Medical Malpractice Lawsuit Trends: What Doctors Need to Know

By Elena Pak, Credentialing Department, WCH

The headline from the American Medical Association’s latest research report sounds reassuring: the share of physicians who have faced a malpractice lawsuit is falling. In 2024, 28.7% of doctors reported having been sued at least once in their career — a notable decline from 31.2% in 2022. For a profession that has long operated under the shadow of litigation, that movement in the right direction matters.

But the fuller picture in the AMA’s report is more complicated, and providers who take the headline at face value may be drawing the wrong conclusions. Litigation frequency is declining — and at the same time, the financial consequences of being sued are becoming more severe, specialty-specific risk remains sharply elevated, and insurance costs are climbing at rates not seen in two decades. For most practicing physicians, this is not a moment to relax. It is a moment to understand exactly where the risk sits and build accordingly.

The Numbers that Should Concern You

Start with the specialty breakdown. Almost half of surgeons reported having been sued at least once in their career, with obstetricians-gynecologists and general surgeons facing the highest liability risk. These figures are consistent with long-standing patterns in the literature — high-acuity procedures, complex outcomes, and patients with heightened expectations create conditions where disputes are more likely to arise, and where the stakes of any individual case are substantial.

On the other end of the spectrum, endocrinologists and psychiatrists had some of the lowest litigation rates, with roughly 9% of physicians in each specialty reporting they had been sued. The gap between specialties is not incidental — it reflects real differences in procedure complexity, patient vulnerability, outcome predictability, and the documentation standards that govern each field.

What the aggregate decline in lawsuit frequency does not capture is the cost trajectory. Medical malpractice premiums for general surgery, obstetrics and gynecology, and internal medicine have been rising steadily since 2019, with nearly 40% of premiums for surveyed insurers increasing in 2025 alone. The AMA describes this as a pattern of consistent upward trends not seen since the early 2000s, when annual premium increases reached 70% to 80%. That era is remembered as a malpractice crisis that drove physicians out of high-risk specialties and reduced patient access in entire regions. Whether the current trajectory reaches that severity remains to be seen, but the direction is clear, and the AMA is not minimizing it.

The systemic cost is significant as well. In 2008, medical liability expenses cost the U.S. healthcare system over $55 billion — and that figure does not account for the downstream costs of defensive medicine, the ordering of additional tests and procedures driven not by clinical necessity but by liability concern. When the AMA notes that malpractice risk “increases practice expenses, reinforces defensive medical practices, and drives up health care costs for patients and families,” it is describing a dynamic with real consequences for how care is delivered and priced.

Why Documentation and Billing Accuracy Matter More Than Ever

One aspect of malpractice exposure that often goes underappreciated in clinical settings is the connection between billing practices and liability risk. Inaccurate or incomplete documentation does not only create compliance problems — it creates evidentiary problems if a claim is ever filed.

Consider what a plaintiff’s attorney examines when building a case: the medical record, the billing record, and the relationship between them. Inconsistencies between what was documented and what was billed raise questions about care quality. Missing documentation for services rendered leaves gaps that are difficult to close after the fact. Billing errors that suggest a service was performed differently than documented can undermine a physician’s credibility in ways that are hard to recover from, regardless of the clinical reality.

This means that the same documentation discipline that protects against audit risk also protects against litigation risk. When records accurately reflect what was done, when, and why — and when billing matches those records precisely — providers are in a fundamentally stronger position, both with payers and in any subsequent legal proceeding.

For practices that rely on nonphysician practitioners, the documentation stakes are even higher. Supervision requirements, scope-of-practice limitations, and incident-to billing conditions all create potential liability exposure if they are not reflected clearly in the record. A claim billed under a physician’s name for a service performed without proper supervision is not just a compliance problem — if that service is later the subject of a malpractice claim, the billing irregularity becomes part of the evidentiary record.

The Risk Increases with Time — and That Has Operational Implications

The AMA’s data also shows that litigation risk increases the longer a physician practices medicine. This is worth examining carefully. It does not simply mean that older physicians are more careless — it reflects the cumulative probability effect of practicing over many years, combined with the reality that long-tenured physicians often carry larger and more complex patient panels, and may have developed documentation habits during earlier eras of practice that do not meet current standards.

For practices with senior physicians, this points to a specific operational priority: periodic audits of documentation and billing practices, not just for compliance purposes, but as a form of liability risk management. Patterns that were acceptable — or at least tolerated — ten years ago may create exposure today. Coding specificity has increased. Documentation standards have become more rigorous. Payer audit technology has become more sophisticated. A practice that has not reviewed its processes in several years is likely operating with outdated assumptions about what an adequate record looks like.

What Practices Should Do Now

The AMA data, taken together, suggests a clear set of priorities for provider organizations.

For high-risk specialties — surgery, OB/GYN, internal medicine — the combination of elevated litigation probability and rising insurance premiums makes proactive risk management a financial imperative, not just a best practice. This means consistent documentation review, clear informed consent processes, and regular staff training on the standards that govern clinical records.

For all practices, the connection between billing accuracy and liability protection deserves more attention than it typically receives. Accurate billing is not only about avoiding payer recoupment. It is about maintaining the integrity of the clinical record as a defensible document.

And for practices evaluating their malpractice coverage, the premium trend data in the AMA report suggests that shopping coverage passively — renewing with the same carrier year after year without reviewing terms, limits, or alternatives — may be leaving both protection and cost savings on the table.

The frequency of lawsuits is declining. The cost of the ones that do occur is not. That is the distinction that should be driving practice management decisions in 2026.

Have questions about how billing accuracy and documentation practices affect your compliance and liability position? The team at WCH Service Bureau works with providers to build record-keeping and billing systems that hold up under scrutiny. Contact us to learn more. https://wchsb.com/contact-form/

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