How much would something like sovereign immunity be worth to you?

[namethatsmell]

Since med-mal is a topic de jour (thanks to @RustedFox's awesome post), I've often wondered how much folks would value having sovereign immunity or something similar (ie Kaiser) where you basically can't be personally named/held liable in a suit. Thought a poll would be interesting.

If you think this thread is lame, go ahead and reply with a snide, tangential meme instead 🍻

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[Kryptocoin]

I have sovereign immunity at my current gig. It was one of the reason I signed up for the job. I just haven't been sued yet, to test it out. Or maybe I've been sued and just don't know about it...

 

[namethatsmell]

I have sovereign immunity at my current gig. It was one of the reason I signed up for the job. I just haven't been sued yet, to test it out. Or maybe I've been sued and just don't know about it...

Nice! Hopefully you'll never have to take it for a test drive. And I bet your hospital is overall less targeted by lawyers compared to neighboring shops.

I've had a few jobs that offered Kaiser-like protection (ie self-insured systems). One day I get a call from hospital counsel that they've been notified about an impending suit and I'm one of the docs that plaintiff's attorney claims has exposure. Frivolous case where nobody did anything wrong. Hospital counsel has me do a call with them asking for my recollection of the case and answer some Qs. At the end they tell me not to worry and it's unlikely I'll ever hear from them again. And I never do. The whole thing just went away and felt like magic compared to every other job I'd had until that point (aside from wishing they'd have formally closed the loop with me to confirm it was over). After that, I started giving potential jobs offering this kind of protection extra consideration. Have only turned down one of them since.

 

[WilcoWorld]

I have sovereign immunity at my current gig as well.

So I took what my pals up the road in the ED at Sisters of the Holy CrosSurgicenter make and subtracted my salary, then I rounded to the closest number.

 

[bravotwozero]

Sovereign immunity would be fantastic to have.

As far as how much pay I’m willing to give up, wouldn’t be willing to for this perk by itself, especially at this stage in my career.

Now, if it was a sovereign immunity + circadian friendly setup, like some VA jobs and I’m in my late 50s, I’d jump all over that instead of retiring early and gladly take a 100k pay cut.

 

[emergentmd]

Sovereign immunity would be worth about 1k/yr to me which would essentially save me from dealing with deposition in the rare lawsuits.

Now if you take away any chance or lawsuits AND admin ignoring pt complaints, then I would go 100K/yr. I would cut down on labs/imaging and discharge 2x more pts without any labs.

 

[cyanide12345678]

Im just starting to accept that lawsuits are just a game for lawyers to try to get money out of insurance companies. It has nothing to do with our care, it’s just a game.

Glad i live in one of the best malpractice states with a panel of docs that approves lawsuits and has a state fund for blockbuster over policy limits.

 

[Vandalia]

Nothing.

Malpractice suits always settle for policy limits, even if there is a large jury verdict it settles to avoid an appeal. As the commercial says “It’s my money and I want it now.”

More specifically, it is not “sovereign immunity”, since every state and the federal government have waived sovereign immunity for any act that would be a tort if committed by a private individual, e.g., Federal Tort Claims Act.

The deep pocket always pays, whether it is the hospital or the practice group, particularly if it is one of the PE backed practices.

If you end up facing a large civil liability it isn’t going to be because of a malpractice suit, it is going to be because your 16 year old kills someone while driving.

“Sovereign immunity” is something physicians talk about a lot, but in reality it is pretty meaningless.

 

[emergentmd]

Im just starting to accept that lawsuits are just a game for lawyers to try to get money out of insurance companies. It has nothing to do with our care, it’s just a game.

Glad i live in one of the best malpractice report states with a panel of docs that approves lawsuits and has a state fund for blockbuster overt policy limits.

What state is this?

 

[emergentmd]

Nothing.

Malpractice suits always settle for policy limits, even if there is a large jury verdict it settles to avoid an appeal. As the commercial says “It’s my money and I want it now.”

More specifically, it is not “sovereign immunity”, since every state and the federal government have waived sovereign immunity for any act that would be a tort if committed by a private individual, e.g., Federal Tort Claims Act.

The deep pocket always pays, whether it is the hospital or the practice group, particularly if it is one of the PE backed practices.

If you end up facing a large civil liability it isn’t going to be because of a malpractice suit, it is going to be because your 16 year old kills someone while driving.

“Sovereign immunity” is something physicians talk about a lot, but in reality it is pretty meaningless.

There is truth about this and was taken aback when we reupped our SDG's medmal limits. I think we had a 1M occurrence policy. Our medmal lawyers told us to drop it down to the hospital limits (300K) b/c they just always sue for the limit. Don't be the rich target. Crazy, but our docs suddenly were sued for 300K.

 

[cyanide12345678]

What state is this?

Indiana. Good state for docs.

 

[namethatsmell]

Nothing.

Malpractice suits always settle for policy limits, even if there is a large jury verdict it settles to avoid an appeal. As the commercial says “It’s my money and I want it now.”

More specifically, it is not “sovereign immunity”, since every state and the federal government have waived sovereign immunity for any act that would be a tort if committed by a private individual, e.g., Federal Tort Claims Act.

The deep pocket always pays, whether it is the hospital or the practice group, particularly if it is one of the PE backed practices.

If you end up facing a large civil liability it isn’t going to be because of a malpractice suit, it is going to be because your 16 year old kills someone while driving.

“Sovereign immunity” is something physicians talk about a lot, but in reality it is pretty meaningless.

Sure, you're correct re: sovereign immunity but for us lowly non-lawyers it's essentially an exercise in semantics as the ultimate outcome for the doc is basically the same.

You're 100% right re: auto or home liability is much more likely to go after personal money. Every doc needs a solid umbrella.

But personally I don't see the main benefit of having something like Kaiser or FTCA protection as being backside asset protection. I view it as current+future sanity protection by removing a major work stressor (I've practiced in some supreme medical-legal hellholes) and also protecting my future income -- since having my time/energy wasted on dealing with frivolous suits (or the threat thereof) always gets me thinking about leaving medicine.

 

[namethatsmell]

Im just starting to accept that lawsuits are just a game for lawyers to try to get money out of insurance companies. It has nothing to do with our care, it’s just a game.

Glad i live in one of the best malpractice states with a panel of docs that approves lawsuits and has a state fund for blockbuster over policy limits.

There is truth about this and was taken aback when we reupped our SDG's medmal limits. I think we had a 1M occurrence policy. Our medmal lawyers told us to drop it down to the hospital limits (300K) b/c they just always sue for the limit. Don't be the rich target. Crazy, but our docs suddenly were sued for 300K.

It is 100% just a game and business transaction. I used to screen cases for some lawyers who did medmal and disability work. It paid poorly but they truly wanted my honest input which was refreshing.

Anyway, 99% of the time all the lawyers want to achieve is the best ratio of $$$ earned : their time/effort. For them, it really is "just business." Trying to go trial and/or above policy limits is enormously expensive, time-consuming, and challenging for them (going above policy limits is particularly arduous/challenging).

 

[Janders]

I chose the answer closest to the annual price of my malpractice insurance rounded up(which I assume would be much cheaper and smaller if I had official sovereign immunity…).

 

[ScepticSkeksis]

I'm not worried about sovereign immunity for the (hopefully rare) lawsuit. I'd like a better mechanism through which we can dispense with spurious patient complaints to the hospital, and to the medical board. These are both very time-consuming and job-threatening.

 

[Old_Mil]

Since med-mal is a topic de jour (thanks to @RustedFox's awesome post), I've often wondered how much folks would value having sovereign immunity or something similar (ie Kaiser) where you basically can't be personally named/held liable in a suit. Thought a poll would be interesting.

If you think this thread is lame, go ahead and reply with a snide, tangential meme instead 🍻

Practicing in a low med mal/soverign immunity environment changes how you practice. You cut way back on defensive medicine. Your charting changes. You're far more efficient. You sleep better at night knowing that unless you really screwed something up, that you won't ever hear about what happened on your last shift again. Assigning a dollar value to it is difficult. Maybe 10% of your annual income?

 

[GonnaBeADoc2222]

I would pay 0%.

I've been sued.

I knew immediately I did nothing wrong. I was stressed for a few hours, then I drank a beer and went to a baseball game.

If you have a settlement or two, its not a big deal. Everyone knows we get sued in EM.

It blows, but that's American medicine.

 

[Mad Jack]

Indiana. Good state for docs.

Might consider moving there, damn

 

[Vandalia]

Indiana. Good state for docs.

Yep.

If you have a qualifying malpractice policy - and almost all of them for physicians are - the suit first has to go to a panel comprised of three physicians with a lawyer as the non-voting chair. The party that "lost" can still sue, but the panel opinion is admissible as evidence and juries give it significant weight.

There was a case recently where the panel found the physician was negligent, but they went to trial and the physician won. Probably because the panel was composed of a bariatric surgeon, a pulmonologist, and an anesthesiologist, and the last two testified that they basically deferred to the surgeon. (Bariatric procedure; lower anastomosis closed; vomiting; apparently aspirated during induction; pneumonia; died. Claimed the surgeon waited too long to operate the second time.) The patient appealed the jury verdict but lost on that as well.

I pretty much think Indiana has close to the ideal system.

However,the overall environment depends some on what part of the state. Juries are usually pretty pro-physician in most of the state; but it can be difficult in Marion County (Indianapolis) or Lake County (outside of Chicago.)

 

[NYEMMED]

I would pay 0%.

I've been sued.

I knew immediately I did nothing wrong. I was stressed for a few hours, then I drank a beer and went to a baseball game.

If you have a settlement or two, its not a big deal. Everyone knows we get sued in EM.

It blows, but that's American medicine.

I used to think that, but I think it is now changing. I have seen two EM listings now from different states. Under requirements was all the usual, board certified, EM residency blah blah. But the last line on both…

“No medical malpractice previous payouts, minimal malpractice history required”

If this is a new incoming thing, then we need to be more forceful in not rolling over and taking it.

 

[CoolDoc1729]

I used to think that, but I think it is now changing. I have seen two EM listings now from different states. Under requirements was all the usual, board certified, EM residency blah blah. But the last line on both…

“No medical malpractice previous payouts, minimal malpractice history required”

If this is a new incoming thing, then we need to be more forceful in not rolling over and taking it.

Maybe a strategy to recruit only new grads ?

 

[CliveStaples]

I work at an institution that has sovereign immunity, but the individual physicians do not. The result is that we are a less appealing target to be sued, since the big money in malpractice is to go after the hospital and not just the doctors.

I'm not sure I would assign a particular monetary amount to it. I haven't been sued but I like to think I'd be able to take the "just the cost of doing business" approach mentally.

 

[Rendar5]

The only time I ever got sued was when I had sovereign immunity. It went away after 5 years and I got to be defended by the NY state attorney general’s office. I did 0 wrong. It made me nervous for a couple years and I had to write a 3 sentence blurb on job applications. And I had to take 10 seconds to explain it to one hospital application committee.

Now that I got my legal jitters out of the way, and work medicolegally, I would pay zero. I practice how I practice (pretty much middle of the road standard of care), and when I get sued again, i will likely pay it little mind. Let my lawyers get my deposition.

 

[comp1]

I know this is a necro thread bump, but they don't bother me that much for interesting questions like this. The issue with assigning a value to this is that you don't know when you WOULD have been sued in a different setting. The neat thing about sovereign immunity is that it makes the target just much, much less interesting to plaintiff's attorneys unless they have a spectacularly good case. Remember they get nothing if they don't win and they're just much less likely to win (even a settlement) than against a general medmal carrier, statistically, since there is an extra layer of red tape.