HOW DO I KNOW IF MY DOCTOR HAS A MALPRACTICE HISTORY?

“Wait – You mean to tell me that he has hurt other patients before?” 

 I can’t tell you the number of times I’ve seen a medical malpractice client’s face turn pale with shock and despair when I share with them that their doctor has been sued successfully in the past.  Typically, these clients have very similar responses:

“I had no idea!”

“If I had just known about my doctor’s history I would have gotten my care somewhere else!”

“How was I supposed to learn that?  Where can I find information about a doctor’s claims history?”

The answers to these  questions can be complicated.

A recent study published in the New England Journal of Medicine revealed that just 1% of active U.S. physicians are responsible for nearly a third (1/3) of the nation’s paid malpractice claims.  In other words, most of the instances of medical malpractice are committed by a small number of doctors.  The study also found that the more paid claims a doctor has had, the higher that risk that doctor would have another paid claim in the future.

It is important to emphasize that the study focused on paid claims.  A paid claim means either (1) a jury found that the doctor had committed malpractice in a case that was tried in court; or (2) the doctor and/or the insurance company agreed to pay the claim – i.e., they agreed that a lawsuit against them would likely be successful.  Just because a doctor has been sued for malpractice does not necessarily mean that the claims are true.  Plenty, indeed most, malpractice claims brought against physicians are successfully defended and the fact of a prior claim, by itself, does not necessarily mean that the doctor did anything wrong.  Paid claims, on the other hand, are relatively rare and should be a red flag for a patient to try to obtain additional information.

The Virginia Board of Medicine web site contains useful information about physicians licensed in Virginia.  Searching by name, the site provides general information about where the doctor went to school, what insurance plans they accept and any academic appointments they may have had.  The site also contains two important links:  “Proceedings, Actions and Convictions” and “Paid Claims“.

The “Proceedings” tab contains information provided by the Board of Medicine itself about claims, investigations and administrative orders pertaining to the doctor’s fitness to practice medicine.  An example would include a Board investigation into a doctor who abused drugs or alcohol while treating patients.  The web page actually provides links to PDFs of the important documents themselves.

 

The “Paid Claims” tab can be useful to a patient, but is less reliable.  The Board of Medicine requires doctors to report all paid claims over $10,000 from the past ten years.  When provided, there is some select information listed about the claim, such as whether the settlement was average, above average or small compared to similar claims, etc.

 

The limitation with the site is that the information is only as good as the source.  While doctors are required to self‑report, they do not always do so.  Also, there are loop holes – sometimes an insurance company will settle a malpractice claim on behalf of the group or practice in order to protect the individual doctor from having to report a settlement.  Technically, this complies with the reporting requirements even though, in this writer’s opinion, it defeats the purpose of requiring the doctor to disclose the information publicly.

The take-away here is that there may be information about your doctors out there if you know where to look.  At the same time, it is important to also recognize that even a careful investigation may not turn up everything there is to know.