Medical Malpractice Insurance for Residents and Fellows

3 ResidentsLate April, early May is the time of the year that our website and 800 number (1-866-824-0137) is deluged with calls, e-mails and submissions regarding medical malpractice insurance for residents and fellows. In most cases, residents are covered under the hospital policy with which they are affiliated. However, there are times when a resident has time available and access to other programs at other institutions. In that case, the current hospital’s medical malpractice insurance policy would not cover the resident at the new institution and the resident would then qualify for an inexpensive short-term policy. (Please note that surgical residencies are likely to cost more.)

As residents finish their training, and July 1 rolls around, there is a mad scramble for fellowship medical malpractice insurance coverage –especially among foreign medical residents. It’s always advisable to try and secure coverage as soon as possible. We’ve seen physicians lose their fellowships because they have not secured coverage in time. And, it’s silly to put off getting coverage –the process is simple and streamlined.

Rates. Ok, so we promised you inexpensive and streamlined medical malpractice insurance for residents and fellows. Now what? To get the process started, we’ll mail you a short, two-page application that you can e-mail or fax back to us. Along with the medical malpractice insurance for residents application, please include a short description of the dates of coverage needed and the hospital or the medical center location. We’ll process it and send you a binding document along with payment information within 24 hours. As noted above, surgical medical malpractice insurance coverage is available but the application is much more comprehensive and the processing time is longer. The cost of (non-surgical) medical malpractice insurance for residents and fellows coverage is roughly $300-400/month for up to 12 months. The 12 month cost of coverage is roughly $1200. The policy will reflect the traditional medical malpractice insurance limits that are in the state where the coverage is being requested.

And, you should know that even if you are reading this in the evening or on the weekend and you need medical malpractice insurance for residents and fellows, please know that we can still answer your questions and/or accept your application. Talk to one of our medical malpractice insurance agents today!

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Number of Pennsylvania Medical Malpractice Claims Continues to Drop

According to a new report from the Administrative Office of Pennsylvania Courts, the number of reported Pennsylvania medical malpractice claims in 2011 is at least 40 percent lower from the state’s high water mark of 2000 to 2002. This is the fourth consecutive year that the number of claims has been at least 40 percent lower than the years 2000 to 2002.

According to the new report, the number of medical malpractice claims filed in Pennsylvania for 2001 was 1,528, or 44.1 percent less than the average number of medical malpractice claims filed annually between 2000 and 2002.

Many medical malpractice pundits credit the decrease in claims frequency to tort reforms that the Commonwealth legislated in 2002 and went into effect in 2003. The legislation allows medical malpractice damages to be paid over time, eliminates the practice of venue shopping, created more stringent requirements for expert witnesses, a strict certificate of merit requirement and established a seven-year statute of limitations for filing a medical malpractice lawsuit.

According to those who track Pennsylvania’s medical malpractice data, the most effective of the state’s 2002 medical liability tort reforms have been the certificate of merit requirement and the elimination of venue shopping.

The Pennsylvania certificate of merit requirement mandates that when any legal action alleging that a healthcare professional deviated from an acceptable professional standard is filed, it must be followed within the following 60 days by the submission of a certificate of merit letter—signed by a healthcare professional practicing in a similar specialty—that states that there exists a reasonable probability that the care, skill or knowledge exercised or exhibited in the treatment, practice or work that is the subject of the complaint, fell outside acceptable professional standards and that such conduct was a cause in bringing about the harm. The success of this reform can be seen in the dramatic drop in claims frequency. The certificate of merit requirement effectively restricted access to the courts for large numbers of frivolous lawsuits.

Pennsylvania’s 2002 venue shopping reform dealt with the practice of filing a medical malpractice lawsuit in court districts that have little relation to the cause of action or the defendant, but that have a history of favoring plaintiffs. In Pennsylvania, that jurisdiction had most commonly been Philadelphia. The City of Brotherly Love has the dubious reputation of being consistently on the American Tort Reform Association’s Judicial Hellhole List, which annually ranks the most plaintiff-friendly court jurisdictions in the nation. Philadelphia was No. 1 on the Judicial Hellhole list for 2011. Looking at the data compiled by the Administrative Office of Pennsylvania Courts, the success of the venue shopping restriction is impressive. Previous to the restriction, an average of 1,365 medical malpractice claims were filed in annually in Philadelphia; in 2010, the number had fallen to just 381.

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Medical Malpractice Insurance for Physicians in Training, Part 1: Medical Students and Foreign Medical Students

Every year around this time, the agents and MyMedicalMalpracticeInsurance.com field requests for short-term medical malpractice insurance coverage for all types of medical students, including foreign medical students. Luckily for our clients, this type of insurance is readily available, and can be low-cost.

Today we will specifically focus on medical malpractice insurance for students and medical malpractice insurance for foreign medical students. Up until recently, medical students had limited medical malpractice insurance choices and medical malpractice insurance for students cost $1,500 minimum and policies were minimum one year in length. Today, policies can be had for any length of time, the cost is significantly less and the processing of the application is very quick.

For foreign medical students, that have an externship or observational requirement, medical malpractice insurance for foreign medical students with limits of $1 million per claim and $3 million aggregate, can be had for as little as $400 per month. Policies of up to a year usually max out at $1,000 per year.

The cost of medical malpractice insurance for students and medical malpractice insurance for foreign medical students ranges from $400 to $1100 depending on the length that the coverage is needed.

Externships that require surgery may not qualify for this coverage. So, always let your agent know if you will be doing surgery and might need surgical malpractice insurance. For physicians in training in a surgical situation, costs will vary depending on the specialty and the state of practice. Most policies begin at about $1000 base and can go as high as $2500, depending on the situation.

When applying for an externship or an internship, you should be aware that the credentialing department at the hospital where you will be will need proof of medical malpractice insurance right away. Because these positions are often very competitive, our agents can give you a quick turn around, which is often essential for securing these positions.

The greatest feature of medical malpractice insurance for students and medical malpractice insurance for foreign medical students is that the agents at MyMedicalMalpracticeInsurance.com have access to exact pricing for whatever your situation. So please complete our online quote request form or call us at 1-866-824-0137 and ask for a medical malpractice insurance quote today. Call us even if it’s the evening or weekend. Our agents regularly check their e-mail and voice mail.

Don’t lose your internship or externship because you didn’t secure your medical malpractice insurance for students coverage in time!

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Part II: PPACA Opens Market Opportunities for More Personalized Medicine

Editor’s note: Today’s blogpost is the second of a two-part series on how the Patient Protection & Affordable Care Act could open market possibilities for more personalized medicine. The article it originates from was initially published in the April 2012 issue of Medical Liability Monitor, the industry’s premier source for consistent, reliable coverage and fresh perspectives on medical professional liability insurance and risk management issues.

(continued from yesterday)

Lipton supports the PPACA’s goals of offering healthcare to a wider percentage of Americans and deflating the overall cost of healthcare delivery, but he questions the efficacy of the ACO model it encourages. He believes the cost savings of the ACO model will not be derived through efficiencies of scale, but rather reductions in the actual delivery of care.

“I don’t think the ACO model is an absolutely positive thing, but it does attempt to insure more people and control costs. The unfortunate thing is that it also encourages a depersonalization of medicine. That group model emphasizes the use of lower-level providers, like nurse practitioners and physician assistants. It doesn’t emphasize the physician-patient relationship, where the doctor knows the ‘wellness state’ of the patient and his or her medical history.”

The hybrid model’s flexibility is designed to meet the varying needs of physicians and patients. It allows physicians to continue seeing all their patients, while offering those who want a concierge option that choice. Physicians limit their hybrid concierge practice to between 50 and 200 patients, a much smaller number than typical for primary care, and far less than a full concierge model of 300 to 600 exclusive patients, charging their concierge patients an annual fee generally around $150 a month for membership.

“I think the hybrid concierge model will have tremendous opportunity in the future as groups and entities realize that not everyone is going to want to fit into the box of what the ACO requires,” Lipton said. “I think the hybrid concierge model can be successfully married to the ACO approach. We are not at the point yet where ACOs are established enough or comfortable enough to consider that next step, but they ultimately will be because it is another vehicle for increased revenue and increased patient options.”

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Part I: PPACA Opens Market Opportunities for More Personalized Medicine

Editor’s note: Today’s blogpost is the first of a two-part series on how the Patient Protection & Affordable Care Act could open market possibilities for more personalized medicine. The article it originates from was initially published in the April 2012 issue of Medical Liability Monitor, the industry’s premier source for consistent, reliable coverage and fresh perspectives on medical professional liability insurance and risk management issues.

If one believes the healthcare industry prognosticators, the future of medicine will be more efficient and cost effective, but less personal and shepherded by accountable care organizations (ACOs) that will tie provider reimbursements to quality metrics and reductions in the total cost of care for an assigned population of patients. Gone will be the days of customized care and services. Gone will be the days of the small, independent primary care physician practice.

The industry’s move toward an ACO model was galvanized by the Patient Protection & Affordable Care Act (PPACA) of 2010, which is laden with incentives to lower the overall cost of healthcare via increased administrative efficiencies. The PPACA encourages a market consolidation and the concentration of power in fewer organizations, like larger, regional hospital systems.

Will the ACO delivery model be a death knell for the independent physician practice and nurture a culture of depersonalized healthcare? Or will it create a demand for primary care physicians who practice boutique, personalized, concierge-style medicine?

“There has been a push toward what I call ‘big box’ or ‘factory medicine,’ which is unfortunate because I think it takes a lot away from the art of medicine and leaves little room for the strengths of the individual provider,” said Wayne Lipton, founder and managing partner of Concierge Choice Physicians (CCP), a New York-based company that helps primary care physicians implement a hybrid model of concierge healthcare. “The larger the group, the less physician autonomy there is. A hybrid concierge model enables small groups, middle-sized groups and individual physicians to keep practicing without succumbing to the economic pressure to aggregate into mega units. It also emphasizes the one-to-one relationship, establishing value between the patient and doctor rather than the patient and an entity.”

The CCP program has more than 200 physician offices in 20 states with members caring for more than 300,000 traditional and concierge patients. CCP provides marketing and support services for all the varied aspects of designing and implementing a hybrid concierge program. The hybrid concierge model maintains the individual integrity of the independent private practices, and CCP does not impose uniformity on its member practices. The company does not offer its members an alternative vehicle for insuring their medical liability, although it is open to making one available in the future.

“We currently don’t offer our members an alternative to traditional medical liability insurance companies,” Lipton said. “We are a service provider. We don’t own the practices; we don’t run the practices. One of the challenges to providing liability insurance would be that we have members practicing in 20 states, but I would love to be able to do so as our membership gets larger.

“The great thing, from a liability standpoint, is that we have selectivity when deciding who we work with. The physicians we work with are the ones who are most appreciated by their patient base and have the greatest relationships with their patients, so they have remarkably low exposure. Our doctors are a much more beneficial group to cover than a broader, less select group of doctors.”

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Should You Consider Data Breach Insurance?

Physician on Computer We have written a lot here about technology and how it can make your practice more efficient and yet also make it more vulnerable. Technology is no longer just electronic medical records. As physicians and other health care providers come to reply on portable electronic devices more and more to run their practice and take care of their patients, cell phones, tablets and the like are becoming technology used in medical practice. And, data breach insurance is becoming increasingly important.

When a physician’s mobile devices cross over from personal items to tools used to conduct patient care, they must become guarded and treated as securely as if they were electronic medical records. (And, as we all know even electronic medical records are not impervious to data breaches just because they have high level security.) So, all electronic technology must be constantly monitored and updated to guard against threats and data breaches.

With the use of technology only escalating, we here at MyMedicalMalpracticeInsurance.com recommend that all practices and physicians have data breach insurance coverage if it is not already part of their medical malpractice insurance plans.

If you need to shop for data breach insurance, I recently came across an article on BeckersHospitalReview.com, titled, “3 Considerations for Evaluating Data Breach Insurance Policies.” If you have time, it is worth the read. If not, you may wish to simply contact one of our agents today to discuss data breach insurance with our professionals.

Not only is a data breach disastrous in terms of violating patient identity and confidentiality, it can cause a devastating financial fall-out. Like malpractice insurance coverage, terms of a data breach insurance policy can vary and it is important to know what is covered (and to what extent) and what is not covered. In other words, know the policy you are purchasing.

Thinking about getting data breach insurance? Do you have questions? Contact us today. Our agents are happy to answer your questions about data breach insurance or any type of malpractice insurance.

Posted in cyber liability, Electronic Medical Records, HIPPA, Medical Data Security, Medical Technology, Patient Privacy, risk management | Leave a comment

ACI to Host Obstetric Malpractice Forum in June

Sidenote: This announcement is from the American Conference Institute and our media partner, Medical Liability Monitor. If you would like to subscribe to Medical Liability Monitor, please click here.

On June 27-28, the American Conference Institute (ACI) will be hosting its 11th Annual Advanced Forum on Obstetric Malpractice at the Union League of Philadelphia, which occupies an entire city block in the center of Philadelphia’s commercial and cultural district. Medical Liability Monitor is a media sponsor of the event, and its subscribers are entitled to a discounted registration.

At this year’s Advanced Forum on Obstetric Malpractice, the nation’s leading obstetric malpractice attorneys, healthcare professionals, insurance professionals and hospital risk managers will conduct discussions on the latest litigation and claims trends, new theories of liability, emerging defense and damage mitigation strategies, cutting-edge technologies and techniques as well as evolving standards of care in obstetrics.

Discussion topics will include:

• Litigating claims arising from prenatal care as well as identifying and managing the risks during the prenatal period;

• Determining when perinatal asphyxia is the underlying cause of a brain injury;

• Emerging standards of care for infants born with brain injuries and other emergency situations;

• Developing an effective litigation strategy for claims due to shoulder dystocia;

• Ensuring the correct interpretation and response to fetal monitoring and litigating claims relating to fetal monitoring;

• How placental pathology and neuroimaging are impacting assessments of causation and timing of injuries;

• Assessing the impact of intrauterine infections and genetic disorders on the placenta and fetus;

• Minimizing exposure to obstetric malpractice litigation by identifying key drivers of risk, enhancing incident management practices and utilizing a systematic approach to process improvement;

• Determining the monetary value of a case through the effective assessment and use of life care plans.

Medical Liability Monitor readers are entitled to a discount when registering with the code: “MLM 200.”

If you are interested in registering, or to learn more about the conference, please call 888-224-2480 or visit the conference website at www.AmericanConference.com/ObMal.

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Study Questions Texas Medical Malpractice Tort Reforms

A new study of call into question the commonly held belief that Texas’s 2003 tort reform not only lowered medical malpractice insurance premiums, but also attracted an influx of doctors to serve the state’s more rural patients

The 2003 Texas tort reforms are legendary in medical malpractice insurance circles. At the heart of the reforms is a $250,000 cap on pain-and-suffering, non-economic damages. In cases with multiple defendants, the non-economic damage cap is $250,000 for all defendants total. The cap is also $250,000 for a defendant hospital.

The $250,000 cap on non-economic damages is similar to California’s Medical Injury Compensation Reform Act (MICRA), which has been the gold standard of medical liability tort reforms since 1975. Where Texas differs from almost every other state is that the cap on non-economic damages is enshrined in the state’s constitution.

When other states have passed non-economic damage cap legislation, medical malpractice insurance companies generally take a wait-and-see approach before lowering premiums. Texas medical malpractice insurance premiums, on the other hand, immediately began to shrink because the Texas Medical Society and pro-tort reform groups got the legislation into the constitution via a ballot initiative effort that passed with slightly more than half of voting Texans in support. The No. 1 medical malpractice insurance company in Texas cut its rates by 12 percent the year after the tort reforms passed, and—to date—malpractice insurance rates have fallen by 27.5 percent on average

Texas has taken great pride in its medical malpractice tort reform, and the government has touted how it has attracted doctors in droves top practice in the state. Some in the state government have said that the number of doctors applying to practice in the state has grown by 60 percent.

A new paper, titled “Does Tort Reform Affect Physician Supply? Evidence from Texas,” argues that the number of practicing doctors in Texas did not increase in the wake of the 2003 tort reforms. For more information on the study, please visit here.

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Recent Changes to the New York Medical Malpractice Insurance Market

Thermometer and PillsAlthough it’s one of the largest states from the medical malpractice insurance premium point of view, New York can be a very frustrating state when looking for medical malpractice insurance. Doctors have limited choices for New York medical malpractice insurance and the state needs to see some reform in order to have a more competitive environment. But, we are hopeful for the future for a couple of reasons that we will discuss later in this post.

The two main admitted carriers (See our Medical Malpractice Insurance Q & A page for our glossary of terms) in New York state are PRI and MLMIC. (Most states’ physicians will have access to 10 or more admitted carriers.) Because of the quirkiness of New York state overall, the only other type of medical malpractice insurance carriers are risk retention groups (RRGs). The RRGs play an important role in creating a competitive market and offering an alternative to physicians. Although the RRGs are not admitted, and considered a surplus, or non-admitted carrier, they still offer an excellent alternative and should not be dismissed or overlooked. It’s important to note that most major New York City-based hospitals do not accept coverage by RRGs. Before you shop for coverage with risk retention groups, you should contact your hospital’s risk management or credentialing groups to see if they accept risk retention group coverage.

But, there’s some good news. The outlook for the future is encouraging. For instance, Med Pro, from Berkshire Hathaway, has entered the state in the form of its own RRG. Because the Med Pro policies are written on Med Pro paper, this means that physicians have the backing of a company with over $60 billion in cash. Med Pro was unwilling to enter New York state as an admitted company but was willing to enter the state as an RRG. And, in the past week, we have learned that another major national medical malpractice insurance carrier, Coverys, is also in the process of setting up an RRG in New York state and we think that other major carriers are not far behind.

Because the market is always changing, if you are a New York physician, it’s always important to shop for coverage every year. Contact us today.

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Professor Argues Against Massachusetts Apology Approach

Last month, the Massachusetts Medical Society (MMS), joined by six healthcare organizations, announced the launch of a new initiative to improve the commonwealth’s medical liability system.

The new alliance collectively created what it refers to as the Roadmap to Reform, an alternative approach to medical liability rooted in the process of Disclosure, Apology and Offer (DA&O) that has proven highly successful at the University of Michigan Health Care System for more than a decade. The new approach is expected to improve patient safety, increase transparency, reduce litigation and cut costs to the commonwealth’s healthcare system.

Under the DA&O model, healthcare professionals and institutions as well as their insurers disclose to patients and families when unanticipated adverse outcomes occur. They explain what happened, establish systems to improve patient safety and prevent the recurrence of such incidents. When appropriate, the healthcare team apologizes and offers fair financial compensation prior to the patient resorting to legal action. This system should not deny patients the right to bring legal action, but rather make tort claims a last resort. Of course, when claims have no merit, they will be robustly defended.

In the wake of the fanfare that surrounded the announcement of the Roadmap to Reform and its implementation, Gabriel, Teninbaum, JD, a professor of legal writing, has come out criticizing the initiative. According to Teninbaum, the new system is rife with opportunity to confuse patients and manipulate them into accepting unfair compensation for medical injury.

Is the manipulation of a patient under the DA&O model a possibility? Yes, but apology in medicine is not a new concept, and it has proven successful in application at the University of Michigan Health System. It’s also a known fact that many patients sue their doctor because they feel the doctor simply didn’t care about their injury or dissatisfaction. When dealt with honestly and with empathy, most patients are less likely to sue their doctor for medical malpractice.

Let’s give this Roadmap to Reform some time to prove whether it is in fact a positive, rather than jump to nefarious conclusions.

Posted in apology, apology in medicine, Massachusetts Medical Malpractice Insurance, medical malpractice | Leave a comment