Study Provides Insights on Medical Malpractice Allegations Against Internal Medicine Physicians

NAPA, CA--(Marketwired - September 21, 2016) - A study issued today of 1,180 claims against internal medicine physicians insured by The Doctors Company, the nation's largest physician-owned medical malpractice insurer, shows that the most common claims are diagnosis related, that internists are more likely to be sued for high-severity injuries than doctors in other specialties, and that both hospitals and physician practices are at risk. The research is based on claims that closed from 2007 to 2014, regardless of the outcome.

The analysis found that 39 percent of all claims alleged failed, delayed, or wrong diagnosis, with 56 percent of these claims alleging inadequate patient assessments such as failure or delay in ordering diagnostic tests. The study further shows that 58 percent of claims against internal medicine specialists were for high-severity injuries, compared to 34 percent of claims against all physicians, and that over a third of all injuries took place in hospitals.

"We hope this information will assist both internal medicine physicians and hospital risk managers in understanding common allegations and the factors behind these claims," said study co-author David B. Troxel, MD, medical director, The Doctors Company. "With the data on patient allegations and the actual factors that led to injuries included in this study, physicians and risk managers can identify system weaknesses and reduce risk of harm to patients."

In preparing the study, The Doctors Company partnered with practicing physicians, who reviewed the cases to determine the top factors that contributed to patient injury. The top three factors were patient assessment issues (33 percent), patient factors such as noncompliance with the treatment plan (25 percent), and communication breakdown between patient or family and the provider (21 percent). In the analysis, more than one factor often contributed to the injury. Also included in the study are examples of actual malpractice cases and suggested risk mitigation strategies.

"This study reinforces that physicians fail to diagnose and treat accurately for a variety of reasons," said Howard R. Marcus, MD, internal medicine physician with Austin (TX) Regional Clinic. "The average primary care physician will diagnose about 400 different diseases a year and occasionally encounters a rare medical condition that he or she may have never seen before. It is in this context that failure to diagnose may be caused by an error or lapse in reasoning rather than a failure of knowledge or clinical skill. The case studies in this study will be used in our medical group's continuing medical education to demonstrate to our more than 250 primary care physicians how to avoid pitfalls in medical decision making."

The study is available at and will be distributed at the ASHRM 2016 Annual Conference that takes place September 25 to 28, 2016, in Orlando, Florida.

About The Doctors Company
Founded and led by physicians, The Doctors Company ( is relentlessly committed to advancing, protecting, and rewarding the practice of good medicine. The Doctors Company is the nation's largest physician-owned medical malpractice insurer, with 78,000 members and $4.3 billion in assets, and is rated A by A.M. Best Company and Fitch Ratings.

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