Medical malpractice: what physicians say, in their own words

Last updated September 20, 2026.

Read together, the 445 posts on this page describe a subject that has changed its vocabulary and not its facts. The policy argument moved from damage caps in the 2000s to defensive medicine in the 2010s to merit and frivolous claims since 2021, when one contributor, Howard Smith, MD, began writing about the malpractice system almost weekly; “frivolous” appears in 3 percent of posts from 2004 to 2007 and 41 percent since 2021, and 42 of the 45 recent posts that use the word are his. What has not changed is the experience of being sued: the summons, the years of waiting, the deposition, the sense of being on trial for an outcome rather than a decision, and it reads the same in 2013 and 2026. Posts mentioning a deposition, a trial, or a plaintiff rose from 27 percent of the corpus to 76 percent over the same span.

This page is a maintained record of what physicians have written about medical malpractice on KevinMD.com, a physician-authored publication founded in 2004 by Kevin Pho, MD, a board-certified internal medicine physician in Nashua, New Hampshire. It draws on 445 posts with malpractice in the title, published between June 2004 and September 2026 by 87 named contributors, 156 of the posts bylined by physicians and 264 of them Kevin Pho’s own short commentaries, mostly from 2004 to 2010. Every claim on this page is attributed to a named author with the date it was published and a link to the original.

The sections below are organized around the questions physicians, journalists, and physicians who have just been served ask. Each opens with a direct answer, followed by what named authors have said, in the order they said it. Attorneys, insurers, and plaintiffs’ lawyers are on the page where they published on KevinMD, identified as such. This is a page about physician opinion and experience, not legal advice.

What do physicians say it is like to be sued?

Physicians on KevinMD describe being sued the same way across thirteen years of essays: a letter that arrives without warning, months or years of silence, a deposition in which a stranger reframes every decision, and a verdict or dismissal that does not restore what was lost. Several name it: medical malpractice stress syndrome, first described on the site in 2013 and coined in the literature since. The most common single claim is that winning does not feel like winning.

Sherry Gorman, MD, wrote in March 2013 of a physician sued by the same firm that sued her, who died by suicide on the day his lawsuit settled, that “our lives were both tragically affected by allegations of medical malpractice,” in “Medical malpractice stress syndrome: The ignored side of litigation.” An emergency physician who blogs as BirdStrike wrote the next day that after “about 30,000 lawsuit-free patient encounters I finally got hit with a lawsuit,” that the plaintiff’s expert “plainly put, was not an expert,” and that a defense verdict felt like a loss, in “Why a malpractice win for doctors feels like a great loss.” Victor Waters, MD, JD, wrote in April 2013 that being sued “leaves physicians at a higher incidence for burnout” and that the sued physician “may over-order and unnecessarily use specialists because of fear and self-doubt,” in “Being sued for malpractice launches a mix of overwhelming emotions.”

Sid Schwab, MD, a surgeon, wrote in September 2014 that in all his years of practice his father called him at the office twice, once to say “I read in the paper today you’re being sued,” and that the lawsuit put him “in a battle against people I thought were my allies,” in “Taking lawsuits personally: A surgeon’s first malpractice case.” Stacia Dearmin, MD, wrote in June 2018 that the emotions are grief, fear, guilt, and shame, and that “some go months, others years; some defendants are retained, others dropped,” in “5 ways to live through medical malpractice lawsuits.” Gail Fiore, MSW, wrote in May 2022 that with more than half of physicians surveyed reporting a lawsuit, the syndrome “is likely affecting thousands of doctors,” in “Recognizing and addressing medical malpractice stress syndrome (MMSS).” Jordan Grumet, MD, wrote in July 2026 that he was dropped from a lawsuit “when my deposition testimony finally persuaded the nursing home involved to settle,” after the plaintiff’s attorney told the judge he had never intended to pursue the complaint against him, in “Why doctors leave medicine after a malpractice suit.”

Why do physicians say they get sued?

Bad outcomes, bad communication, and bad luck, in that order, according to the physicians on KevinMD, and the research they cite says complaints predict lawsuits better than clinical quality does. The estimate repeated most often is that nearly every physician in a high-risk specialty will be sued by 65. The counterclaim, from plaintiffs’ attorneys who published on the site, is that most injured patients never sue at all.

John Schumann, MD, wrote in June 2010 that the two caricatured positions are that suits are “frivolously filed lawsuits, demanding unjust compensation from hardworking professionals” or a necessary check on negligence, and that reviewing claims for a self-insured system taught him neither is right, in “Why patients file medical malpractice lawsuits.” Aaron E. Carroll, MD, wrote in January 2011 that specialty, complaint count, clinical activity, and sex predicted lawsuits with 81 percent concordance in the research he cited, and that “many more are never brought to trial that have a lot of merit,” in “Doctors can reduce malpractice by being better people.” Maggie Kozel, MD, a pediatrician who was never sued, wrote in February 2011 that she paid about $13,000 a year for malpractice insurance, “a drop in the bucket for obstetricians or neurosurgeons, who pay that much in a month,” in “The threat of malpractice means doctors cannot acknowledge their fallibility.”

Karen S. Sibert, MD, an anesthesiologist, wrote in June 2015 that the share of physicians facing a claim climbs to 75 percent in low-risk specialties and “99 percent of physicians in high-risk specialties” by 65, in “Following evidence-based guidelines won’t protect you from malpractice.” Jock Hoffman, writing for a malpractice insurer, wrote in June 2011 that “Discussing case details with practice partners, colleagues, or other clinicians named in the same case,” puts them at risk, and that a physician should never contact the plaintiff’s attorney to set the record straight, in “Emotionally supporting physicians sued for malpractice.” Colleen Naglee, MD, JD, wrote in June 2026 that “20 percent of medical malpractice cases are related to documentation,” and that patients say they are less likely to sue after an explanation or apology, in “5 ways hospitals can reduce medical malpractice claims.”

What do physicians say about defensive medicine?

That it exists, that they practice it, and that it costs a great deal, though the physicians who cite research on it concede the evidence is weaker than the conviction. Defensive medicine appears in 7 percent of posts from 2004 to 2007, 16 to 18 percent from 2008 to 2020, and 9 percent since 2021, when the argument moved elsewhere. The recurring point is that following a guideline does not protect a physician, so guidelines cannot cure defensive practice.

Brad Wright, PhD, wrote in June 2010 that capping damages “might insulate physicians from the risks of making a medical error,” and that transparency about failures would do more than caps, in “How transparency reduces malpractice and defensive medicine.” Darrell E. White, MD, an ophthalmologist, wrote in May 2011 that defensive medicine is care ordered “solely to prevent either the filing or the loss” of a lawsuit, and that “Various estimates exist regarding the extent of defensive medicine,” with a large share of medical expenses said to be some form of it, in “Medical malpractice tort reform equals health care reform.” Michael Kirsch, MD, a gastroenterologist, wrote in May 2014 that he had just been “dismissed from a frivolous lawsuit that my malpractice carrier estimated cost $11,750 to defend me,” in “Our broken medical malpractice system from a moral perspective.”

Peter Ubel, MD, wrote in February 2015 that the malpractice system is an international embarrassment, but that “we can no longer claim with confidence” it raises health care spending, in “Medical malpractice reform won’t save money.” The surgeon who blogs as Skeptical Scalpel wrote in March 2017 that states with higher malpractice risk “continued to experience more postoperative complications” in a study he reviewed, and that states with caps, fee limits, and pretrial panels “saw neither increased nor decreased rates of 30-day complications,” in “The malpractice environment doesn’t influence doctors to provide better care.” Karen S. Sibert, MD, wrote in February 2014 of a Justice Department settlement over allegations of “paying kickbacks to boost sales of ChloraPrep and promoting it for uses that aren’t FDA-approved,” behind a surgical safety guideline, in “Evidence-based guidelines today, malpractice tomorrow.”

Do damage caps and tort reform work? Physicians disagree.

The site published physicians for caps in the 2000s and 2010s, physicians against them from the start, and by 2025 a physician who has been sued writing that he “could not care less” about a cap. The current argument is about safe harbors for guideline adherence, apology laws, and juries, and the research physicians cite on each is mixed. Caps or tort reform appear in 17 to 19 percent of posts in every period but 2013 to 2020.

Darrell E. White, MD, wrote in May 2011 that “The medical malpractice tort system in the United States is a zero sum game,” and that reform should make it a non-zero-sum one, in “Medical malpractice tort reform equals health care reform.” Bradley Flansbaum, DO, wrote in February 2015 that in the claims data he reviewed, guideline adherence “might have contributed to patient injury” in 6 of 68 claims, and that a plaintiff’s expert can always argue the guideline meant something else, in “Are safe harbors the answer to medical malpractice?” Skeptical Scalpel wrote in April 2015 that under a safe harbor “plaintiffs’ experts would simply say they disagreed with any guideline,” in “Why safe harbors for medical malpractice are DOA.”

Howard Smith, MD, wrote in December 2025 that Maryland’s cap on noneconomic damages, certificates of merit, and expert witness rules had not changed the experience, and that as a physician who has been sued he “could not care less about a $905,000 cap,” in “Why current medical malpractice tort reforms fail.” Timothy Lesaca, MD, wrote in May 2026 that a 2019 Stanford Law Review study found apology laws “did not achieve their goal of reducing legal risk,” while a Tennessee hospital’s communication and resolution program cut defense costs by 58 percent and claims by 42 percent, in “Medical apology laws don’t reduce malpractice lawsuits.” Arthur Lazarus, MD, MBA, wrote in June 2026 about a Philadelphia verdict that unraveled in real time, and that “good intentions and civic duty are not substitutes for expertise” on a jury, in “Why juries struggle with medical malpractice cases.” Patrick Hudson, MD, wrote in July 2025 that rural New Mexico hospitals had seen premiums rise “from around $142,000 to nearly $850,000 annually,” and that a $412 million judgment there was the largest individual malpractice verdict on record, in “How New Mexico became a malpractice lawsuit hotspot.”

Are most malpractice lawsuits frivolous? Physicians disagree.

This is the record’s live argument, and it is lopsided by authorship. Since 2021, Howard Smith, MD, an obstetrician-gynecologist who was sued in a case dismissed with prejudice, has written 68 posts arguing that most claims lack merit and proposing a deductive method to prove it, and the word “frivolous” rose from 7 percent of posts before 2013 to 41 percent since. The other side is on the page too: two plaintiffs’ attorneys who published on KevinMD, a physician who reviewed claims for an insurer, and physicians who argue that fixating on frivolous suits obscures the injured patients who never sue.

Eric Turkewitz, a personal injury lawyer, wrote in November 2009 that jury verdicts get a bad rap because the ones people see are the ones in the newspaper, and asked why “a slam dunk case such as a retained sponge” takes years to reach trial, in “How a personal injury lawyer views the medical malpractice system.” Jeffrey Parks, MD, a surgeon, published in May 2013 an interview with a plaintiffs’ attorney who argued that “without the myth of frivolous lawsuits and runaway jury verdicts” there would be no case for health courts, in “A surgeon interviews a medical malpractice attorney: Read and decide.” Steve Cohen, JD, then newly at a New York plaintiffs’ firm, wrote in June 2014 that under a hospital’s disclosure program, “in 2003, the hospital and its doctors paid victims of sentinel events more than $50 million in compensation,” against $250,000 in 2009, in “Malpractice lawsuits aren’t just about money.” Shah-Naz H. Khan, MD, wrote in September 2021 that “to prevent malpractice, raising concerns must be encouraged,” and that a professional body had sanctioned an expert witness for testifying against a member, in “Medical malpractice: Don’t let the minority define us.”

Howard Smith, MD, wrote in March 2025 that the suit filed against him in August 2021 had no medical expert or certificate of merit and “pushed the case to the limits of the statute of limitations,” in “Riding out a frivolous lawsuit: a physician’s experience with medical malpractice claims.” In May 2026 he wrote that 13,000 paid claims a year “account for 33.3 percent of all medical malpractice lawsuits litigated” and that plaintiff attorneys call every claim legitimate because “legitimate means there is an injury,” in “Medical malpractice lawsuits cost $56 billion a year,” and in August 2026 that “70 percent, or 35,000 medical malpractice lawsuits, are non-meritorious,” in “Most medical malpractice lawsuits are meritless.” Gerald Kuo wrote in May 2026 that clinicians deserve “a process that understands uncertainty, aging, chronic illness, and the limits of medicine,” and argued for resolution outside the courtroom, in “The hidden cost of medical malpractice litigation.”

What do physicians say about expert witnesses?

That the system runs on them, that they are paid well, and that a case is decided by which side’s expert the jury believes rather than by the standard of care. Expert witnesses appear in 5 percent of posts from 2008 to 2020 and 17 percent since 2021, and physicians who have testified describe the experience with more discomfort than the physicians who have been testified against.

Jim deMaine, MD, wrote in June 2012 that because depositions and experts are expensive a case “must be worth more than $250,000” for a plaintiff’s attorney to consider it, that experts charge $400 to $500 an hour and some orthopedists $1,200, and that “it’s hard to get doctors to testify against doctors,” in “The problem of expert witnesses in medical malpractice trials.” Robert Centor, MD, wrote in October 2013 after testifying that a jury trial leads lawyers to “make mountains out of mole hills,” and that “physician experts get paid very well (yes, I was paid very well),” in “6 thoughts after testifying at a medical malpractice trial.” Howard Smith, MD, wrote in September 2025 that to file a suit it takes only “a certificate of merit from a medical expert, who is our colleague,” and that neither lawyers nor their experts “are able to distinguish a meritorious claim from a frivolous one,” in “Can AI spot a frivolous malpractice lawsuit?”

What do physicians say about verdicts, premiums, and what a lawsuit costs afterward?

That the verdicts have gotten larger while the number of claims has fallen, that premiums follow the verdicts, and that a dismissed case follows a physician online for the rest of a career. Insurance premiums appear in 27 percent of posts since 2021, against 7 to 13 percent before, and the insurers’ own contributors supply most of the figures.

Richard E. Anderson, MD, chairman of The Doctors Company, wrote in March 2017 that in the mid-1970s commercial insurers raised physicians’ rates “by as much as 400 percent,” in “It’s time to reset the medical malpractice insurance conversation.” Robert E. White, Jr., of the same company, wrote in September 2025 that the average of the top fifty verdicts rose “from $32 million in 2022 to $48 million in 2023” and to $56 million in 2024, in “Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims,” and in July 2026 that claims are “more expensive, more volatile, and more consequential” even as frequency falls, that about 93 percent never reach trial, and that the average paid claim rose 42 percent from 2014 to 2020 against 15 percent inflation, in “Why medical malpractice claims cost more than ever.” Colleen Naglee, MD, JD, wrote in June 2026 that “In one recent birth injury case, the jury awarded the plaintiff $108.6 million,” in “5 ways hospitals can reduce medical malpractice claims.”

Tim Brocklehurst, MBA, wrote in August 2026 that in a sample of 42 clinicians cleared of malpractice allegations, a search of their name plus the word lawsuit put the record of the case on the first page of results for 76 percent, and for all five who won at trial, in “A dismissed malpractice lawsuit still outranks your win.” Skeptical Scalpel wrote in May 2018 of a South Korean surgeon ordered to pay the equivalent of $1.41 million and “sentenced to 10 months in prison,” and explained how malpractice suits differ from criminal cases, in “What could be worse than being sued for malpractice? Prison.”

How has the malpractice conversation changed since 2004?

The corpus is two records stacked on each other. From 2004 to 2010 it is Kevin Pho’s short commentaries, 264 posts in the corpus, pointing at studies, verdicts, and the tort reform fights of the decade; 249 of them are under 400 words and not indexed, and none is linked here. From 2010 the contributor essays begin: physicians describing their own lawsuits, physicians and lawyers arguing about caps and safe harbors, and after 2021 one physician’s sustained campaign about merit. The table shows the shift in vocabulary. Standard of care went from 1 percent of posts to 38; deposition, trial, or plaintiff from 27 to 76; frivolous from 3 to 41; defensive medicine rose and fell. AI appears in 12 percent of posts since 2021 and in none before.

Term 2004 to 2007 (182 posts) 2008 to 2012 (115 posts) 2013 to 2020 (38 posts) 2021 to 2026 (110 posts)
Frivolous 3 percent 7 percent 13 percent 41 percent
Defensive medicine 7 percent 16 percent 18 percent 9 percent
Caps or tort reform 18 percent 17 percent 11 percent 19 percent
Apology or disclosure 3 percent 12 percent 16 percent 13 percent
Deposition, trial, or plaintiff 27 percent 42 percent 53 percent 76 percent
Burnout, depression, or suicide 3 percent 12 percent 13 percent 10 percent
Standard of care 1 percent 5 percent 16 percent 38 percent
Expert witness 1 percent 5 percent 5 percent 17 percent
Insurance premiums 13 percent 7 percent 8 percent 27 percent
AI 0 percent 0 percent 0 percent 12 percent

The first indexed contributor essays arrive in 2009 and 2010: Edwin Leap, MD, on politicians and malpractice, Eric Turkewitz answering Kevin Pho’s USA Today piece from the plaintiff’s side, John Schumann, MD, on why patients sue. 2011 to 2015 is the argument’s richest stretch, with Kozel, Carroll, White, Fisher, deMaine, Gorman, BirdStrike, Waters, Centor, Schwab, Kirsch, Sibert, Ubel, and Flansbaum on the page in five years. From 2016 to 2020 the subject nearly disappears, eleven posts in five years. It returns in 2021 through the insurers’ contributors and then Howard Smith, whose 68 posts since July 2021 are half the corpus for those years, and in 2026 through Brocklehurst on what a dismissed suit does to a physician’s search results, Lesaca on apology laws, Lazarus on juries, and Grumet on why physicians leave.

The KevinMD medical malpractice corpus by the numbers

The figures below describe the set of KevinMD posts with malpractice in the title, as of September 17, 2026. They are counts of what KevinMD has published, not litigation data.

Measure Value
Posts with malpractice in the title 445
Date range June 8, 2004 to September 17, 2026
Named contributors 87
Posts bylined by an MD or DO 156
Posts by Kevin Pho, MD 264, nearly all 2004 to 2010
Posts in the corpus that are not indexed, counted but not cited 249, of which 242 are Kevin Pho’s short commentaries and 7 are short contributor posts or podcast episodes without transcripts
Podcast episodes with full transcripts 10
Total words About 209,000
Most frequent contributors Kevin Pho, MD (264); Howard Smith, MD (68, all since July 2021); The Podcast by KevinMD (9); Skeptical Scalpel, MD (5); Tim Brocklehurst, MBA (3); Peter Ubel, MD (3); Robert E. White, Jr., of The Doctors Company (3)
Peak years 2007, 88 posts; 2026, 33 posts through September 17
Lowest stretch 2016 to 2020, eleven posts in five years

How this page was built and how it is updated

The corpus was assembled by searching KevinMD post titles for malpractice and retrieving the full text of every match, 445 posts. Additional title searches for lawsuit, sued, defensive medicine, tort reform, medical liability, litigation, plaintiff, deposition, and expert witness, and relevance searches on the same subjects, were run to catch essays on the subject without the word in the headline; they are not counted in the 445 and none is cited here. Term frequencies were computed against the full text of each post on the corpus assembled for the September 17, 2026 build; this page was converted to the current standard on September 20, 2026 without rebuilding that corpus, so the counts and figures are as of September 17, 2026. Posts are counted whether or not they are indexed; citations on this page are limited to posts that are indexed and can be verified at the link. Two hundred forty-nine posts in the corpus are not indexed, Kevin Pho’s short 2004 to 2010 commentaries and a handful of short contributor posts and untranscribed podcast episodes, and they are counted but not cited. Howard Smith, MD, is cited five times, which is the cap this record applies to any single contributor; his 68 posts are otherwise represented by the term counts. Insurers’ contributors and plaintiffs’ attorneys are identified as such where cited. Quotations are taken verbatim from the original posts. Author credentials are as they appeared in the byline at publication. Every source is linked in the sentence that cites it, and the full list appears at the end of the page. The closest archive is the Malpractice tag. Related records: Medical errors: what physicians say, in their own words, Physician burnout: what physicians say, in their own words, Artificial intelligence: what physicians say, in their own words, and The electronic health record: what physicians say, in their own words.

This page is updated as new malpractice essays are published on KevinMD. When it is updated, the date at the top changes, the counts in the tables are recomputed, and new named claims are added to the relevant section. Nothing is removed unless the original post is removed. An author who believes a quotation on this page misrepresents them can write to Kevin Pho and the page will be corrected.

To cite this page: Pho K. Medical malpractice: what physicians say, in their own words. KevinMD.com. Updated September 20, 2026. https://kevinmd.com/medical-malpractice

The 41 KevinMD posts cited on this page, in order of publication