The Relationship Between Physicians' Malpractice Claims History and Later Claims-Reply

Abstract

In Reply. —We welcome these interesting letters that raise some technical issues, as does Mr Smarr's Commentary. 1 The main scientific protection against error is replication. Already, two different research teams, using different databases from different states, have obtained results similar to those in our article. Dr Wertkin accurately notes that we lacked controls for physicians' practice volume. Volume plausibly influences claims frequency and might even be used in setting premiums. However, such information is difficult to obtain. We considered ourselves fortunate that prior work had painstakingly obtained corresponding data from years of directory listings compiled by the American Medical Association. We agree with Dr Frank that adversarial litigation creates substantial stress for everyone but the lawyers. Malpractice claims are relatively rare compared, for example, with automobile claims, especially considering that most insured people drive only part-time. This does not, however, belittle the psychic costs of law, which are one