The Economics of Plaintiff Med Mal Practice: What Your Intake Process Is Actually Costing You

Medical malpractice is one of the most economically demanding practice areas in plaintiff law. Most plaintiff attorneys track their hard case costs carefully. What most attorneys do not track is what their intake process costs them annually in cases that should never have been taken.

That number is less visible. And it is often larger than it needs to be.

The Full Cost of a Case That Does Not File

When a case reaches expert retention before the clinical foundation is properly evaluated, and the expert comes back with a no-case finding, the cost is not just the expert fee.

The figures below are an illustrative model, not survey data. Substitute your own numbers. Expert retention: $2,000 to $3,000 in upfront retainer fees. Add hourly review at $350 to $500 per hour for 6 to 10 hours and you are at $4,000 to $8,000. Record retrieval: $500 to $2,000. Staff time: 15 to 30 combined hours. In this model, the unrecoverable cost of a single case is $8,000 to $15,000.

What This Looks Like Annually

A practice handling 15 to 20 potential med mal intakes per year, converting 3 to 5 into filed cases, is absorbing costs on 10 to 17 cases that do not proceed. If half reach expert retention before being declined, the annual unrecoverable cost is $40,000 to $100,000 in hard and soft costs combined.

Some version of that number sits in the overhead of most practices without a clinical screening step before retention.

The Math on Pre-Litigation Screening

A clinical screening at $1,250 per case, applied to every potential med mal intake, costs roughly $18,750 to $25,000 annually for a practice handling that volume.

Whether screening pays for itself depends on your volume, your decline rate, and how far declined cases progress before they are dropped. In this model, avoiding two or three retained-expert reviews a year offsets much or all of the screening cost. Run it with your own numbers.

What Changes Beyond the Direct Cost

Case quality improves. Client relationships improve. Cases that are declined in week two with a clinical explanation leave clients with a clearer understanding of why their case does not proceed rather than 12 months of managed expectations followed by a collapsed case.

The economics of plaintiff med mal practice are ultimately the economics of case selection. Pre-litigation clinical screening is not a cost center. It is the investment that makes the rest of the economics work.

Submit your next case for clinical screening before retention.

Related reading

More on this topic: flat-rate merit review and the real math behind premature expert retention.