Rads overestimate malpractice risk in breast imaging
Malpractice suits related to mammography remain low. Image Source: STATSimple

Radiologists who work in breast imaging tend to overestimate the actual risk of medical malpractice lawsuits, according to a study published in the February issue of the American Journal of Roentgenology.

The authors wrote that the purpose of their study, conducted at the University of Washington School of Public Health and Community Medicine in Seattle, was to examine radiologists’ reported experiences and perceptions of future lawsuit risk and explore personal and professional factors that may be associated with elevated perceptions of risk.

Radiologists completed a mailed survey in 2002 and in 2006 that included questions on demographics, practice characteristics and medicolegal experience and perceptions, as well as validated scale measuring reactions to uncertainty in clinical situations.

Participation by eligible radiologists was 77 percent in 2002 and 71 percent in 2006. The percentage of radiologists reporting malpractice claims related to mammography in the previous five years was 8 percent on the 2002 survey and 10 percent on the 2006 survey.

Radiologists’ age, sex, clinical experience and workload were not associated with a higher perceived risk of being sued. Radiologists who reported higher perceived risk of lawsuits were more likely to have experienced a prior malpractice claim, to report knowing colleagues with prior lawsuits, and to score higher on a scale measuring anxiety caused by uncertainty in clinical situations. Radiologists working at facilities that did not use double reading reported higher perceived risk, but the difference was not statistically significant.

Results showed that “the radiologist’s median estimate for the likelihood of being sued was four times higher than their actual risk,” said Joann G. Elmore, MD, lead author of the study. In 2002, a radiologist’s perceived risk of being sued in the next five years was 41 percent and in 2006 was 35 percent.

“Their perception of risk is much higher than the reported reality,” she said.

“Failure to detect breast cancer has been the leading cause of medical malpractice lawsuits. Malpractice litigation has a direct effect on healthcare delivery in the U.S. and ultimately may influence the way we practice medicine,” said Elmore. “Under such circumstances, doctors are turning to defensive medicine, where we order more tests to make certain we aren’t missing something.”

Work force shortages in breast imaging may also be considered the result of a physician’s perceived risk of malpractice lawsuits. “We have seen fewer residents interested in going into breast imaging, partially because of their perceived risk of being sued,” Elmore concluded.