A small group of physicians accounts for a substantial share of all claims, and an ability to reliably identify those physicians at an early stage could guide efforts to improve heath care, according to a new study.

A substantial share of all malpractice claims in the United States is attributable to a small number of physicians, according to a study led by researchers at Stanford University and the University of Melbourne.

The team found that just 1 percent of practicing physicians accounted for 32 percent of paid malpractice claims over a decade. The study also found that claim-prone physicians had a number of distinctive characteristics.

“The fact that these frequent flyers looked quite different from their colleagues — in terms of specialty, gender, age and several other characteristics — was the most exciting finding,” said David Studdert, LLB, ScD, MPH, professor of medicine and of law at Stanford. “It suggests that it may be possible to identify high-risk physicians before they accumulate troubling track records, and then do something to stop that happening.”

Studdert, who is also a core faculty member at Stanford Health Policy, is the lead author of the study, published Jan. 28 in The New England Journal of Medicine.

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“The concentration of malpractice claims among physicians we observed is larger than has been found in the few previous studies that have looked at this distributional question,” said Michelle Mello, JD, PhD, MPhil, a co-author of the study and professor of law and of health research and policy at Stanford.

“It’s difficult to say why that is,” Mello added. “The earlier estimates come from studies of single insurers or single states, whereas ours is national in scope. Also, the earlier numbers are more than 25 years old now, and claim-prone physicians may be a bigger problem today than they were then.”

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