Survey revealed that many members are unaware of ACEP’s medical-legal resources and activities.

Introduction and Methods

During June and July 2010, more than 2,200 ACEP members responded electronically to a survey regarding their career medical-legal experiences. The survey was sent out to all ACEP members who agreed to be contacted by e-mail. Not all respondents answered all 37 multipart questions, but the approximately 10% response rate is considered good for a lengthy and complicated survey. Only the general nature of the survey was disclosed in the invitation, sent out in the name of the president of ACEP. The survey was voluntary, and repeated assurances were made of confidentiality. No follow-up of nonresponders was done. Other than the lack of a valid e-mail address or permission to e-mail, the general reluctance of physicians to respond to surveys, and perhaps an avoidance of all things legal by some members, there is no reason to suspect a significant bias in the respondents. Not surprisingly, there was some attenuation of responses toward the end of the rather extensive survey.

Tellingly, in a 68-page report on the results, fully 56 pages were single-spaced comments by respondents.

Although the comments covered a very wide range of issues, the most frequent recurring themes in the spontaneous commentary were regarding expert witness testimony and a general sense of dismay and betrayal regarding malpractice litigation.

It was clear from the comments, as well as from the responses, that many members are unaware of resources and activities that ACEP has pursued in the medical-legal arena on their behalf.

Demographics

Of the respondents, 97.5% reported clinical practice in EM, 60% more than 10 years. A total of 72% of respondents reported urban or community practice, 16% academic, 8% rural, and 1.3% military (categories overlap). This is reflective of the general demographic makeup of ACEP members, who are 51.9% urban, 37.05% suburban, 24% academic, and 7.46% rural (3.58% are other; categories overlap).

Litigation Experience and Sequelae

More than 57% of respondents reported having been named in a claim for malpractice at least once. Of these, 59% reported more than one claim, and 9.5% had been named five or more times. About 83% of respondents with claims reported that one or more had been settled or dismissed without payment.

Of those who reported claims, 40% reported some payment was made on their behalf in one or more claims. Although results are not clearcut, of cases litigated, it appears that more than 86% resulted in a defense verdict. This comports with other recently reported data about litigated ED claims. Only 29% of respondents who had been sued (about 18% of all respondents) were aware of having been reported to the National Practitioner Data Bank based on malpractice payouts.