Which specialties face the highest malpractice premiums? Premiums are a function of the expected cost to insure a physician against potential malpractice suits. Thus, premiums are higher for specialties that have a higher risk of having a claim filed against them or specialties where the average payout conditional on having a claim is higher. A paper by Jena et al. (2011) examines this question.

The graph below describes the likelihood a physician in a given specialty has a claim filed against them. Surgical specialties (e.g., neurosurgery, thoracic-cardiovascular surgery, general surgery, orthopedic surgery and plasitc surgery are the specialties most likely to have a claim filed against them.

As the second figure below demonstrates, the typical payout, however, is highest for neurosurgery, neurology, internal medicine, pulmonary medicine and general surgery.

The authors conclude the following:

 Using physician-level malpractice claims from a nationwide liability insurer, we found substantial variability across specialties in each of these descriptors of liability risk. Specialties in which the largest proportion of physicians faced a claim were not necessarily those with the highest average payment size. For example, physicians in obstetrics and general surgery — both fields that are regarded as high-risk specialties — were substantially more likely to face a claim than pediatricians and pathologists, yet the average payments among pediatricians and pathologists were considerably greater.

Source:

• Anupam B. Jena, M.D., Ph.D., Seth Seabury, Ph.D., Darius Lakdawalla, Ph.D., and Amitabh Chandra, Ph.D. Malpractice Risk According to Physician Specialty. N Engl J Med 2011; 365:629-636. August 18, 2011DOI: 10.1056/NEJMsa1012370