Asset Protection: Malpractice risk by the numbers

Ike Devji, JD

While physicians face many financial and legal risks, the elephant in the room is always your professional liability and the risk of a malpractice lawsuit. We start an in-depth look at the facts about these lawsuits including where they happen, who they happen to, and what they cost.

We’ve recently covered a variety of issues that can threaten physicians’ wealth ranging from the predictable and recurring seasonal risks of summer to those associated current real estate boom and the asset protection and estate planning issues associated with cryptocurrency investing. As much I have taken great efforts to remind physicians to think of their legal risk factors holistically— beyond just malpractice risk—and to include their risks as employers, investors, property owners, and even parents, medical malpractice claims remain a serious risk that requires proactive defensive planning.

We’ll start our review of medical malpractice lawsuit risk with a look at some facts and numbers that will help you understand and hopefully manage your position on the lawsuit food chain based on factors including specialty, location, and compensation. In addition to the details below, consider two other variables; male physicians generally earn more than their female colleagues (earning nearly sixty thousand dollars more a year among primary care physicians and nearly ninety thousand more among specialists) and self-employed physicians earn an average of just of fifty thousand dollars more per year than employed physicians in the same specialty.

Which Medical Specialties Get Sued the Most?

Here are the 10 specialties hit with the most lawsuits, according to a wide-ranging medical malpractice reportthat surveyed a national sample of 4,300 physicians across 29 specialties.


1. General surgery
2. Urology
3. Otolaryngology
4. OB-GYN & Women's Health
5. Surgery, specialized
6. Radiology
7. Emergency medicine
8. Cardiology
9. Gastroenterology
10. Anesthesiology

Risk vs. Reward – Which Medical Specialties Earn the Most?

In a ranking of 29 distinct medical specialties where average earnings ranged from a low of $221K a year for pediatricians to a high of $526K a year for plastic surgeons, these are the top ten.

  1. Plastic Surgery $526K
  2. Orthopedics and Orthopedic Surgery $511K
  3. Cardiology $459K
  4. Urology $427K
  5. Otolaryngology $417K
  6. Radiology $413K
  7. Gastroenterology $406K
  8. Oncology $403
  9. Dermatology $394
  10. Ophthalmology $379K

What States Pay Doctors the Most?

Probably not the ones you’d guess. The top ten states with the highest average physician income ranged from $329K to $348.

  1. Tennessee $329K
  2. Iowa $330K
  3. Georgia $330K
  4. Florida $331K
  5. South Carolina $332K
  6. Missouri $332
  7. Indiana $337K
  8. Oklahoma $338K
  9. Kentucky $340K
  10. Alabama $348K

What States Are Highest Risk for Doctors?

Again, if you think that all the lawsuit action would be states with the highest populations or the biggest urban centers overflowing with plaintiff’s attorneys, you may be surprised. These are the top ten most litigious states for doctors, from a low of 63% (Arizona) of all physicians in the state being sued, to a high of 75% in Kentucky.

Top Ten Most Litigious States – Percentage of Physicians Sued

1. Arizona 63%

6. Indiana 70%

2. New York 66%

7. New Mexico 70%

3. Tennessee 67%

8. Illinois 71%

4. Pennsylvania 68%

9. Nevada 73%

5. Florida 69%

10. Kentucky 75%

Medical Malpractice Premiums Are Rising

Malpractice insurance is a vital line of defense and after remaining steady for nearly a decade, prices are rising across the country according to a recent report by the AMA. From 2010 to 2018 insurance premium prices rose nationally on 12-17% of all specialties and varied widely based on location and specialty. They rose by about 25% in 2019 and 30% in 2020. Surprisingly, the report is explicit that the recent increase is not due to COVID-19 related claims, as there has not been time for the industry to adjust to data from 2020. Premiums and premium increases vary widely based on a variety of factors including medical specialty as well as the local legal climate including variances in both consumer and lawyer behavior. Geography is also a big factor, as one example OB/GYN faced base premiums ranging from $49,804 in one California county to over $200,000 in Miami.

These numbers provide the backdrop for our continuing discussions that will include at the causes of these claims and a variety of defense strategies available to informed physicians that will make you a hard target.

About the Author
Ike Devji, JD, has practiced law exclusively in the areas of asset protection, risk management and wealth preservation for the last 16 years. He helps protect a national client base with more than $5 billion in personal assets, including several thousand physicians. He is a contributing author to multiple books for physicians and a frequent medical conference speaker and CME presenter. Learn more at www.ProAssetProtection.com.