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Print this pagePP25. An Ex Ante Analysis of Medical Malpractice Claims Risk in Vascular Surgery
Matthew J. Borkon, M. Bernadette Cornett, James W. Pichert, Ge Yan, Gerald B. Hickson, Jeffery B. Dattilo
Vanderbilt Medical Center, Nashville, TN
OBJECTIVES: Previous studies demonstrate that unsolicited patient complaints are associated with medical malpractice claims. These studies reveal that a small subset of physicians are associated with a disproportionate share of patient complaints compared with their peers and are, therefore, at a disproportionate risk for medical malpractice claims. We investigated whether vascular surgeons follow this pattern, the nature of the patient complaints contributing to vascular surgeons’ risk, and how vascular surgeons compared to other surgeons.
METHODS: This retrospective study examined 14,792 unsolicited patient complaints filed against a cohort of 3,435 surgeons representing 20 subspecialties, of which 66 were fellowship trained vascular surgeons. Malpractice claims “risk scores” were generated by analyzing patient complaint data collected by ombudsmen from 14 geographically diverse health systems between 12/16/2004 and 12/15/2008. Patient comments were coded using a standardized complaint coding system to create a complaint profile. A weighted sum algorithm generated the risk score from four consecutive years of complaint data.
RESULTS: Vascular surgeons’ risk scores were non-randomly distributed: 31% had no complaints, 40% had few complaints (risk scores 1-30), and 7.6% had scores >50, which are associated with high risk. Concerns about treatment (45%) and communication (27%) predominated followed by access and availability (16%), humanistic concern for patient and family (8%), and billing (5%). Among other surgical subspecialties, 57% had no complaints; 6.9% were in the high-risk group.
CONCLUSIONS: Patient complaints and medical malpractice claims risk are non-randomly distributed among vascular surgeons. Similar to other surgeons, a large percentage of vascular surgeons have low-risk for malpractice claims while a small percentage carry a disproportionate share of this risk. Non-randomly distributed risk indicates that aggregated patient complaints provide an ex ante approach to identifying vascular surgeons at a high-risk for medical malpractice claims. Patient complaint monitoring that identifies vascular surgeons with disproportionately high-risk scores would permit targeted interventions aimed at decreasing future risk before lawsuits accumulate.
AUTHOR DISCLOSURES: M.J. Borkon, None; M.B. Cornett, None; J.W. Pichert, None; G. Yan, None; G.B. Hickson, None; J.B. Dattilo, None.
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© 2010 VascularWeb. All rights reserved. Use of the VascularWeb site constitutes acceptance of all of the policies, rules and regulations for the site.