Malpractice by Specialty: Which Doctors Face the Most Claims

Neurosurgery: $605K Average Payment

Neurosurgery has the highest average malpractice payment of any specialty at $605K per case. This reflects the catastrophic nature of outcomes when brain and spinal surgery goes wrong — permanent paralysis, brain damage, and death are disproportionately common. Despite having only 1,602 cases in the NPDB, the severity of each case drives enormous settlement values.

Emergency Medicine: $340K Average Payment

Emergency physicians face unique malpractice risk because they treat patients under time pressure with incomplete information. Missed diagnoses — particularly heart attacks, strokes, and appendicitis — are the most common allegations. The average payment of $340K reflects cases where delayed diagnosis led to death or permanent disability.

OB/GYN: $322K Average Payment, 10,428 Cases

Obstetrics carries the highest combination of case volume and severity. Birth injury cases, particularly those involving cerebral palsy or brachial plexus injuries, can result in lifetime care costs exceeding $10 million. With 10,428 payment reports and an average of $322K, OB/GYN represents one of the largest total payout categories.

General/Family Practice: 377,089 Cases ($296K Average)

General and family practice physicians account for the most malpractice payments by far — 377,089 cases, representing the largest single specialty category. This makes sense given that general practitioners see the broadest range of patients and conditions, creating more opportunities for diagnostic errors. The average payment of $296K is close to the national average, reflecting a mix of minor and severe outcomes.

This analysis uses the National Practitioner Data Bank (NPDB) Public Use Data File, maintained by the Health Resources and Services Administration (HRSA). Specialty classification is based on the NPDB “license_field” code, which identifies the practitioner’s primary field of licensure.

Important Caveats

• The NPDB “license_field” code reflects the practitioner’s primary licensure, not necessarily the specialty involved in the malpractice incident.
• General/Family Practice (code 10) is a broad category that may include practitioners who sub-specialize but hold a general license.
• Case counts reflect payment reports, not individual practitioners — one practitioner may appear in multiple reports.
• The data does not capture claims that were dismissed or settled without payment.