Abstract：
OBJECTIVES:There is evidence that most adverse events result from individual errors and that most malpractice suits with payouts reflect both patient injury and error. HYPOTHESIS:There are outlier physicians with regard to the frequency and total amount of malpractice payouts. METHODS:Using the public use file of the National Practitioner Data Bank (NPDB), we sought the percentage of physicians who lay above several cutoff points with regard to total amounts of payments and number of payments. We looked at the frequency with which outliers were likely to have additional paid claims and to be disciplined by their hospitals and state boards. RESULTS:Approximately 1.8% of physicians were responsible for half of the $83,368,588,200 reported to the NPDB over 25 years. Within that group, 12.6% had an adverse licensure action reported to the NPDB, and 6.3% had a clinical privileges action reported. Physicians who were in the high dollar payout category and had one malpractice claim payout had a 74.5% chance of another payout, more than twice the rate for all physicians who had a single payout (chi-square, P < 0.0001). The likelihood that that physician would have additional payments increased as the number of previous payments increased. Total dollar payouts per physician better predicted future payouts than numbers of payouts. (For 1, 2, and 3 payouts, the P value was less than 0.0001 for each category.) Limitations: Neither a prospective nor a randomized study was feasible. Sorting by specialty was not done. Malpractice cases are an indirect measure of adverse events. CONCLUSIONS:There is a clustering of payments in medical malpractice cases among a small group of physicians. These findings point up the need to oppose the negative impact of such outlier physicians on the safety of patients.
journal_name
J Patient Safjournal_title
Journal of patient safetyauthors
Oshel RE,Levitt Pdoi
10.1097/PTS.0000000000000326subject
Has Abstractpub_date
2020-12-01 00:00:00pages
274-278issue
4eissn
1549-8417issn
1549-8425pii
01209203-202012000-00007journal_volume
16pub_type
杂志文章abstract：OBJECTIVES:The aims of this study were to investigate the demographics, causes, and contributing factors of retained guidewires (GWs) and to make specific recommendations for their prevention. METHODS:The Veterans Administration patient safety reporting system database for 2000-2016 was queried for cases of retained G...
journal_title：Journal of patient safety
pub_type： 杂志文章
doi：10.1097/PTS.0000000000000475
更新日期：2018-02-13 00:00:00
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journal_title：Journal of patient safety
pub_type： 杂志文章
doi：10.1097/PTS.0b013e3182446c51
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journal_title：Journal of patient safety
pub_type： 杂志文章
doi：10.1097/PTS.0b013e31827cda38
更新日期：2013-06-01 00:00:00
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journal_title：Journal of patient safety
pub_type： 杂志文章
doi：10.1097/PTS.0000000000000791
更新日期：2020-10-01 00:00:00
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pub_type： 杂志文章
doi：10.1097/PTS.0b013e3182995e5b
更新日期：2013-12-01 00:00:00
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journal_title：Journal of patient safety
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更新日期：2018-05-16 00:00:00
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journal_title：Journal of patient safety
pub_type： 杂志文章
doi：10.1097/PTS.0000000000000101
更新日期：2017-03-01 00:00:00
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journal_title：Journal of patient safety
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doi：10.1097/PTS.0000000000000670
更新日期：2020-03-11 00:00:00
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journal_title：Journal of patient safety
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更新日期：2019-12-01 00:00:00
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journal_title：Journal of patient safety
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更新日期：2017-12-01 00:00:00
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journal_title：Journal of patient safety
pub_type： 杂志文章,随机对照试验
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更新日期：2013-09-01 00:00:00
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journal_title：Journal of patient safety
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doi：10.1097/PTS.0000000000000068
更新日期：2015-12-01 00:00:00
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journal_title：Journal of patient safety
pub_type： 杂志文章
doi：10.1097/PTS.0000000000000346
更新日期：2017-03-17 00:00:00
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journal_title：Journal of patient safety
pub_type： 杂志文章
doi：10.1097/PTS.0000000000000182
更新日期：2018-06-01 00:00:00
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journal_title：Journal of patient safety
pub_type： 杂志文章
doi：10.1097/PTS.0000000000000086
更新日期：2016-06-01 00:00:00
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doi：10.1097/PTS.0000000000000711
更新日期：2020-06-01 00:00:00
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journal_title：Journal of patient safety
pub_type： 杂志文章
doi：10.1097/PTS.0b013e3181d108cb
更新日期：2010-03-01 00:00:00
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journal_title：Journal of patient safety
pub_type： 杂志文章
doi：10.1097/PTS.0000000000000270
更新日期：2019-09-01 00:00:00
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journal_title：Journal of patient safety
pub_type： 杂志文章
doi：10.1097/PTS.0b013e31821b8a6c
更新日期：2011-06-01 00:00:00
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journal_title：Journal of patient safety
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更新日期：2020-03-24 00:00:00
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更新日期：2018-06-27 00:00:00
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更新日期：2016-08-03 00:00:00
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更新日期：2020-09-01 00:00:00
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更新日期：2010-09-01 00:00:00
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journal_title：Journal of patient safety
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更新日期：2018-12-01 00:00:00
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journal_title：Journal of patient safety
pub_type： 杂志文章
doi：10.1097/PTS.0000000000000514
更新日期：2020-09-01 00:00:00
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journal_title：Journal of patient safety
pub_type： 杂志文章
doi：10.1097/PTS.0000000000000370
更新日期：2017-02-24 00:00:00
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journal_title：Journal of patient safety
pub_type： 杂志文章
doi：10.1097/PTS.0b013e318267c4aa
更新日期：2012-12-01 00:00:00
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更新日期：2020-03-11 00:00:00
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更新日期：2019-10-22 00:00:00
