Annual Scientific Meeting
Introduction: In the recent years medical malpractice claims have contributed significantly to the rising cost of medical practice in all specialties in the United States by increasing the malpractice insurance premiums and costs associated with the practice of defensive medicine. Being a procedure oriented specialty, the trends in gastroenterology diagnoses and endoscopy related claims need to be studied to educate the gastroenterologists towards risk management.
Methods: Retrospective analysis of Medical professional liability (MPL) claims data for the years 2006-2015 obtained from the MPL association [formerly the Physician Insurers Association of America (PIAA) Data Sharing Project (DSP)] was done. Among the gastroenterology claims the presenting medical condition, operative procedure, outcomes of the claims and the costs associated with the closed claims were compared between 2006-2010 and 2011-2015 time periods to analyze the trend over the years.
Results: From 2006-2015, 90,743 MPL claims were closed . Out of all the claims, 2.07% (1879/90,743) of closed claims and 1.5% (367/24,106) of all paid claims were against gastroenterologists. In the claims against gastroenterologists, 71.0% of were dropped, withdrawn, or dismissed. Within the GI, MPL claims involving diagnostic procedures of large intestine were the most common accounting for 26% of all closed claims leading to a payment of $18,392,668 in total and $301,519 as average indemnity. Average indemnity was highest for diagnostic procedures of gallbladder and biliary tract including ERCP procedures ($484,364).This was followed by procedures involving small intestine ($336,078), large intestine ($301,519) and esophagus ($267,577).
In the time frame 2006-2015, the average indemnity increased by 8.2% from $341,563 in 2006-2010 to $369,508 in 2011-2015. Amount spent on legal defense also increased by 8.7% ($44,625 vs. $48,506) in gastroenterology related claims for the respective time periods.
Discussion: Gastroenterology specialty has an increasing trend in spending on average indemnity and defense. Diagnostic procedures of the biliary tract including ERCP have the highest average indemnity among the endoscopic procedures. Adequate endoscopic training, meticulous focus on procedural indication and well informed consent might help to reduce the costs associated with claims. Further studies are needed to investigate the variables associated with this trend in gastroenterology.