Medical Malpractice and Rhinology

SAN DIEGO-Although expenses related to medical malpractice are often seen as a cost of doing business, the experience of litigation is a personal, as well as a professional assault. A malpractice suit attacks a physician’s integrity and confidence.

Douglas E. Dawson, MD, MS, from Unity Health Care in Muscatine, IA, and Eric Kraus, MD, MS, with The Ear Center of Greensboro, NC, have experienced the unpleasantness of malpractice litigation. As did many other physicians and surgeons, they found the language, concepts, and rules of the legal system to be foreign territory. The two otolaryngologists wondered if a better understanding of malpractice statistics, vulnerable areas, and aids to coping would be helpful for other specialists in today’s litigious society.

In an American Rhinologic Society presentation April 26 at the Combined Otolaryngology Spring Meetings, Dr. Dawson represented the two in providing a description of their recently completed research project, titled Medical Malpractice and Rhinology.

Analysis of Claims Data

Douglas E. Dawson, MD, MS

The physicians analyzed 20 years of data from the Physicians Insurers Association of America (PIAA), an organization composed of 43 insurance companies providing malpractice coverage to more than 60% of all physicians in the United States. Since 1985, the PIAA has compiled and made available a data sharing report that represents the largest available source for medical malpractice loss causation data.

Drs. Dawson and Kraus then compared and found strong correlation of the PIAA data to information on judgments, settlements, and adverse actions against US physicians that has been compiled by the federally mandated National Practitioner Data Bank (NPDB).

They found that many rhinology claims contain issues of improper performance, informed consent, and documentation. For example, nearly two-thirds of the total indemnity, or settlements and awards made directly to plaintiffs, was for improper performance by otolaryngology-head and neck surgery (oto-HNS) physicians and surgeons regarding the nose, nasal cavity, and paranasal sinuses.

However, otolaryngology was nowhere near the top of all specialty payouts for malpractice claims, according to Dr. Dawson. Of 28 specialty groups, oto-HNS ranked 17th in the number of claims reported and 14th in total indemnity paid, with $213 million paid as of the 2006 PIAA report. Oto-HNS had the lowest total indemnity of the listed surgical specialties.

The most claims reported were in the specialty of obstetrics/gynecology, with 32,319 (compared to 3,793 in otolaryngology). Ob/gyn indemnity was more than $2.7 billion. Second highest was general surgery, with 24,378 claims and nearly $1.4 billion paid.