Error in diagnosis is the most common reason for lawsuits against radiologists in the United States, according to results from a study published in Radiology.
The study examined the malpractice history of 8,401 radiologists in 47 states using data from One-Call Medical, a specialized preferred provider organization. Data included information such as state of residence, age, sex, and malpractice history. A little less than a third of the radiologists in the study sample — 2,624 to be exact — had at least one claim in their career.
In the category of diagnostic error, breast cancer was the most frequently missed diagnosis to result in a malpractice suit. This was followed by nonvertebral fractures, spinal fractures, and lung cancer. Procedural complications and inadequate communication with patient or referrer are the next most common reasons for suing. However, failure to communicate and failure to recommend additional testing were rarely used as grounds for lawsuit.
In a phone interview with ImagingBiz, Stephen R. Baker, one of the researchers, said that radiologists do not interface with patients as often as other specialties, which explains the low ranking for communication failure. Baker added that poor technique for detecting breast cancer, which is often complicated by dense breasts, combined with the devastating nature of the disease, is the reason why missed diagnosis for breast cancer ranks so highly. To minimize lawsuit, Baker suggested that practices have one or two breast imaging specialists so that they can acquire more experience individually and build stronger relationships with patients.
From the study results, Baker concluded the idea that failure to recommend additional testing would lead to lawsuit was a myth. Baker called it a “self-serving notion” and an “excuse” for radiologists to order more exams, leading to overutilization.
In a separate study, using the same data from One-Call Medical, researchers found that New York had the highest rate of malpractice suits for male and female radiologists, and that Alabama had the lowest rate. The frequency and average payout for suits varied dramatically between states. Male radiologists, on average, were sued more often than their female counterparts. The study concludes that the likelihood of a radiologist being involved in one suit is 50% by age 60.
At least six more studies are planned using the data, according to Baker, which will focus on imaging studies related to bone, GI, chest, and the elderly.
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