By Beth Jones Sanborn

A new study shows internists are at greater risk of being sued for high-severity injuries than other specialists, both hospitals and physician practices are vulnerable, and diagnosis-related claims represent the biggest chunk of patient allegations.

The study looked at 1,180 claims made against internal medicine physicians insured by a physician-owned medical malpractice insurer. The research was based on claims closed between 2007 and 2014, regardless of the outcome.

The three most common claims made against internists were diagnosis related, such as failure, delay or incorrect diagnosis; medical treatment; and medication-related error.

Results showed 39 percent of all claims alleged failed, delayed, or wrong diagnosis. Of those, 56 percent were based on inadequate patient assessments, like failure or delays in ordering diagnostic tests. Also, 58 percent of claims against internists were for high-severity injuries, with more than a third of all injuries happening in hospitals. This is in contrast to claims against all physicians, wherein only 34 percent were for high-severity injuries.

The findings pointed to more than half a dozen factors that contribute to patient injury, with the top three coming in as patients assessment issues at 33 percent; patient factors like not showing up for an appointment or noncompliance with the treatment plan at 25 percent; and communication breakdowns between patient or family members and their providers, the study said.

Other factors included problems with the selection or management of patient therapy, insufficient documentation, failure or delay in getting consults or referrals, and communication between providers.

In the analysis, more than one factor often contributed to the injury.

The physician-owned medical malpractice insurer boasts 78,000 members and $4.3 billion in assets.