Malpractice Allegations Against Vascular Surgeons: Prevalence, Risk Factors, and Impact on Surgeon Wellness

Abstract

The contemporary medicolegal environment has been linked to procedure overuse, health care variation, and higher costs. For physicians accused of malpractice, there is also a personal toll. The objective of this study was to evaluate the prevalence of and risk factors for involvement in medical malpractice lawsuits among U.S. vascular surgeons and to examine the association of these allegations with surgeon wellness. In 2018, the Society for Vascular Surgery Wellness Task Force conducted an anonymous survey of active members using a validated burnout assessment (Maslach Burnout Index) embedded into a questionnaire. This survey included questions related to medical errors and malpractice litigation. Demographic, personal, and practice-related characteristics were assessed in respondents who reported malpractice allegations in the preceding 2 years, then compared with those without recent medicolegal litigation. Risk factors for malpractice allegations were identified (χ2 and Kruskal-Wallis tests), and the association between malpractice allegations and wellness was examined. Multivariate logistic regression models were developed to identify independent risk factors for malpractice accusations. Of 2905 active Society for Vascular Surgery members, responses from 871 practicing vascular surgeons were analyzed. Of these, 161 (18.5%) were named in a malpractice lawsuit within 2 years. The nature of malpractice claims included procedural errors (23.1%), failure to treat (18.8%), and error/delay in diagnosis (16.9%); 20% of claims were dismissed and 19% were settled before trial. Defendant vascular surgeons reported a “fair” resolution in 25.4% of closed cases. Malpractice allegations were significantly associated with surgeon burnout (odds ratio, 1.78 [1.01-2.15]; P = .041) but not with self-reported depression or suicidal ideation. By unadjusted analysis, factors significantly associated with recent malpractice claims included male sex, age, years in practice, and greater call frequency. Multivariate analysis revealed independent variables associated with malpractice allegations, including on-call frequency (P = .0178), recent medical errors (P = .0189), and male surgeons (P = .045; Table). Malpractice allegations are common for vascular surgeons. Nearly 20% of survey respondents have been named in a lawsuit within the preceding 2 years. Male surgeons and those with greater call frequency were at increased risk of lawsuit involvement. Moreover, surgeons facing litigation were more likely to report a major medical error within the preceding 3 months, suggesting an “error-prone” self-perception. The association between malpractice allegations and surgeon burnout further demonstrates the emotional impact of a malpractice suit. These findings underscore the need for initiatives to provide counseling and peer support for vascular surgeons facing litigation.TableMultivariate regression analysis of risk factors for malpractice allegationsVariableOdds ratio (95% CI)P valueNights per week on call (Per 1 night)1.13 (1.02, 1.24)0.0178Years of practice (Per 1 year)1.02 (1.00, 1.03)0.0157Gender (Female)0.55 (0.31, 0.99)0.0452Medical error in last 3 months (Yes)1.89 (1.11, 3.21)0.0189Work/home conflict resolution (In favor of work)0.74 (0.50, 1.09)0.1258Electronic Medical Record (EMR) dissatisfaction1.28 (0.84, 1.96)0.2536 Open table in a new tab