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Research suggests that female physicians have a more patient-centered communication style, characterized by more collaboration with the patient and discussion of treatment options. These same communication characteristics have been associated with patient satisfaction and malpractice prevention. Few empirical studies, however, have examined whether gender affects malpractice risk. The primary objective of this study was to determine whether gender was associated with malpractice among health maintenance organization (HMO) physicians. A secondary objective was to examine how malpractice affected physicians' psychological well-being. Data came from mail surveys of physicians practicing in two group model HMOs. The average response rate was 80% (N = 608). Female physicians were significantly less likely than male physicians to have been sued. Only 26% of the female physicians had been sued compared with 49% of the male physicians. These differences remained after adjusting for physician age, time in practice, specialty, workload, and characteristics of physicians' patient panels. Sued physicians were significantly more at risk for burnout than never-sued physicians and were less satisfied with the HMO. These findings did not differ by gender. [ABSTRACT FROM AUTHOR]