The most important findings of this study in identifying medical malpractice predictors for refractive surgeons were a high surgical volume and a history of a prior claim or suit. Using a statistical adjustment for volume, the risk of incurring malpractice litigation was significantly greater in higher-volume refractive practices compared to lower volume practices. Additional risk factors for surgeons performing more than 100 cases per year were associated with gender (male), advertising, preoperative time spent with the patients, and comanagement with optometrists. Thus, a high-volume male refractive surgeon who advertises, comanages, and spends little time with his patients is at a relatively high risk for subsequent litigation, and once a claim is filed, he has an increased chance of incurring additional legal action.

LASIK surgery has often been portrayed as nonessential cosmetic surgery performed as a business and not a medical procedure. Aggressive marketing, with a focus on price and a volume business model, provide significant jury appeal for the plaintiff’s attorney. By identifying some of the risk factors associated with potential malpractice litigation in this study, it is hoped that a change in physician practice patterns will occur. Ultimately, this should help improve the overall quality of care provided to refractive surgery patients and alter the image this procedure has acquired within the legal community and the public.