COMMENTARY
Bloom & Buell's

THE BULL IN THE LABYRINTH

Most of our readers know that we do a considerable amount of work representing health-care professionals before their respective Boards, such as the Board of Registration in Medicine. We have also spoken to many small groups on Grand Rounds about these same agencies. With tongue in cheek we call our lecture, "The Board of Registration in Medicine - The Labyrinth Explained."

As part of our continuing service to the medical profession in explaining the labyrinth, we thought you would like to know how those settlements and jury verdicts earn the appellation, "below average," "average" and "above average." Here it is, printed, as is, from the Board of Registration in Medicine's publications. The test will be on Monday.

METHODOLOGY FOR DETERMINING PROFILES MALPRACTICE CATEGORIES

Malpractice payments listed in Profiles are divided into the categories below average, average, and above average. The following explains the methodology used to determine these categories.

Malpractice payments are first sorted according to the doctors' primary specialty. The payments in each specialty are next sorted in ascending order, based on actual payment amounts. The records are then counted to determine the total number of payments in each specialty.

Specialties with at least four (4) payments. For each specialty with payments, the total number of payment [sic] is divided by 4, rounding up to the next whole number as necessary, to determine the beginning of the interquartile range. This number is also multiplied by 3 to determine the end of the interquartile range. Any payment less than that at the beginning of the interquartile range is categorized as below average. Any payment larger than that found at the end of the interquartile range is categorized as above average. Any amount which falls within the interquartile range is categorized as average. Thus, below average payments are those within the first quartile of payments in a specialty; above average payments are those falling in the fourth quartile; all other payments are considered average.

Specialties with two payments. The same methodology is used. However, one of the three categories is not applied to the specialty because two payments obviously will not sort into three (3) categories.

Specialties with three payments. The middle payment is considered average, the low payment is below average, and the high payment is above average.

Specialties with only one payment. The single payment is considered average.

Whenever new payment information is added to the malpractice database, the program repeats itself. The report on a doctor's payment categories may change as a result. That is, a payment that was once listed as average may shift into the category of below average, etc.

Got it?

For more information regarding this commentary, contact Bloom & Buell via e-mail or call (617)254-4400 or write 1340 Soldiers Field Road, Boston, MA 02135.


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