Jeff Segal, MD, JD, FACS

A recent study in New England Journal Medicine shed light on the frequency of litigation against doctors. For high risk specialties, such as neurosurgeons and cardiothoracic surgeons, the annual rate approached 20% a year. For general surgeons, the rate was 15% per year; for plastic surgery, the rate was 13% per year.

The same study noted that plaintiffs received an award in only 1 of 5 cases.

A more recent study in the Journal of American College of Surgeons examined the effect this litigation had on surgeons.

Seven thousand surgeons (29%) in the professional society returned surveys.

Involvement in a recent malpractice suit was reported by 24.6% responding surgeons. Surgeons involved in a recent malpractice suit were younger, worked longer hours, had more night call, and were more likely to be in private practice.

Not surprisingly, recent malpractice suits were strongly related to burnout, depression, and recent thoughts of suicide. Hours worked, nights on call, subspecialty, and practice setting were also independently associated with recent malpractice suits. Surgeons who had experienced a recent malpractice suit reported less career satisfaction and were less likely to recommend a surgical or medical career to their children.

These conclusions are not exactly news to surgeons. But, it drives home the message that our professional liability system is badly broken. The consequences of a lottery system where only one in five patients win have profound consequences for our healthcare system. One question our healthcare system should address is who will take care of us if there are fewer surgeons to answer the call. Fixing our medico-legal tort system would help ensure a brighter future for surgeons – indeed, all physicians.