Malpractice Limits

[Brioche]

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Most jobs offer $1million/$3million, what does that even mean?
Is that a good/standard amount ?

 

[GonnaBeADoc2222]

Most jobs offer $1million/$3million, what does that even mean?
Is that a good/standard amount ?

Yes. Make sure tail coverage is specifically covered and that it goes out 10 yrs.

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[gamerEMdoc]

It depends on where you will practice, but for the most part, it will be 1/2 or 1/3. That means that they will pay a max of $1 mill for a single claim, and no more than $3 million for all claims in a year (if you get sued multiple times).

 

[deleted859535]

Middle of the road risk where I am, roughly. We have similar coverage.

 

[Birdstrike]

Most jobs offer $1million/$3million, what does that even mean?
Is that a good/standard amount ?

I have $1 mil/$3 mil, also. It's standard where I'm at (middle to slightly better than average malpractice state). I've been sued twice in 16 years, which is less than average by the way, and never came close to those limits. In both instances, I met the standard of care & was falsely and weakly accused of malpractice. If the standard in your area is 1/3, then buy 1/3. Spending more money to get higher limits is nothing but a gift to the lawyers in your community. They'll be drooling over your high limit policy. I wouldn't be surprised if they had a way of finding out who has the fattest policies and specifically target those people and practices.

 

[GonnaBeADoc2222]

There are usually state by state requirements. They will have to comply with the minimum requirements.

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[Makati2008]

Mine is pretty low 250k/1mil. Everyone carries the same amount.

 

[gamerEMdoc]

Mine is pretty low 250k/1mil. Everyone carries the same amount.

Yeah it all depends on your state. If you are in a state with malpractice caps, then it doesnt make sense for single occurance coverage to be over that cap.

 

[deleted497653]

I have $1 mil/$3 mil, also. It's standard where I'm at (middle to slightly better than average malpractice state). I've been sued twice in 16 years, which is less than average by the way, and never came close to those limits. In both instances, I met the standard of care & was falsely and weakly accused of malpractice. If the standard in your area is 1/3, then buy 1/3. Spending more money to get higher limits is nothing but a gift to the lawyers in your community. They'll be drooling over your high limit policy. I wouldn't be surprised if they had a way of finding out who has the fattest policies and specifically target those people and practices.

Were you sued in your EM days? Just wondering. I know the once every 6/7 years risk of lawsuit for emergency medicine. I just seem to meet a lot of older EM docs saying they’ve never been sued.
What’s the malpractice risk for pain medicine? Like how often can someone expect to be sued?

If these are too personal, feel free to ignore the questions.

 

[gamerEMdoc]

Were you sued in your EM days? Just wondering. I know the once every 6/7 years risk of lawsuit for emergency medicine. I just seem to meet a lot of older EM docs saying they’ve never been sued.
What’s the malpractice risk for pain medicine? Like how often can someone expect to be sued?

Being sued is equal parts many times equal parts bad luck and part being in the wrong location. You can be a horrible doctor, mess up all the time, and if you are in a state that places big limitations on malpractice, your chances of getting sued go way down. Likewise, if you are in a state without tort reform, you can be the best doc in the state, but if you are unlucky and in the wrong place at the wrong time, it can happen to you. So depending on where you live and how lucky someone is, its definitely not uncommon to talk to docs that never have been sued. Likewise, there are many that have been sued more than once. It is what it is. You just can't let it bother you, or it will drive you nuts throughout your career. Just accept that getting sued happens in medicine, and in most instances, has nothing to do with how good of a physician you are, unless you are an outlier who's been sued over and over and over again. That's why we carry malpractice insurance. It's not your money. Don't take it personal if you get sued. It's not personal. It's not about whether you are a good doctor or not.

 

[Birdstrike]

Were you sued in your EM days? Just wondering. I know the once every 6/7 years risk of lawsuit for emergency medicine. I just seem to meet a lot of older EM docs saying they’ve never been sued.
What’s the malpractice risk for pain medicine? Like how often can someone expect to be sued?

If these are too personal, feel free to ignore the questions.

Yes, sued in EM days. Twice in 11 years. I’ve heard it’s about once every 10-15 thousand patients, although I don’t have proof of that statistic.

As far as Pain medicine, the only statistics I’ve seen on that, which are hard to find since Pain is such a small specialty, is that Pain was below average. That stat was presented at a Pain conference. The speaker was comparing Pain liability to anesthesia, and he had what looked like very convincing numbers showing the likelihood of getting sued was significant lower than anesthesia. Extrapolate that to EM, based on wherever EM ranks in comparison to anesthesia.

So, I was in EM 11 years, got harassed twice by frivolous suits. I’ve been in Interventional Pain 6.5 years, and nothing yet. Of course that could change, with frivolous suits and false accusations being the norm.

Generally though, Pain feels less liability prone than EM. First of all, people aren’t coming to you on deaths door. It’s far, far less acute. In EM people will come to you dying, possibly unsalvageable. Yet when they die, it’s easy to blame you. You’re the last guy to interact with them, therefore the easiest to blame. In Pain, much of what people have, is chronic. It’s much harder to say, “My Pain was 10 out of ten for 5 years before I saw Birdstrike, now it’s 10/10 but ‘worse.’” That’s a lot harder sell to a lay person than, “I was alive before I saw you, but dead after.”

People can try to sue you if their family member ODs and dies. But again, again it’s a hard sell to blame you for something they did, especially of your doses are within recommended ranges, you’re doing drug screens and can show you’re following DEA/CDC/State guideline, which is easy.

I suppose our biggest liability would be from a procedural complication. Although, if you do them carefully and properly, they’re not common. For example, there’s much more liability cutting into someone’s back as a surgeon, cutting stuff out and driving screws into a person, than there is to putting a needle in them.

It’s all relative. 2/3 of low risk specialty docs get sued at least once. 99% of high risk specialty docs get sued. I’d put Pain somewhere in the middle. We don’t only talk to patients like psych or not see live patients like path, and do do invasive procedures with some liability. But we’re not usually dealing with life of death and not constantly doing high risk surgical stuff, therefore not as high risk as say, neurosurgery.

In Pain, you do have the issue of DEA regulations like all specialties that require a DEA license, which can bring liability, but of a different type. That’s also a very manageable liability if you follow standards of care and are conservative, and go by the book.

 

[Birdstrike]

I just seem to meet a lot of older EM docs saying they’ve never been sued

I would take thise statements with one very large grain of organic, gluten-free sea salt. A lot of people lie about their malpractice history. They’re embarrassed. Some think it makes others think they’re a bad doctor. Also, I’ve known people that I worked with who swore up and down for years they were “never sued” yet come to find out they were jointly named in cases other people I know were named in. Many people keep this information very quiet, or completely concealed, especially when asked by a trainee or someone they don’t know very well.

Also, some people tell partial lies about this, in the sense that they tell themselves that if they were sued and won, or frivolously sued and paid a little bit of money to make it settle, that that’s not “being sued” like it would be to get sued, go to trial and lose. But getting sued and losing at trial is only 5% of times a doctor is served with a suit. Nonetheless, the 95% other times docs are sued and dropped, sued and settle or sued and win at trial, still count as “getting sued.” But not everyone is going to admit it.

Also, the docs you’re talking to that “haven’t been sued,” even if they are telling the truth, aren’t retired and past the statute of limitations yet. You could go your whole working career without getting hit, you retire and then get hit with a case or two in your first 3 years of retirement, because of the statute of limitations. Most suits don’t come for at least 1 to 2 (or 3) years after any chance of your independently remembering any important details, has passed.

Much like the culture of silence around mental health does great harm to many physicians and impedes solving the problem, the culture of silence around our broken legal system and wounds from it does great harm to the cause of fighting back against and fixing it.

Keep in mind that most physicians are hit very hard emotionally when they get hit with a lawsuit. Some sink into severe, clinical depressions. And there’s a strong culture of silence. It’s a real shame, because ultimately it has very little to do with your proficiency as a physician. It’s about lawyers fighting over insurance company money, and we’re caught in the middle.