U.S. Malpractice in Internal Medicine: Closed Claim Cases as Tools for Identification, Teaching and Prevention

Medical malpractice litigation as a system in the U.S. serves multiple goals, including the promotion of safer medicine and the compensation of wrongfully injured patients. However, these aims are often at odds with systems-oriented strategies needed to promote patient safety. Additionally, there is widespread doubt of the actual fairness and efficiency of malpractice litigation. Regardless of the details surrounding major tort reform, to prevent malpractice claims physicians need to practice greater awareness of the evidence-based factors that place them at higher risk for a malpractice claim. Closed claims can be used as positive teaching tools that allow physicians to recognize for themselves important preventive strategies in the area of litigation. Internal medicine may not traditionally be thought of as a comparatively high-risk specialty field. In reality, however, an analysis of physicians facing a malpractice claim annually across all specialties shows that the field of internal medicine achieved greater proportions compared to specialty fields that are more often times considered higher-risk, such as emergency medicine and anesthesiology. This article aims to help the internal medicine physician in (1) analyzing the most frequent clinical events that have led to malpractice claims by using a few showcase examples and (2) introducing how these examples of closed claim cases can serve as a learning resource to reduce medical errors that most commonly lead to litigation and thus harms to both patient and provider.