Does anyone have supplementary malpractice insurance?

[deleted642280]

Question for the attending pathologists in the forum. Do any of you have supplementary malpractice insurance, or do you feel your hospitals/practices cover you sufficiently? What do you recommend?

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[nexus73]

Bump

 

[rirriri]

have always had it through my hospitals...

 

[LADoc00]

Sadly there is a real need for this..

 

[Autopsy101]

If you are signing out risky medicolegal cases - derm and breast come to mind as the most frequently litigated in my experience - I highly recommend.

 

[LADoc00]

If you are signing out risky medicolegal cases - derm and breast come to mind as the most frequently litigated in my experience - I highly recommend.

Interesting from my experience, derm is far less the source of the malpractice cases than you might think.

Breast for sure, then like thyroid, cytology in a general, odd ball stuff and alot of admin cases (as in failure to properly notify clinicians of diagnosis/change in diagnosis, wording etc).

 

[WEBB PINKERTON]

Two of the top 5 things paths are sued for are cytopath. You could always just quit doing cytopath.

 

[y2k_free_radical]

Two of the top 5 things paths are sued for are cytopath. You could always just quit doing cytopath.

Still have to do NON-GYN

 

[WEBB PINKERTON]

Most nongyn are a waste of time anyways. Give it some ambiguous diagnosis and recommend collecting a specimen you can actually get a real diagnosis off of. People in cytopath need to imagine that was their family member and quit overselling the field. It is a nearly useless field.

 

[rirriri]

Most nongyn are a waste of time anyways. Give it some ambiguous diagnosis and recommend collecting a specimen you can actually get a real diagnosis off of. People in cytopath need to imagine that was their family member and quit overselling the field. It is a nearly useless field.

I don’t do cytology but you don’t think Thyroid assessments are useful? We have a large dept. with several Cytopathologists seeing patients in the FNA clinic and I always thought there is utility in this...

 

[MetroPath]

Most nongyn are a waste of time anyways. Give it some ambiguous diagnosis and recommend collecting a specimen you can actually get a real diagnosis off of. People in cytopath need to imagine that was their family member and quit overselling the field. It is a nearly useless field.

Seems like thyroids are pretty subjective.

 

[Autopsy101]

@LADoc00 You are probably right - not frequently litigated in the strictest definition. I guess I was thinking more along the lines of frequently with high monetary awards for the plantiff where a pathologist would be grateful for the foresight of purchasing supplemental insurance. Those wrongful death lawsuits for missed melanoma in young patients can be pretty high stakes because juries are usually very sympathetic to the plantiff.

 

[Autopsy101]

@LADoc00 You are probably right - not frequently litigated in the strictest definition. I was thinking more along the lines of frequently with high monetary awards for the plantiff where a pathologist would be grateful for the foresight of purchasing supplemental insurance. Those wrongful death lawsuits for missed melanoma in young patients can be pretty high stakes because juries are usually very sympathetic to the plantiff.

 

[y2k_free_radical]

I don’t do cytology but you don’t think Thyroid assessments are useful? We have a large dept. with several Cytopathologists seeing patients in the FNA clinic and I always thought there is utility in this...

Can't believe it but i agree with you about some NON GYNS

 

[LADoc00]

Im extra extra salty today, now hear this: Cytology is USELESS TRASH.

~The payment is about 1/2 of what a 20 something stripper makes in Downtown Portland and yes I surveyed a group of them to make sure.
~It eats more time than sitting around waiting for your Comcast cable appt when they are 3 hours late. It is the LOWEST income per unit of time thing you can do other than posting on SDN, actually posting here is actually better because you arent going to be sued.
~The malpractice liability is bonkers given the % volume cytology represents. Its like MASSIVELY outsized in terms of per case risk, I dont have a number but I think it maybe like 50 TIMES higher risk than a GI or GU biopsy. Insanity.
~The WORST is the insane government over-regulation secondary to CLIA 88. But dont worry, old LADOC is going full Rambo Last Blood on this one.

Currently, ANY cytology specimen is capped at a total # of slides per day as part of an utterly bogus misread of CLIA and state business law. Be aware, Joint Commission is really trying ANYONE AND EVERYONE into subjecting themselves to the workload limits created as part of CLIA 88. THIS IS NOT THE LAW.

Go read CLIA 88 before any inspection you are gonna have.

Specifically MEMORIZE: , § 263a : part f, number 4 subparagraph (B) under Standards that speaks to workload limit.
-->(i) the maximum number of cytology slides that any individual may screen in a 24-hour period
This DOES NOT APPLY to Pathologists who are NOT SCREENING. Do not let them convince you it does and yes they will try. They will try because they are getting hundreds of thousands and even millions of dollar fines for CMS when they do.

This is pure racketeering.

Tell them you know the definition of "screening" in cytology: review of cytologic material by either a technologist or in an automated fashion to identify areas of interest which are flagged for advanced review by a pathologist.

Do NOT let them tell you pathologists "screen" as well. Maybe residents, maybe fellows but not board certified pathologists.

Im fully triggered now. And its only Thursday.

 

[Med Director New England]

Is this really a thing ? - supplemental malpractice on top of the 1M/3M we all basically carry

I am aware of the details of many litigated cases b/c of being in practice a bit and by being in charge of credentialling pathologists. In every case I am aware of I don’t know anyone who lost personal assets as a result.

My experience most litigated:
Missed cervical glandular (not endometrial) lesions on Pap smear. They can be sneaky and I do believe progress faster than HSIL/Squamous Cancer. Many HSILs are missed too but when eventually discovered patient has usually not progressed thus no impact from delay and path/lab off the hook. Also missed Paps are almost never litigated if the negative Pap was not referred to pathologist. Treated more like a false negative CP test with known inherent FN rate.

Believe it or not decedent affairs is high on list. Improper consent on autopsy, diening leaves visible mark, deceased remains not handled as per family’s wishes based on religious view, etc

 

[LADoc00]

Is this really a thing ? - supplemental malpractice on top of the 1M/3M we all basically carry

I am aware of the details of many litigated cases b/c of being in practice a bit and by being in charge of credentialling pathologists. In every case I am aware of I don’t know anyone who lost personal assets as a result.

My experience most litigated:
Missed cervical glandular (not endometrial) lesions on Pap smear. They can be sneaky and I do believe progress faster than HSIL/Squamous Cancer. Many HSILs are missed too but when eventually discovered patient has usually not progressed thus no impact from delay and path/lab off the hook. Also missed Paps are almost never litigated if the negative Pap was not referred to pathologist. Treated more like a false negative CP test with known inherent FN rate.

Believe it or not decedent affairs is high on list. Improper consent on autopsy, diening leaves visible mark, deceased remains not handled as per family’s wishes based on religious view, etc

Who the hell is still doing autopsies other than coroner/MEs??

Stop. Just stop. Having families sue you over an autopsy worse than shoveling the snow in your neighbor's yard and then having them shoot you for the favor.

Man I hate people. Humanity is fleshy tide of destruction. Millions of zombies just slowing plodding until they get their next dose of Oxy. Disgusting. I wish was a dermatologist to the wealthy now because so few people out there actually deserve good healthcare. Im literally praying for an apocalyptic tomorrow so I can stop working and just get right to it.

 

[Med Director New England]

Who the hell is still doing autopsies other than coroner/MEs??

Stop. Just stop. Having families sue you over an autopsy worse than shoveling the snow in your neighbor's yard and then having them shoot you for the favor.

Man I hate people. Humanity is fleshy tide of destruction. Millions of zombies just slowing plodding until they get their next dose of Oxy. Disgusting. I wish was a dermatologist to the wealthy now because so few people out there actually deserve good healthcare. Im literally praying for an apocalyptic tomorrow so I can stop working and just get right to it.

Happens more than you think...we all talk about the mis diagnosed sarcoma or pap or whatever but if you happen to be the chief and your system accidentally disposes of a first trimester fetal remains that the family wanted back your ass is getting sued just as fast.

 

[kchan99]

but if you happen to be the chief and your system accidentally disposes of a first trimester fetal remains that the family wanted back your ass is getting sued just as fast.

When I've had surgery or otherwise come across consent forms for procedures, I don't frequently see consent statements covering the fate of removed tissues (e.g,, sent to pathology and/or discarded as surgery waste). Perhaps changes to consent processes by proceduralists and the associated consent forms (hopefully electronic with EMR --> LIS flags) may help so that it would make it clear to the patients what tissues will or will not be returned, may or may not be sent to pathology, under what circumstances, to whom, etc. For instance, I have heard from many acquaintances wanting their gallstones or other stones returned but without success in obtaining them. In addition, the patients will also know about the involvement of pathologists in their health care earlier, rather than through receiving a surprise bill from an out of network pathology group!

 

[y2k_free_radical]

Who the hell is still doing autopsies other than coroner/MEs??

Stop. Just stop. Having families sue you over an autopsy worse than shoveling the snow in your neighbor's yard and then having them shoot you for the favor.

Man I hate people. Humanity is fleshy tide of destruction. Millions of zombies just slowing plodding until they get their next dose of Oxy. Disgusting. I wish was a dermatologist to the wealthy now because so few people out there actually deserve good healthcare. Im literally praying for an apocalyptic tomorrow so I can stop working and just get right to it.

I am for extra income.It helps that my wife is a PA.Forced to do it by decreasing surgical pathology reimbursements and PITIFUL COMPENSATION FOR BEING THE LABORATORY MEDICAL DIRECTOR.

 

[Torsed]

Damn Webb. Crap all over my subspecialty.