"They hate having their name dragged through the local newspaper and having to go to court," he said.
The study might seem to support a common opinion among doctors that most malpractice lawsuits are baseless, but the authors said the truth was more complicated than that.
They noted influential earlier research in New York state concluding that just a tiny fraction of the patients harmed by medical mistakes actually file claims.
Trial lawyers say cost is a barrier to bringing a claim to court. There are very high up-front costs for hiring expert witnesses and preparing a case. Doctors, hospitals, and their insurers often have significant money and legal firepower. Some states also have caps on malpractice awards. So, usually, only very strong cases with high expected payouts are pursued.
Given the expense and other difficulties involved in winning, it's doubtful most claims are filed on a greedy whim, the researchers said.
"A lawyer would have to be an idiot to take a frivolous case to court," Chandra said.
The study was published online Wednesday by the New England Journal of Medicine.
The research team turned to one of the nation's largest national malpractice insurers, analyzing data for about 41,000 physicians who bought coverage from 1991-2005. The researchers could get the data only by signing an agreement not to identify the insurer, so they wouldn't disclose the name of the company.
The insurer represents only about 3 percent of the nation's doctors, but it operates in all 50 states. The average payouts were about the same as seen in the government-created National Practitioner Data Bank, which records payouts but doesn't record all claims filed.
The study found:
About 7.5 percent of doctors have a claim filed against them each year.
Fewer than 2 percent of doctors each year were the subject of a successful claim, in which the insurer had to pay a settlement or court judgment.
Some types of doctors were sued more than others. About 19 percent of neurosurgeons and heart surgeons every year were sued, making them the most targeted specialties. Pediatricians and psychiatrists were sued the least, with only about 3 percent of them every year facing a claim.
When pediatricians did pay a claim, it was much more than other doctors. The average pediatric claim was more than $520,000, while the average was about $275,000.
"Jurors' hearts cry out for injured patients, especially when kids are involved," Chandra said. The amount attached to a pediatric case also rises because many more years of suffering are involved than if the victim is middle-aged or elderly, experts said.
