New Study Shows that Most Doctors Will Get Sued During Their Career

A new study published in the New England Journal of Medicine says that one in 14 doctors faces a malpractice suit every year. Also, just about every physician will face at least one malpractice lawsuit at one point in their career.

The study reports that although many suits are filed, few are successful. The patient wins only 22 percent of the time.

“The report doesn’t provide information that is surprising to those in the medical professional liability industry,” said Rob Francis, chief operating officer at The Doctors Company. “The frequency of claims does vary significantly by specialty, and the majority of claims are resolved in favor of the physician, pointing out the prevalence of frivolous claims. In our data, over 80 percent of claims are closed with no payment to plaintiffs.”

The study looked at data on 40,916 physicians who were insured for at least one year sometime between 1991 and 2005 by a single professional liability insurer.

The researchers were also able to look at the data by specialty, and they found the risk of being sued and the awards associated with losing varied considerably.

The physicians with the highest risk of being sued were neurosurgeons, with an annual risk of 19.1 percent, followed by thoracic-cardiovascular surgeons, with an annual risk of 18.9 percent, followed by general surgeons, with an annual risk of just less than 15.3 percent. The physicians with the lowest risk of being sued were pediatricians, with an annual risk of 3.1 percent, followed lastly buy psychiatrists, with an annual risk of 2.6 percent.

The physicians most likely to lose a malpractice case in any given year were general surgeons, 4 percent of whom lost a case annually.

Overall, the study authors said, 75 percent of physicians practicing in a low-risk specialty will have been sued by the time they are 65 years old, 19 percent will have made an indemnity payment. For those in the high risk specialties, 99 percent will have been sued by age 65, and 71 percent will have lost.

The average indemnity payment was $274,887 in 2008. But, there was a range, from a low of an average of about $110,000 for a claim against a dermatologist to a high of $520,924 for a claim against a pediatrician.

Obstetricians often pay the highest premiums for malpractice insurance of any specialty. According to figures from the federal government, from 2003, the average rate paid by an obstetrician/gynecologist was $64,000 a year, or more. That compared with $28,000 to $50,000 for a general surgeon, and $6,000 to $11,000 for an internist. In Florida, where malpractice premium rates tend to be the highest, an OB/GYN can pay over $100,000 a year, and sometimes more.

In recent years, as malpractice premiums have continued to rise, a number of states have enacted caps on malpractice awards. Twenty-seven states currently limit the amount that can be awarded for non-economic damages, usually to around $250,000, notably California and Texas.

Howard Lamb, chairman of Medicus Insurance Co., Austin, Texas, said that, when just about every physician is likely to be sued, tort reform and awards caps make a huge difference.

He said that in Texas, where tort reform was enacted in 2004, the number of cases filed have dropped by a half. “There appears to be a lot of difference,” Lamb said. “Texas is a good example.”

Make Sure You Are Protected

Madison has the advantage of being able to approach many different insurance carriers in both standard and non-standard markets. This gives you the ability to completely saturate the marketplace and receive multiple quotes fast and effectively. When you work with Madison, we make sure you are taken care of. If you need heart surgery, you don’t try to do it yourself do you? No, you go to a trained professional. Madison is your insurance specialist. This is what we do. We deliver results. You manage care, we manage risk. Click here for a free medical malpractice quote.

* Article information provided by Insurance Journal West Region September 5, 2011

Posted in Medical Malpractice Insurance, News | Tagged , , , , , | Comments Off

Admitted Carriers Vs. Non-Admitted Carriers

The health care insurance industry, or really any insurance industry for that matter, is full of jargon and seemingly cryptic language that only veterans of the language can understand. So let’s get to the point. If I am a health care provider, chances are that whatever state I practice in, I’m going to need insurance.

One of the most important things I’ll want to know as a health care provider is how I can protect myself best, at the lowest price. One of the best ways to save money is to understand how insurance is categorized and in which category you have the most leverage for saving money in.

Two of the largest categories are: insurance written by an admitted carrier, and insurance written by a non-admitted carrier.

What is an Admitted Carrier?

An admitted carrier follows the guidelines outlined by the Department of Insurance (DOI) in the state in which they are writing business. Many times this is multiple states, and sometimes all states. These carriers are required to file their rates with the DOI, which then approves their use. The carriers must use these filed rates on all clients and cannot deviate.

This essentially means that whether you are a podiatrist or a cardiologist, you’ll receive the same insurance rate.

What is a Non-Admitted Carrier?

Often times, admitted carriers often do not meet all the needs of many insurance buyers. Non-admitted insurance carriers (sometimes referred to as surplus lines carriers) offer an opportunity for coverage for doctors that might otherwise be uninsurable. Policies such as Errors & Omissions (E&O), Directors & Officers (D&O), and Employment Practices Liability Insurance (EPLI) are among those that are often not written by admitted carriers.

Without the non-admitted carriers, high-risk specialties, or doctors with claims would be uninsurable. However, because the non-admitted carriers do not have to file their rates with the DOI, they retain the flexibility to price doctors according to their specific exposures. While these companies are not licensed by the DOI, they do have to go through an approval process that includes providing evidence of minimum capital and surplus requirements. When these requirements have been met to the DOI’s satisfaction, the DOI may approve a company to conduct business in that state.

Financial Ratings

Regardless of whether a carrier is admitted or non-admitted, one of the best gauges for determining the security of one’s policy is to check the financial rating of the company. The independent industry standard for rating insurance companies is AM Best Company. AM Best rates a carrier on financial strength and size based on policyholder reserves.

The Madison Advantage

When you look at your quote from Madison, you will see the AM Best rating and also an indication if your carrier is admitted, or non-admitted. We will always verify that all non-admitted insurance companies we offer are approved by the DOI. If you have special concerns about a particular carrier, please contact Madison Healthcare at 800-603-3311. We are more than happy to answer any and all of your health care insurance questions.

Posted in General Information, Medical Malpractice Insurance | Tagged , , , , , , , , | Comments Off

Major Insurance Carrier Lowers Rates

The announcement comes as welcomed news with rates decrease in six states across the country – Arizona, Kansas, Nevada, Ohio, Virginia and Texas.

Decreases in rates vary from state to state. In Arizona, rates are being lowered by 19%. Kansas follows closely behind with a reduction of 15%. Other states will see lowered rates by an average of 9%.

The company cites its “Go Green” initiative as the primary reason behind the rate decreases. As business transactions move further into the digital atmosphere, office costs are falling, enabling the company to extend some of its savings to its clients.

This carrier also announced a new payment option for their clients which will allow policyholders to make several large credit or debit transactions at a single time, saving the company time and paper in processing.

To find out how much you can save on your medical professional liability insurance (MPLI) follow this link to our online quote form or call us toll free at 800-603-3311.  We would love the opportunity to work with you to lower your premium!

Posted in News | Tagged , , , , , , | Comments Off

Tips For Doctors Using LinkedIn

With 100 million users and growing, LinkedIn is the largest social network focused on professional networking. LinkedIn gives users an opportunity to place their resumes online and list important professional qualifications that may be the deciding factor in whether or not you capture the younger generations who increasingly use the internet not only for entertainment, but for goods and services.

A well laid out LinkedIn page can be the difference in capturing the younger generation or blending in with the rest of the yellow page doctors out there; essentially falling victim to anonymity. Here are a few tips that can help your LinkedIn profile shine.

Keep Your Profile Current

The information you maintain on your LinkedIn profile should be treated as if you are looking for a new job. Keep information current and complete.

Although you want to keep your information current, try to avoid a regurgitation of your CV. You aren’t applying for insurance coverage, so give the bullet points.

Remember Your Audience

If you are trying to gain new business from LinkedIn users, show your potential patients how they will benefit from coming to your practice as opposed to someone else. What is your niche? What do you do that makes your practice stand out above the rest? If you aren’t sure, maybe it’s time to find this out. There could be a lot of prosperity in your future if you are able to successfully position yourself against your competition in a way that your patients will understand.

Remember the old saying, “you scratch my back, I’ll scratch yours”? Referrals are kind of the same thing. Take a little bit of time to connect with professionals you would gladly vouch for either online or in writing.

Only write referrals for people that you know provide a premium level of care. Giving out referrals to sub-par doctors reflects poorly on your judgment skills. On the flip side of the coin, you only want referrals from the best doctors. It builds trust and confidence. Trust and confidence are important to any consumer, but particularly in the health care field.

You have the ability to approve which referrals you want, so take care to make sure you are only allowing the referrals you want on your page. One thing you will also want to be aware of–your audience on LinkedIn is smart. They know what link swapping is, and it doesn’t bode well (reputationally speaking) if you make this tactic evident. If you receive a referral, wait one week to write one in return (if you choose to), and the same thing applies if you write a review for one of your peers. Wait at least a week before approving a referral from them.

Get Involved With LinkedIn Answers

LinkedIn provides a platform for people of all different walks of life to ask questions, and give other LinkedIn users an opportunity to answer. If you are seen as a professional with a wealth of knowledge in the Q & A forums, chances are pretty high that you will attract more people to your profile page. That’s where you want them to go right?

Essentially what you will want to remember is that your goal is to actively engage your audience. By using the tools available to you on LinkedIn, you are able to build credibility and trust, drive traffic to your LinkedIn page, and ultimately drive traffic to your business’ website.

Posted in General Information | Tagged , , , | Comments Off

Dismissal Rate Reaches Nearly 60% on Med Mal Claims in Massachusetts

Nearly 60% of liability claims against doctors and other medical professionals in Massachusetts are dropped by plaintiffs during litigation.  This leads to a significant amount wasted in defense costs and unnecessary distress for doctors.

A study conducted by Dwight Golann, a law professor at Suffolk University in Boson and board member of the largest medical liability insurer in Massachusetts, analyzed  3,695 lawsuits against physicians, hospitals and other health care professionals filed between 2006 and 2010.  According to the findings, 58.6% of claims were abandoned by plaintiffs, 26.6% were settled and 14.8% were adjudicated.

Golann said that what he found is the tendency for plaintiffs to hang on to claims until the end of the case.  Golann found that the average cost of a dropped claim was $25,735.  The average cost for settled claims was $39,901 and $84,375 for adjudicated cases.

Golann said the average defendant in the study waited almost three years before a claim was dropped. 

“That’s a significant period that doctors are burdened with a claim hanging over their head”, said Golann.

A 2009 Physician Insurers Association of America analysis found 64.2% of claims were dropped, dismissed or withdrawn.  Fewer than 1% of claims resulted in plaintiff verdicts.  The analysis found the average cost of resolving a medical liability case in 2009 was $324,969, a rise of 13.9% from 2000.  Defense payments in 2009 averaged $47,937, an increase of more than 65% from 2000.

Reasons for dropped claims

As part of Golann’s study, he interviewed attorneys and insurance companies regarding the reasons behind dropped claims.  One common reason was that plaintiffs acquired more information during the course of a lawsuit that weakened the claim.  For example, a medical record may suggest a required treatment step was not taken, but a defendant may later testify in a deposition that the step was completed but not recorded.

“If a case is going to be dropped, the plaintiff has an actual interest in knowing that quickly and so does the defendant, said Golann.  “This is one of the few areas where they could cooperate.”

Golann recommends insurers and hospitals adopt procedures that encourage attorneys to discuss the merits of cases more candidly.  Such reforms would reduce the frequency and duration of dropped cases and decrease legal costs, he said.

Posted in General Information, Medical Malpractice Insurance, News, Uncategorized | Tagged , , , , | Comments Off

August Newsletter

Click to enlarge this month’s newsletter.  If you are interested in signing up for the Madison Newsletter, simply enter your email address at the bottom right of this web page.

Posted in General Information, News | Tagged , , | Comments Off

Comparing MICRA to Areas Around the Country

It has long been said that California’s MICRA bill is the standard to which many other states strive to reach with tort reform.  But what are the actual numbers?  Is MICRA really that much better than currrent legislation in other areas of the country.  In the July issue of Southern California Physician, we took a closer look.  The results are interesting.

Click to Receive a Free Quote!

Posted in Hospital Professional Liability, Medical Malpractice Insurance | Tagged , , | Comments Off

MICRA Under Attack

Trial lawyers in California are pushing to raise the cap on non-economic damages to as high as $ 1 million. The California Medical Association reports that even an increase of $500,000 would raise California health care costs by $7.9 billion per year. MICRA (Medical Injury Compensation Reform Act) was enacted in 1975 due to increasing amounts of medical malpractice lawsuits.

Doctors, at that time, were faced with extremely difficult decisions. On one hand, they could increase the cost of services, which would put more money in the doctor’s pocket and help them compensate a claim. The problem with that is the simple economics of raising prices. If the doctor chooses to raise the cost of services, the patient will seek care elsewhere, which cuts the doctor out of the market and the business will ultimately fail if the proper adjustments aren’t made. Another option doctors had would be to leave the state or stop practicing medicine altogether. None of these options are beneficial for either the doctor or the patient.

Higher caps simply means that the quality of healthcare in the state of California will decrease. Increasing the caps inevitably pushes California doctors to other states and drives up the cost for those who choose to continue practicing in the state.

Although it is difficult to imagine legislation approving any changes to MICRA given the fact that the bill has been the standard to which all other states strive for over 3 decades, healthcare professionals owe it to themselves to fight tooth and nail against such proposals. Especially since many practicing doctors today remember how dire the situation once was in the early 70s.

Posted in Hospital Professional Liability, Medical Malpractice Insurance, News | Tagged , , , , | Comments Off

Wisconsin’s Liability Fund to be Restored

According to a law enacted on June 15th, Wisconsin state officials have until June 30th, 2012, to repay more than $200 million that was taken from the state’s medical liability compensation fund, four years ago.

The AMA reports that the legislation is following through with a decision by the state Supreme Court, which found the financial transfer unconstitutional in 2010. State representatives have been working with medical society officials to determine the amount to be repaid to the fund as well as the amount of interest and cost earnings incurred on the debt.

The money was transferred in 2007 from the Injured Patients and Families Compensation Fund by Wisconsin legislators sighting reasons for the transfer as being needed to pay for other state healthcare program.

During the initial ruling in 2008, the court sided with the state, ruling physicians pay mandatory fees to the fund for medical liability insurance coverage. The main cause for concern in this, is the fact that these fees were going to the fund for a benefit that Wisconsin doctors were already receiving.

In the July 20th, 2010 ruling by the Supreme Court of Wisconsin, the court said that healthcare professionals have a constitutionally protected property interest in the fund. The court stated that healthcare professionals in Wisconsin have certain rights to the fund including “a right to the security of integrity of the fund.” The court also said that any transfer of this money used for improper purposes infringes upon these rights.

Ruth Heitz, general counsel for the Wisconsin Medical Society said Wisconsin legislation is sending a clear message that the state is committed to repaying the debt.

Wisconsin State Representative Tom Larson, said “We must do the prudent thing and take care of our responsibilities like Wisconsin families do each and every day.”

Posted in News | Tagged , , , | Comments Off

Healthcare Accountability and ACOs

Tort Reform

With ongoing talks of reforming America’s healthcare system, it seems that more questions are being asked rather than answers being provided. Many people argue that reforming the medical malpractice laws and placing caps on rewards is the answer. After much debate, the issue still stands. States such as California, who have passed reform bills like MICRA, argue that this is the best way to overhaul the system. Maybe there’s another way.

Are Accountable Care Organizations the answer?

“Over and over again, we have seen that improving how care is delivered to patients is key to reducing the growth in healthcare spending,” said Dr. Donald Berwick, administrator of the Centers for Medicare & Medicaid Services. “When we improve the coordination of care between providers, reduce duplication of services and avoid medical errors, we can get better outcomes for patients at less cost. The Affordable Care Act has given us the tools to achieve these goals.”

Although accountable care organizations are slated to become active January 2012, the American Medical Association, among others, have doubts of whether or not doctors will be able to put forth the investment necessary to join an ACO.

Among the costs to consider would be the robust infrastructure that is needed for all the different doctors to share medical records seamlessly, and the ability to protect medical records. With records moving more and more into the digital platform, there is more opportunities for data breaches.

Harold Miller, president and CEO of the Network for Regional Healthcare Improvement and executive director of the Center for Healthcare Quality & Payment Reform in Pittsburgh, states that an ACO can be compared to buying a television.

“A TV manufacturer like Sony may contract with many suppliers to build sets. Like Sony does for TVs, an ACO would bring together the different component parts of care for the patient—primary care, specialists, hospitals, home healthcare, etc.—and ensure that all of the parts work well together.

Miller says that the problem with healthcare today is that patients are trying to get each part of their healthcare separately.

“People want to buy individual circuit boards, not a whole TV. If we can show them that the TV works better, maybe they’ll buy it rather than assembling a patchwork of services themselves.

Miller says that it is up to the ACOs to prove that the product they are providing for the patient is a better deal and is more efficient than the old method of receiving care from multiple sources.

The efficiency of ACOs remains to be seen, but many would agree that some major shifts in policy are on the horizon.

Posted in Cyber Liability, General Information | Tagged , , , , , , | Comments Off