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PSNet: Patient Safety Network
Journal Article

Primary care closed claims experience of Massachusetts malpractice insurers.

Schiff GD, Puopolo AL, Huben-Kearney A, et al. JAMA internal medicine. 2013;173:2063-8.

Malpractice risk in outpatient primary care is increasingly under scrutiny. This study screened malpractice claims from two Massachusetts insurers and found that those from outpatient primary care settings were more likely to be settled or found in favor of the plaintiff compared with those from other practice settings. Similar to previous research, claims related to missed and delayed diagnoses were most frequent, and the most common disease involved was cancer, followed by cardiovascular disease. The accompanying editorial argues that primary care settings will become increasingly important for malpractice claims with the advent of patient-centered medical homes and accountable care organizations, which shift a larger proportion of medical care to the outpatient primary care setting. The authors note a high prevalence of failure-to-diagnose claims and recommend further emphasis on diagnostic safety. A missed diagnosis of myocardial infarction was discussed in an AHRQ WebM&M commentary.