Advanced Practice Providers and Malpractice - Risk Management Monthly

"Physician Assistant and Nurse Practitioner Malpractice Trends" by Brock, D.M., et al (Med Care Res Rev 74[5], 2017) reports on 178,035 medical malpractice (62%) or adverse actions (38%) involving 104,482 unique providers, based on the information in the National Practitioner Databank (2005-2014).

Physicians were involved in 94.8% of the incidents, PAs in 2.9% and NPs in 2.2% (it is believed to be likely that a physician will almost always be named when a PA or NP is named).

The number of events per 1000 providers was 11.2-19.0 for physicians, 1.4-2.4 for PAs and 1.1-1.4 for NPs.

Diagnosis-related issues were more frequent for PAs (53%) and NPs (41%) than for physicians (32%).

The number of malpractice reports declined over time for physicians, increased for PAs and remained flat for NPs. Awards related to physician actions trended downwards (perhaps due to tightening of malpractice laws) (decreased from about $221,000 to $195,000), while rewards related to PA and NP actions increased from $112,000 to about $120,000.

The panel notes that about one-third of ED patients are seen by PAs and NPs, and that discerning trends in these outcomes specific to emergency medicine will require additional time.