The relationship between malpractice claims history and subsequent obstetric care

S. S. Entman, C. A. Glass, G. B. Hickson, P. B. Githens, K. Whetten-Goldstein and F. A. Sloan
Department of Obstetrics and Gynecology, Vanderbilt University Medical Center Nashville, TN.

OBJECTIVE--To determine the relationship between prior malpractice claims experience and the quality of clinical obstetric care. DESIGN--Historical cohort study of obstetricians, classified by their prior malpractice claims experience, with blinded review of medical records from their practices 5 to 10 years later. SETTING--Florida obstetricians who lost, settled, or defended malpractice claims between 1977 and 1983 and who were still practicing obstetrics in 1987. MAIN OUTCOME MEASURES--Objective and subjective assessment of quality of clinical care of patients attended by obstetricians with different histories of malpractice claims. RESULTS--No differences were found in any of the objective or subjective measures of the quality of clinical care provided to patients of obstetricians who were classified into one of four groups according to their prior claims history. CONCLUSIONS--No relationship was found between prior malpractice claims experience and the technical quality of practice by Florida obstetricians. Strategies that attempt to identify physicians at risk for future clinical errors by using data on prior malpractice claims (such as the National Practitioner Data Bank) may be misjudging the likelihood that substandard clinical care will be provided by physicians with prior claims.

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