HealthDay News — Physicians with 1 or more paid malpractice claims are more likely to leave practice or shift into smaller practice settings, according to a study published in the March 28 issue of the New England Journal of Medicine.

David M. Studdert, LLB, ScD, from the Stanford University School of Medicine in California, and colleagues created a national cohort of physicians aged 35 to 65 years who practiced during 2008 through 2015. The associations between the number of paid malpractice claims that physicians accrued and exits from medical practice, changes in clinical volume, geographic relocations, and change in practice size group were analyzed. Data were included for 480,894 physicians with 68,956 paid claims.

The researchers found that 89, 8.8, and 2.3% of the physicians had no claims, 1 claim, and 2 or more claims, with the latter accounting for 38.9% of all claims. There was a positive association for the number of claims with the odds of leaving the practice of medicine (odds ratio for one vs no claims, 1.09; odds ratio for 5 or more claims, 1.45). There was no correlation for the number of claims with geographic relocation; there was a positive association with shifts into smaller practice settings. Physicians with 5 or more claims were more likely than those with no claims to go into solo practice (odds ratio, 2.39).

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“Such activity warrants close attention, especially in light of evidence that the number of paid claims that physicians have accrued is strongly and positively associated with their risks of incurring more,” the authors write.

The study was partly funded by SUMIT (Stanford University Medical Indemnity and Trust) Insurance, a company that is wholly owned by Stanford Hospital and Clinics and Lucile Packard Children’s Hospital.

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