If a group of physicians were asked to list the specialties of clinical medicine that carry the highest risk of malpractice, invariably the first responses would include obstetrics/gynecology, anesthesia, and various surgical specialties. These clinical domains are well recognized to carry risk and have done so for many years. The results of adverse events in these clinical fields tend to be catastrophic and historically have often resulted in high-profile legal cases, covered in the media and associated with large indemnity payments. It is the rare clinician who will list a general internist or other noninterventional outpatient specialty in the list of high-risk physicians. This unrecognized risk, and the associated absence of risk management programs in ambulatory care settings across the country, is a cause for concern.
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