A new study in The Journal of Patient Safety proves again what medical malpractice lawyers have known for years: the worst doctors cause a very large part of medical malpractice injuries.

The study, “The Detection, Analysis, and Significance of Physician Clustering in Medical Malpractice Lawsuit Payouts,” reviewed payment data from the National Practitioner Data Bank (NPDB), an electronic database that follows malpractice settlements, actions by state medicine boards, and actions by hospital medical boards. The medical researchers looked at all of the malpractice compensation from September 1, 1990, through June 30, 2015, a time period during which over 1.2 million physicians practiced medicine in the United States. Incredibly, 25% of the payments in that time could be traced back to just 6,521 physicians, and 50% of the payments could be traced back to 22,511, which amounts to just 1.8% of all physicians who practiced then.

The data showed more shocking facts about the worst doctors in America:

  • 74.5% of these same physicians had at least 2 payments.
  • 761 of these physicians had 10 or more payments.
  • 15 of these physicians had more than 50 payments.
  • 7 had more than 100 payments!

To put that in perspective, imagine if I told you that half of the serious car accidents were caused by 1.8% of drivers. And then I told you that most of those same drivers already had another claim against them. What would you recommend? That we make them take driving classes? That we restrict their licenses? That we take the licenses away?

Surely we would do something if it turned out that 1.8% of drivers were causing more than half the damage. But that’s not what we do with the worst doctors. The Boards of Medicine rarely do anything about them: only 12.6% ever had any action taken against their license. (I’ve written before about how awful the Board of Medicine is for most states when it comes to sexual assault by doctors.) Even more outrageously, the hospitals do even less: only 6.3% of the high-negligence doctors had any actions against their clinical privileges.

The study doesn’t say what types of doctors were responsible for most malpractice claims, but we already know those details from a study that came out last year in The New England Journal of Medicine called “Prevalence and Characteristics of Physicians Prone to Malpractice Claims.” A review of ten years of data from the NPDB found physician specialties with the most malpractice claims were:

  1. Internal medicine (15%)
  2. Obstetrics and gynecology (13%)
  3. General surgery (12%)
  4. Family medicine (11%)
  5. Orthopedics (7%)
  6. Radiology (6%)
  7. Emergency medicine (5%)
  8. Anesthesiology (4%)
  9. Cardiology (4%)
  10. Pediatrics (3%)

Unfortunately, it doesn’t look like anything will be done to fix these problems soon. The current political climate is leaning towards giving these worst doctors even more legal immunity and protections.