physicians overall (35%). Most surgeons (43%) said their lawsuits took 1-2 years to adjudicate and 34% said the suit dragged on 3-5 years.

Nearly two fifths of surgeons (39%) reported that cases were settled before trial, a slightly higher proportion than physicians overall (33%). The second most common case outcome among surgeons was the court ruling in favor of the respondent (17%), and 11% reported that the case was still ongoing.

When the patient was awarded a monetary payment, nearly half of surgeons (46%) reported paying between $100,000 and $500,000 to the plaintiff, compared with 35% of physicians overall. The second most common payment among surgeons was under $100,000 (34%), followed by payments under $1 million (15%).

A lower percentage of surgeons (38%) said they would have done nothing differently compared to the general physician pool (43%). Nearly one fifth of surgeons (18%) said they would not have taken on the patient in the first place, 12% said they would have better chart documentation, and 10% said they would have spent more time with the patient and his or her family.

Most surgeons (69%) said that the lawsuit did not have a negative effect on their career, with slightly over half (51%) reporting that they did not undergo any attitude or career changes after the lawsuit. More than a quarter (26%) of respondents said they trusted patients less. "I never felt the same way about practicing medicine since then," commented one surgeon. "To be sued for trying to help someone changes the way you look at a patient."

Although most surgeons (54%) said that the outcome of their case was fair, some shared that the process of patient compensation and malpractice needed revision. "The current system is a mess," wrote another respondent. "There needs to be a better way to compensate those who are injured without this long, expensive, and stressful process on both sides. The only ones who win are the lawyers."

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