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      Pediatricians and the Liability Marketplace

      Since 1987, the American Academy of Pediatrics (AAP), the predominant specialty organization in the field, has been collecting information about various aspects of malpractice cases in the specialty of pediatrics. Its most recent survey, in 2001, found that 26 percent of pediatricians had faced a malpractice claim at some time in their careers. This figure does not include claims faced during a residency. Among the pediatricians who did report a claim, 36 percent of cases were settled out of court, while 33 percent were dropped by the plaintiff.

      An extensive study on malpractice claims involving pediatricians was published in 2007 in the industry journal Pediatrics. The study examined data on malpractice cases from the Physician Insurers Association of America (PIAA), a large trade association of malpractice insurers. Researchers found that pediatricians account for 2.97 percent of the closed claims in the PIAA database, ranking pediatrics 10th of 28 specialties. These cases had an indemnity rate of 28.13 percent. The average indemnity payment in a pediatric malpractice case has been steadily increasing since 1985. The most alarming finding of the study was the high cost of defending against a pediatric malpractice case. The average defense cost for cases in which no indemnity was found was $28,779 and for cases with indemnity found was $67,502. These figures make pediatrics 4th highest among specialties in average defense costs.

      Because the cost of defending against a malpractice suit can be so high, it is important for pediatricians to know how to protect themselves against risk by becoming familiar with the common causes of lawsuits against pediatricians. Most of these suits are the result of an error in diagnosis. Data, again from the PIAA, show that the most common specific misdiagnoses are of meningitis, appendicitis, nonteratogenic anomalies, pneumonia and brain damage in infants.

      Pediatricians can employ risk management techniques to minimize the likelihood of being sued. Documenting all cases carefully is very important; physicians should record not only what is present in a case, but also what is notably absent, and should be sure to keep organized, clearly written notes. Also, do not be afraid to refer to a specialist or to seek the advice of a colleague. Finally, pediatricians should employ effective communication skills, maintaining a compassionate bedside manner and making certain that they are understood by their patients.

      In addition to employing risk management techniques, pediatricians who are concerned about the rising cost of their medical malpractice insurance and the effects of this trend on their practice should support the efforts of their specialty organizations, like the AAP, and communicate with politicians to advance meaningful reforms to the liability system. Click here to read the medical liability reform position statement of the American Academy of Pediatrics, which outlines a variety of reforms and describes methods for physicians to get involved.

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      This write-up for Pediatricians was put together by Michael Matray, the Editor of the Medical Liability Monitor

      Illinois Chapter American Academy of Pediatrics
      American Board of Pediatrics
      New York Times – Health – Pediatrics
      American Academy of Pediatrics
      Journal of Pediatrics
      FDA – Pediatrics
      Pediatric Research
      American Physical Therapy Association -Section on Pediatrics
      Pediatric Care Online
      U of M Evidence-Based Pediatrics Website