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 i njured patients. However, these aims are often at o dds with systems-oriented strategies needed to promote patient safety. Additionally, there is widespread d oubt of the actual fairness and efficiency of malpractic e litigation. Regardless of the details surrounding major tort reform, to prevent malpractice claims physicia ns need to practice greater awareness of the eviden cebased factors that place them at higher risk for a malpractice claim. Closed claims can be used as pos itive teaching tools that allow physicians to recognize f or themselves important preventive strategies in th e area of litigation. Internal medicine may not traditiona lly be thought of as a comparatively high-risk spec ialty field. In reality, however, an analysis of physicia ns facing a malpractice claim annually across all s pecialties shows that the field of internal medicine achieved greater proportions compared to specialty fields th at are more often times considered higher-risk, such as em ergency medicine and anesthesiology. This article a ims to help the internal medicine physician in (1) anal yzing the most frequent clinical events that have l ed 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 red uce medical errors that most commonly lead to litig ation and thus harms to both patient and provider.