​Although the frequency of medical malpractice claims against physicians and hospitals has remained stable for the past few years, a deeper dive into the data uncovers trends that should be on risk managers' radar screens, said speakers at a session on physician claims and liability trends during the October 7 through 10, 2018, annual conference of the American Society for Health Care Risk Management in Nashville. One area is the rise in the number of surgical specialty claims related to complications known to the patient, said Darrell Ranum, JD, CPHRM, vice president, The Doctors Company. These complications should be discussed with the patient during the informed consent process, he said, but the increase in claims in this area suggests that "a lot of patients are struggling with these concepts in the informed consent" process. Surgeons should do their best to explain to patients complications that can arise and, if an untoward outcome occurs, assure the patient that "we'll take care of you" while relating the complication back to the informed consent discussion, said Ranum. Another area to track is diagnostic error claims, which John Swift, MBA, director of systems and software, CRICO, described as "persistent and pervasive." More than 50% of diagnostic error claims originate in the ambulatory setting, often, Swift said, with internal medicine specialties. Based on the large number of claims in ambulatory care related to patient assessment or evaluation or to diagnostic test ordering, he said, opportunities may be missed early in the diagnostic process that can affect the trajectory of ambulatory care. Noting that ambulatory care settings are not as far along as hospitals in adopting patient safety strategies, Swift said, "it will take effort to drive down" diagnostic error claims. Speaker Paul Greve, Jr., JD, RPLU, principal at Greve Medical Risk Management, commented on the "record pace for large verdicts of $10 million or more," which are affecting health systems more than physicians. "I worry about the decline of goodwill" for hospitals in their communities, with health system mergers, disappearing jobs, and less visibility. "Are juries trying to spank us because they perceive us as big business?" he asked. Eventually, physicians could be affected if reimbursement changes, such as value-based purchasing, negatively affect physician behavior. "I encourage you to watch for changes in physician behavior," Greve said. "It could affect claims."