Plenary - 04: MALPRACTICE ALLEGATIONS: A REALITY CHECK FOR RESIDENT PHYSICIANS
Beiqun Zhao, MD, Luis Cajas-Monson, MD, Sonia Ramamoorthy, MD; University of California, San Diego

Purpose: Medical malpractice is a significant source of stress to physicians and cost to the healthcare system. Medico-legal training is not often included in surgical residency curricula. Little is known about the number of resident physicians that are involved in medical malpractice suits and the total costs incurred.

Methods: The Comparative Benchmarking System (CBS) is a nationwide database that includes approximately 400,000 malpractice cases (~30% of total US malpractice cases). We analyzed data for cases between 2007 and 2016, in which a resident physician was identified in a medical malpractice allegation. In addition, we surveyed general surgery residents at our institution regarding medical malpractice knowledge.

Results: Between 2007 and 2016, 2,353 out 57,744 total cases (4%) identified a resident physician, incurring a total of $831.7 million paid (11% of $7.5 billion total). 750 cases (32% of total) were filed against a surgical specialty and resulted in $259 million (31%) paid. General surgery had the most cases (188, 25% of all surgical services). The most common allegations were “improper performance of surgery” (289 cases, 39%, $275,043 per case) and “improper management of surgical patient” (208 cases, 28%, $525,871 per case). 18% of surgical cases specifically named a resident physician as a defendant, with total payout of $8 million (3%). Only 1 of the 750 cases attributed supervision as the major allegation. However, house-staff supervision was a contributing factor in 205 (27%) cases. The majority of residents correctly answered that residents can be named in a lawsuit (68.75% of respondents), but had “poor” to “terrible” self-reported understanding of medico-legal ramifications (68.75%) and assessment of the current medico-legal curriculum on SCORE (62.5%). Lastly, most residents agree that a medico-legal curriculum is “moderately important” to “extremely important” in general surgery training (96.87%).

Conclusions: A significant number of medical malpractice claims involve resident physicians as a responsible party. Though universally recognized as important, medico-legal training in surgical residency is often lacking. A more comprehensive education platform is needed during residency training to improve patient safety, encourage responsible habits, and decrease litigation costs in the future.