Malpractice data challenge defensive radiology stance

Imaging procedures performed to protect a radiologist against the threat of future litigation make little practical sense, according to an evaluation of the malpractice claims experience of 4300 radiologists across the nation.

The analysis by New Jersey Medical School radiology chair Dr. Stephen Baker and reported at the RSNA meeting found that radiologists are rarely sued for failing to perform an imaging procedure. Failure to perform an additional test was relevant in only 21 of 3000 claims filed against the radiologists in Baker's study.

These findings give radiologists a rare look at medical imaging malpractice claims information from the Department of Health and Human Services' National Medical Practitioners Database of medical malpractice claims experience. Baker examined the malpractice histories of 4300 radiologists in the database while performing routine credentialing functions for One-Call Medical, a specialty PPO network for workers' compensation-related MR and CT imaging. The PPO serves 40 states and contracts with about 15% of practicing U.S. radiologists, he said.

Claims experience from 1990 to 2000 indicates that U.S. radiologists have had about a one-in-three chance of being sued for malpractice. The odds have been highest for radiologists in Pennsylvania and Oregon. At least half of the radiologists in those states have been named in at least one medical malpractice lawsuit.

States where 41% to 50% of radiologists have been sued at least once are Idaho, Illinois, New York, Michigan, New Jersey, Louisiana, and Mississippi.

Florida, a state infamous for the size of monetary settlements for medical malpractice, ranks near the national average for malpractice claims risk. Between 30% and 40% of Florida's radiologists have been involved in a malpractice claim, Baker said.

The number of claims filed against radiologists annually relative to utilization growth actually fell between 1990 and 2000. Although the claims total has been stable from year to year, claims involving lung cancer and failure to diagnose in all conditions have increased. Mammography-related claims fell, despite a large increase in breast imaging volume, he said.

Data suggesting that radiologists may not be sued as often as some analysts claim does not mean that the American College of Radiology will give up its fight for tort reform, said ACR immediate past president Dr. William Thorwarth. ACR lobby efforts are directed at reducing malpractice rates and awards.

"And we know the size of malpractice settlements in Florida and some other states has exploded," Thorwarth said.

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2/1/05, Issue # 2702, page 9.