Medical Malpractice and Physician Discipline: The Good, The Bad and The Ugly

We study the overlap between the medical malpractice (med mal) and medical disciplinary systems using the records of almost 90,000 Illinois physicians who held an active license at any point from 1990–2016. We quantify the specialty‐specific risk of having a paid med mal claim or a disciplinary action; how many physicians have both; and the extent to which physicians with two or more paid claims or two or more disciplinary actions account for a disproportionate share of the activity of both systems. We also examine which factors are associated with paid claims and disciplinary actions, and whether physicians with multiple paid claims or disciplinary actions are concentrated at particular hospitals. Physicians with two or more paid claims account for only 2.37 percent of all licensed physicians, but they account for 53 percent of paid claims and payouts. Physicians with two or more disciplinary actions account for only 0.47 percent of physicians but 28 percent of all disciplinary actions. The risk of paid claims and disciplinary actions varies greatly by specialty. Physicians who attended non‐U.S. medical schools are more likely to have paid claims but (except for high‐disciplinary‐risk specialties) are not more likely to be subject to disciplinary action. Physicians with prior paid claims are more likely to be the target of disciplinary action—but not vice versa. A small number of Illinois hospitals are staffed by physicians with unusually high numbers of paid med mal claims, disciplinary actions, or both.