Less liability working for the government?

[SuckySurgeon7]

Hey all,

I'm wondering whether a physician who works for the government, such as at the VA, a federal non-profit, or any other government entity has less risk of being sued?

From the VA website: "...the burden of liability protection is also lifted from our physicians' shoulders, as they do not need to purchase malpractice insurance; nor do they have to worry about "tail" insurance coverage if they leave VA employment."

Okay, but what does this look like, and what are the trade offs?

Next, and maybe more importantly, what are the types of places that have this protection other than the VA or other military institutions?

My hope is to find a reservation or other non-profit job where there is a large demand and good post-residency experience but that also qualifies for IBR. If I can get all that with less liability, I'll be a happy camper.

Thanks,
SS7

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[VentJockey]

Basically, the way lawsuits work in the federal system is the patient files a "claim" and the government (military or VA) has six months to review, negotiate or pay the claim. After that, a lawsuit can be filed. The lawsuit will be Patient vs. United States of America not Patient vs. Doctor. If there is a payment made in the case, you are still liable to be reported to the NPDB. But at least in the military system, there is some discretion depending on the circumstances of the payment and they have a much lower rate of NPDB reporting--take that for what you will.

 

[SuckySurgeon7]

I appreciate the reply by VentJockey, but I'm wondering if anyone can touch on the other part of my post: are there non-profits such as reservations or rural health clinics that also qualify as government facilities and fall under this liability protection?

Thanks in advance!

 

[smq123]

I appreciate the reply by VentJockey, but I'm wondering if anyone can touch on the other part of my post: are there non-profits such as reservations or rural health clinics that also qualify as government facilities and fall under this liability protection?

Thanks in advance!

Yes, if you work for the Indian Health Services, or for a Federally Qualified Health Center, you get the same protection. They will usually label it as FTCA (Federal Tort Claims Act) protection.

 

[SuckySurgeon7]

Yes, if you work for the Indian Health Services, or for a Federally Qualified Health Center, you get the same protection. They will usually label it as FTCA (Federal Tort Claims Act) protection.

Thanks!

 

[styphon]

I appreciate the reply by VentJockey, but I'm wondering if anyone can touch on the other part of my post: are there non-profits such as reservations or rural health clinics that also qualify as government facilities and fall under this liability protection?

Thanks in advance!

I work at a reservation which is mostly tribal, but also has some funding from Indian Health Services (IHS), because of this I am protected by the Federal Torts act (no malpractice needed). The same holds true for the Federal Qualified Health Centers - which are often in rural or urban areas.

 

[DrMason]

I worked for the Feds before. I think looking at it from a stance of having less liability us less about who you work for and more about what you do.

In this society, if you take care of ill people, you are likely to be blamed for a bad outcome irrespective of your performance.

This is one of the main reasons for choosing FM if that is an issue.

Otherwise, the federal tort may deter many lawyers from trying, but it is still going to haunt you the rest of your life for the most. A friend of mine from medical school was sued and it lasted over 5 years before the plaintiff dropped the case. he is a broken man today and a door mat to any patient.

Not to mention any time you fill for credentialing, licensure or ANYTHING that is designed to give you privileges, you need to explain it in length or depth at any turn, EVEN if nothing happened. For many companies, a YES answer to "Have you ever had complaint or malpractice suit brought against you"? Note it matters little if you won or not. If you answer yes to this, many companies won't even look at you after that.

This is not to discourage anything, but just to point out that caps are good, but even being mentioned in an initial suit can destroy your career and I haven't even brought up the national databank yet..

 

[DrMason]

Basically, the way lawsuits work in the federal system is the patient files a "claim" and the government (military or VA) has six months to review, negotiate or pay the claim. After that, a lawsuit can be filed. The lawsuit will be Patient vs. United States of America not Patient vs. Doctor. If there is a payment made in the case, you are still liable to be reported to the NPDB. But at least in the military system, there is some discretion depending on the circumstances of the payment and they have a much lower rate of NPDB reporting--take that for what you will.

Military as less likely to be vindictive towards individual physicians since they have already forfeited lots of income to work for them. Hospitals or " non-profits" can toil and intimidate any physician by just uttering the words of NPDB.

NPDB is an intimidation tool (just another one) versus physicians and affects arbitrarily with no difference. If you are in it, whether it was because you yelled at a nurse or raped your patient, you will be assumed to be the worst of the worst. And then keep in mind the constant and looming threat of being reportedly anyone at any time, including patients.

However, working for the VA was something I found very depressing and full of red tape from far left to far right.

 

[styphon]

Not to mention any time you fill for credentialing, licensure or ANYTHING that is designed to give you privileges, you need to explain it in length or depth at any turn, EVEN if nothing happened. For many companies, a YES answer to "Have you ever had complaint or malpractice suit brought against you"? Note it matters little if you won or not. If you answer yes to this, many companies won't even look at you after that.

This is not to discourage anything, but just to point out that caps are good, but even being mentioned in an initial suit can destroy your career and I haven't even brought up the national databank yet..

Except when covered by the Federal Torts act, they can not name you, and instead the defendant is the US Federal Government.

 

[DrMason]

I still do not think you can lie on an application when asked if you have ever been sued. If anything, this may make it HARDER for you to explain your situation if you cannot produce a story.

There ARE advantages of working for the feds (no need to put heart into it; you don't need to care what patients say and there is les "quality control"), but otherwise it is a mixed bag, IMHO.

 

[simpler2]

Some hidden pros/cons of FTCA:

Pros - Patients and personal injury lawyers have to sue the US government in a process that many ambulance chasing lawyers do not understand and that is very drawn out. This discourages many legal actions moving much past record requests. If cases do go to arbitration, many are dismissed or settled eventually without any involvement of provider/agency named.
You don't pay for it.

Cons - Even if desired, you or your agency cannot actively participate in the FTCA process. Because the process can take years for a decision to be reached, there is a long time between hearing about a suit and learning the outcome (if you even find this out).