It is well known that medical malpractice suits are common, but very little data existed regarding which specialties are sued the most.

“Despite tremendous interest in medical malpractice and its reform, data are lacking on the proportion of physicians who face malpractice claims according to physician specialty, the size of payments according to specialty, and the cumulative incidence of being sued during the course of a physician’s career,” Anupam B. Jena, MD, PhD, of Harvard Medical School in Boston, and colleagues, wrote in the New England Journal of Medicine.

To further explore these topics the researchers analyzed records from 1991 to 2005 that included closed malpractice claims against almost 41,000 clinicians in all 50 states. Clinician age ranged from 30 years to 70 years, with a median age of 49 years.

They found that 7.4% of clinicians included in the study had a claim against them regardless of specialty, and that 1.6% had made an indemnity payment.

The most sued specialties, in order of greatest to least, are as follows: neurosurgery, thoracic-cardiovascular surgery, general surgery, orthopedic surgery, plastic surgery, gastroenterology, obstetrics and gynecology, urology, pulmonary medicine and oncology. Specialties that paid the most in plaintiff claims include general surgery, gynecology, thoracic-cardiovascular surgery and orthopedic surgery.

The least sued specialties are psychiatry, pediatrics, family general practice, dermatology, pathology and nephrology, the researchers found.

The good news is that although malpractice lawsuits are common, payments are not — only about 20% resulted in indemnity payments, which averaged about $247,887 per payment across all specialties.

Interestingly, the most-sued specialties were not always the ones that that paid out the most to plaintiffs. For example, although pediatricians are rarely sued, average indemnity payments in this specialty are high, at $520,924; whereas, neurosurgeons, although sued more frequently, had an average indemnity payment of $344,811.

The researchers also projected the proportion of clinicians expected to face a malpractice claim over the course of their career. By age 45, 36% of health-care providers working in low-risk specialties are projected to face a malpractice suit vs. 88% of doctors in high-risk specialties, data indicated.

By age 65, those numbers increase to 75% of those practicing in low-risk specialties compared with 99% of those in high-risk fields. Clinicians practicing in surgical specialties in particular run a greater risk for lawsuits, with 80% of physicians in these specialties projected to face a claim by age 45.

Jena AB et al. N Engl J Med. 2011; 365:629-636.