We Are Not Alone ================ * S. Mirbagheri * K. Yousem * D.M. Yousem While numerous recent US studies indicate a decline in medical malpractice suits across many medical specialties in the past decade, medicolegal concerns facing radiologists have conversely increased.1⇓⇓–4 A 2013 report on diagnostic radiologists indicated that 30.9% (2600 of 8401) of all US radiologists have been sued.4 A subsequent 2014 study of neuroradiologists found that 449/904 (49.7%) American Society of Neuroradiology members had been sued, and of these, nearly 50% were sued multiple times.3 The level of concern over malpractice suits was reported as moderate in severity by practicing neuroradiologists in the United States, and most respondents, despite substantial contradictory evidence on the outcomes of malpractice trials favoring defendants, thought that the medicolegal system was weighted against them.3 We are scared. Have we exported malpractice suits as readily as we have exported Kentucky Fried Chicken and Subway outlets across the globe? With the exception of the European Union, few countries outside the United States report malpractice lawsuit rates. We, therefore, created an informal survey, which was sent via e-mail to 96 neuroradiologists worldwide, representing 49 countries, to gain a sense of whether the American experience and anxiety over being sued are unique or universal. The survey results were sent to 60 officers of those national radiology society boards to confirm the data. The data from this informal survey are presented in the Table. The following are the 8 countries with the highest rates of radiologic malpractice suits, shown with average radiologist salaries and annual malpractice premium rates (presented respectively in parentheses): * United States, government and private (46%, $340,000, $21,000)3 * Italy, government (50%, $300,000, $3000) * Ireland, government (35%, $235,000, $8000) * Germany, government and private (30%, $300,000, $1670) * Spain, government (10%, $65,000, $550) * Sweden, government (10%, $130,000, $550) * Saudi Arabia, government (10%, $300,000, $8500) * Chile, government (10%, $120,000, $1000). View this table: [Table1](http://www.ajnr.org/content/36/10/1794/T1) Survey research data collected The responses generally revealed a moderate level of concern about malpractice that is a global phenomenon. The impact on our collective practice of medicine varies from mild to moderate across countries. As to Americans' fear of malpractice lawyers, WE ARE NOT ALONE. ## REFERENCES 1. 1. Jena AB, Seabury S, Lakdawalla D, et al. Malpractice risk according to physician specialty. N Engl J Med 2011;365:629–36 doi:10.1056/NEJMsa1012370 pmid:21848463 [CrossRef](http://www.ajnr.org/lookup/external-ref?access_num=10.1056/NEJMsa1012370&link_type=DOI) [PubMed](http://www.ajnr.org/lookup/external-ref?access_num=21848463&link_type=MED&atom=%2Fajnr%2F36%2F10%2F1794.atom) [Web of Science](http://www.ajnr.org/lookup/external-ref?access_num=000293960500010&link_type=ISI) 2. 2. Mello MM, Studdert DM, Kachalia A. The medical liability climate and prospects for reform. JAMA 2014;312:2146–55 doi:10.1001/jama.2014.10705 pmid:25358122 [CrossRef](http://www.ajnr.org/lookup/external-ref?access_num=10.1001/jama.2014.10705&link_type=DOI) [PubMed](http://www.ajnr.org/lookup/external-ref?access_num=25358122&link_type=MED&atom=%2Fajnr%2F36%2F10%2F1794.atom) [Web of Science](http://www.ajnr.org/lookup/external-ref?access_num=000345626800018&link_type=ISI) 3. 3. Pereira NP, Lewin JS, Yousem KP, et al. Attitudes about medical malpractice: an American Society of Neuroradiology survey. AJNR Am J Neuroradiol 2014;35:638–43 doi:10.3174/ajnr.A3730 pmid:24335545 [Abstract/FREE Full Text](http://www.ajnr.org/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiYWpuciI7czo1OiJyZXNpZCI7czo4OiIzNS80LzYzOCI7czo0OiJhdG9tIjtzOjIxOiIvYWpuci8zNi8xMC8xNzk0LmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==) 4. 4. Baker SR, Whang JS, Luk L, et al. The demography of medical malpractice suits against radiologists. Radiology 2013;266:539–47 doi:10.1148/radiol.12110971 pmid:23192777 [CrossRef](http://www.ajnr.org/lookup/external-ref?access_num=10.1148/radiol.12110971&link_type=DOI) [PubMed](http://www.ajnr.org/lookup/external-ref?access_num=23192777&link_type=MED&atom=%2Fajnr%2F36%2F10%2F1794.atom) * © 2015 by American Journal of Neuroradiology