Malpractice prevalence in Orthopaedics?

[Med1]

I stumbled upon this NYT blog recently, and I was struck by the amount of malpractice litigation reported in ortho. On top of ranking 4th out of all specialties in number annual of malpractice claims filed (~14% of all orthopaedists annually), ortho litigation results in plantiff payment more frequently than in any other specialty (relative to total # of claims).

http://graphics8.nytimes.com/images/201 ... log480.jpg

Is there a particular subspecialty within ortho that is highly litigous (maybe spine?)? I'm a bit confused, because one of the widely cited perks of practicing orthopaedics is the largely positive patient outcomes. Is this graphic representative of the specialty, as a whole?

[wnlevine]

Provocative topic. Yes these statistics are true and a bit daunting for all of us. Unfortunately it is the nature of our culture at this point in our history to want to blame someone when there is an untoward event. As someone who does a fair bit of medicolegal work I can assure you that a high percentage of the claims that I am asked to review as an expert are beyond frivolous. However, malpractice does occur as you know.

Orthopaedic surgery is an incredibly high-reward field and while the threat is always there the benefits so far outweigh the risks that it is just something we accept and always strive to avoid. However, as one of my mentors used to say during residency "if you say you don't have complications you're either not operating enough or you're a liar!" Once you have a complication, however, how you manage your patients will go a long way in determining whether or not they bring a lawsuit against you. While there is no absolute protection, ignoring or disrespecting the patient is a sure-fire way to guarantee one.

Thanks for the post -- hope this helps to answer some of your questions.

wnl

[Med1]

Thanks for your response, Dr. Levine. It's refreshing to hear from a seasoned orthopaedist that the positives in ortho far outweigh the negatives brought on by the litigious environment. This really is a remarkable specialty.

I am curious though, what are the career implications of a lawsuit? Much of the work we do is dangerous by nature, and as you said, complications are inevitable. When these complications lead to malpractice claims, can a surgeon still practice as usual? I can only imagine how awful it would be to lose your career over a poor outcome, which might have been unavoidable. Do we have any defense against the inherent risk in our profession, apart from treating our patients well and hoping for the best?

Thanks again for taking the time to answer these questions. This forum is a great resource.


**For those interested, here's a link to the original NEJM article:

http://www.nejm.org/doi/full/10.1056/NE ... articleTop