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      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Editorial</span></div>
  
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      <h1 class="highwire-cite-title" id="page-title">We Are Not Alone</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">S. Mirbagheri</span>, <span class="highwire-citation-author" data-delta="1">K. Yousem</span> and <span class="highwire-citation-author" data-delta="2">D.M. Yousem</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">October 2015,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">36 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1794-1795; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A4531 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-14057--61720477999" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">S. Mirbagheri </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.%2BMirbagheri%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Mirbagheri%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AS.%2BMirbagheri%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-3689-7273" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for S. Mirbagheri</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">K. Yousem </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=K.%2BYousem%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Yousem%20K&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AK.%2BYousem%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">D.M. Yousem </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=D.M.%2BYousem%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Yousem%20D&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AD.M.%2BYousem%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-1222-6643" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for D.M. Yousem</a></li></ul></div></div></div>  </div>

  
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    <div class="messages highwire-corrections highwire-correction-type-correction highwire-correction-type-correction"><h3 class="highwire-corrections-title">This article has a correction. Please see:</h3><ul class="highwire-corrections-list"><li class="relation-1065 first last"><a href="/content/36/12/E71" class="" data-icon-position="" data-hide-link-title="0">Erratum - December 01, 2015</a></li></ul></div>  </div>

  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" data-highwire-cite-ref-tooltip-instance="highwire_reflinks_tooltip" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article fulltext-view "><span class="highwire-journal-article-marker-start"></span><p id="p-1">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.<sup><a id="xref-ref-1-1" class="xref-bibr" href="#ref-1">1</a><a id="xref-ref-2-1" class="xref-down-link" href="#ref-2"><span>⇓</span></a><a id="xref-ref-3-1" class="xref-down-link" href="#ref-3"><span>⇓</span></a>–<a id="xref-ref-4-1" class="xref-bibr" href="#ref-4">4</a></sup> A 2013 report on diagnostic radiologists indicated that 30.9% (2600 of 8401) of all US radiologists have been sued.<sup><a id="xref-ref-4-2" class="xref-bibr" href="#ref-4">4</a></sup> 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.<sup><a id="xref-ref-3-2" class="xref-bibr" href="#ref-3">3</a></sup> 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.<sup><a id="xref-ref-3-3" class="xref-bibr" href="#ref-3">3</a></sup> We are scared.</p><p id="p-2">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.</p><p>The data from this informal survey are presented in the <a id="xref-table-wrap-1-1" class="xref-table" href="#T1">Table</a>. 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):
</p><ul class="list-unord " id="list-1"><li id="list-item-1"><p id="p-4">United States, government and private (46%, $340,000, $21,000)<sup><a id="xref-ref-3-4" class="xref-bibr" href="#ref-3">3</a></sup></p></li><li id="list-item-2"><p id="p-5">Italy, government (50%, $300,000, $3000)</p></li><li id="list-item-3"><p id="p-6">Ireland, government (35%, $235,000, $8000)</p></li><li id="list-item-4"><p id="p-7">Germany, government and private (30%, $300,000, $1670)</p></li><li id="list-item-5"><p id="p-8">Spain, government (10%, $65,000, $550)</p></li><li id="list-item-6"><p id="p-9">Sweden, government (10%, $130,000, $550)</p></li><li id="list-item-7"><p id="p-10">Saudi Arabia, government (10%, $300,000, $8500)</p></li><li id="list-item-8"><p id="p-11">Chile, government (10%, $120,000, $1000).</p></li></ul><div id="T1" class="table pos-float"><div class="table-inline table-callout-links"><div class="callout"><span>View this table:</span><ul class="callout-links"><li class="view-inline first"><a href="" class="table-expand-inline" data-table-url="/highwire/markup/44795/expansion?postprocessors=highwire_tables%2Chighwire_reclass%2Chighwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed&amp;table-expand-inline=1" data-icon-position="" data-hide-link-title="0">View inline</a></li><li class="view-popup last"><a href="/highwire/markup/44795/expansion?width=1000&amp;height=500&amp;iframe=true&amp;postprocessors=highwire_tables%2Chighwire_reclass%2Chighwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed" class="colorbox colorbox-load table-expand-popup" rel="gallery-fragment-tables" data-icon-position="" data-hide-link-title="0">View popup</a></li></ul></div></div><div class="table-caption"><p id="p-12" class="first-child">Survey research data collected</p><div class="sb-div caption-clear"></div></div></div><p id="p-15">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.</p><div class="section ref-list" id="ref-list-1"><h2 class="">REFERENCES</h2><ol class="cit-list ref-use-labels"><li><span class="ref-label">1.</span><a class="rev-xref-ref" href="#xref-ref-1-1" title="View reference 1. in text" id="ref-1">↵</a><div class="cit ref-cit ref-journal" id="cit-36.10.1794.1" data-doi="10.1056/NEJMsa1012370"><div class="cit-metadata"><ol class="cit-auth-list"><li>
</li><li><span class="cit-auth"><span class="cit-name-surname">Jena</span>  <span class="cit-name-given-names">AB</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Seabury</span>  <span class="cit-name-given-names">S</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Lakdawalla</span>  <span class="cit-name-given-names">D</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Malpractice risk according to physician specialty</span>. <abbr class="cit-jnl-abbrev">N Engl J Med</abbr> <span class="cit-pub-date">2011</span>;<span class="cit-vol">365</span>:<span class="cit-fpage">629</span>–<span class="cit-lpage">36</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1056/NEJMsa1012370</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>21848463</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1056/NEJMsa1012370&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=21848463&amp;link_type=MED&amp;atom=%2Fajnr%2F36%2F10%2F1794.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">2.</span><a class="rev-xref-ref" href="#xref-ref-2-1" title="View reference 2. in text" id="ref-2">↵</a><div class="cit ref-cit ref-journal" id="cit-36.10.1794.2" data-doi="10.1001/jama.2014.10705"><div class="cit-metadata"><ol class="cit-auth-list"><li>
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</li><li><span class="cit-auth"><span class="cit-name-surname">Pereira</span>  <span class="cit-name-given-names">NP</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Lewin</span>  <span class="cit-name-given-names">JS</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Yousem</span>  <span class="cit-name-given-names">KP</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Attitudes about medical malpractice: an American Society of Neuroradiology survey</span>. <abbr class="cit-jnl-abbrev">AJNR Am J Neuroradiol</abbr> <span class="cit-pub-date">2014</span>;<span class="cit-vol">35</span>:<span class="cit-fpage">638</span>–<span class="cit-lpage">43</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.3174/ajnr.A3730</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>24335545</span></cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiYWpuciI7czo1OiJyZXNpZCI7czo4OiIzNS80LzYzOCI7czo0OiJhdG9tIjtzOjIxOiIvYWpuci8zNi8xMC8xNzk0LmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div></li><li><span class="ref-label">4.</span><a class="rev-xref-ref" href="#xref-ref-4-1" title="View reference 4. in text" id="ref-4">↵</a><div class="cit ref-cit ref-journal" id="cit-36.10.1794.4" data-doi="10.1148/radiol.12110971"><div class="cit-metadata"><ol class="cit-auth-list"><li>
</li><li><span class="cit-auth"><span class="cit-name-surname">Baker</span>  <span class="cit-name-given-names">SR</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Whang</span>  <span class="cit-name-given-names">JS</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Luk</span>  <span class="cit-name-given-names">L</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">The demography of medical malpractice suits against radiologists</span>. <abbr class="cit-jnl-abbrev">Radiology</abbr> <span class="cit-pub-date">2013</span>;<span class="cit-vol">266</span>:<span class="cit-fpage">539</span>–<span class="cit-lpage">47</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1148/radiol.12110971</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>23192777</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1148/radiol.12110971&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=23192777&amp;link_type=MED&amp;atom=%2Fajnr%2F36%2F10%2F1794.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li></ol></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2015 by American Journal of Neuroradiology</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div></div>  </div>

  
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