[erasmopa]

I dont think theres any truth to that. But I dont think anybody keeps any meaningful data on med mal. The only way I can see it as a true statement is if certain academic institutions take steps to insulate the doc. I believe Hopkins does this by removing the docs name and replacing it with the institution. But I think its bs to suggest lawyers hesitate to sue academics.

[william.wang_997]

In PP, everyone is overworked. In academics, studies are read by a resident with an attending and then the attending finalizes the report. The margin of error decreases. 

[dranjana]

Yea thats a good point. Also, the more complex cases are presented at multidisciplinary conferences and then reviewed again by a different attending radiologist. 

[erasmopa]

You are both making an assumption that lawsuits are a result of errors. I think thats a misperception, at least in radiology.

[btomba_77]

I have no data on this … but I do have a couple of theories.
 
 
First, as mentioned above, is the “multiple sets of eyes” on more studies *may* decrease the number of perceptual/cognitive errors within academic radiology departments compared to non-academic.
 
 
Second, patients tend to sue when they have bad outcomes. Outcomes tend to be better overall at academic medical centers. Therefore it would make sense to have the overall percentage of lawsuits for academic radiologists dragged into case be lower in the academic setting.
 
 
Third, similar to the radiology-specific “multiple sets of eyes” theory, the swiss cheese model says that errors tend to arise after many people have missed the error.  Academic centers with multiple layers of residents, fellows etc, and perhaps a greater focus on process may have a more robust series of barriers to prevent errors and fewer “holes” in the swiss chees for patients to fall through.
 
 
Finally, private practice radiologists read a larger number of studies.  The more read the more your odds of getting sued on one of the cases.
 
 

[ds_428_213]

Lawyers will happily sue you in any practice setting.

I think in general, subspecialized radiologists reading within their specialty are less likely to get sued. This tends to occur more frequently in academia vs private practice where everyone MAY have to rotate through breast or cover general call and read inpatient or emergent studies that are not within their wheelhouse. But, there are also large subspecialized private practices with specialty specific call pools or those that dont take any call.

As others have stated, patients sue when they have bad outcomes. Outcomes for bread and butter cases are probably better at academic centers, but academic centers also get shipped more of the train wreck cases and are often dealing with more complicated situations with potential for error.

I dont know that having more eyes or more hands is necessarily a good thing. Having more residents and fellows pre dictate reports seems like a greater chance for something stupid to get into a report and you not noticing as you sign off on cases. During my brief stint in academia as a fellow, I routinely deleted and redictated the entire resident report because it was easier and faster than carefully reviewing and editing everything they dictated. Likewise, there are more untrained medical students and residents in the OR and on the floors with potential for mishaps. When bad outcomes occur, everyone gets wrapped up in the lawsuit, at least initially.

No idea what the data bears out on any of this.

I think the bottom line for a young career radiologist is to control what you can control. If you dont feel comfortable reading breast or neuro or MSK and dont think you ever will, you have far more leverage than any time in recent history and can likely tailor a job to suit your strengths and weaknesses.

[btomba_77]

Yeah. I never got around to answering the second part of the OP’s question.
 
” if this is something to even consider when deciding between PP and academic gigs.”
 
 
Answer: No

[amotter]

Im some settings you may get sovereign immunity, particularly if you work for a county, state or federal institution.