Sovereign Immunity

[EMIM2011]

How does sovereign immunity in Florida work? I saw that academic jobs are being advertised as "enjoy the benefits of sovereign immunity". I always thought that working in Florida equals a judicial disaster waiting to happen?

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[Vandalia]

Basically, you can only sue the "government", if the "government" allows you to do so.

This is not done on a case-by-case basis, but there are generally laws (the Federal Tort Claims Act for the federal government) that specify when someone can sue the government, and the specific procedures that they must use.

As a general rule, government employees are immune from being personally sued. A claimant (patient) must sue the government instead.

So, yes, having true "sovereign immunity" is a plus, since it means that you cannot be held personally liable. You will likely still have to report a "malpractice claim" against you on your licensing application/re-application.

The obvious point is to make sure that you actually DO have "sovereign immunity." If you are working at a prison, it is pretty obvious. If you are working for the physician corporation of a state-university there can be a bit more gray-area. Just don't accept an advertisement as certain proof of that fact.

 

[Birdstrike]

I don't work in Florida but isn't the immunity only for people that work at public or teaching hospitals?

Is it total and true immunity, ie, you can't personally get sued at all for malpractice, no exceptions (unless criminal action)?

Then if you don't work in that setting you can get sued to high heaven with no limit on award amounts?

"Florida Supreme Court voids caps on medical malpractice lawsuits"

http://mobile.reuters.com/article/idUSBREA2C2CO20140313?irpc=932

 

[Vandalia]

No, you are thinking of something very different. "Sovereign immunity" means the "sovereign" i.e., the "government" cannot be sued unless the "government" (federal, state, local) allows someone to do so.

You only have "sovereign immunity" if you work for the government. So the idea of a "civilian doctor" having "sovereign immunity" is impossible.

What the original poster is referring to is almost certainly a "government job" as a physician. What the add is saying is that the advantage working as a government physician is that you cannot be (individually) sued. That can be a significant benefit that may compensate for a lower salary.

The real question is if the position actually has full "sovereign immunity." As I said, it is pretty clear that if you are a physician working for a state prison, or the health department, you enjoy the benefit of full "sovereign immunity." You cannot be personally sued. Anyone would have to sue the state - and the state would have to permit the suit to be filed. It gets a bit more questionable when it comes to medical school faculty working at state universities. Depending on how things are set up, those physicians may or may not have the benefit of full "sovereign immunity." Again, this is a pretty substantial benefit that can make up for a lower salary. However, depending on the state, this can depend on how things are set up. I would not simply take the word of an advertisement.

"Sovereign immunity" has absolutely nothing to do with the "caps on malpractice lawsuits."

 

[Birdstrike]

"Sovereign immunity" has absolutely nothing to do with the "caps on malpractice lawsuits."

I know that. I posted that link because I think it's a stark contrast to have one small minority of physicians in a state with full immunity (supposedly, according to the OP), yet the plaintiffs attorneys have "open season" on the great majority with no award cap, so to speak.

Overall, for the vast majority, Florida still gets a kinda crappy C grade (28 out of 50 states) for Medial Liability on ACEPs EM Report card. I'm not sure if this was ranked before or after the State Supreme Court wiped out award caps, or not. This is a great, great, must read for any physician relocating, including final year residents job searching:

http://www.emreportcard.org

Every state is so different, and the rules are constantly changing, so I'm not going to pretend to know the tort situation in all 50 states.

This link also has some interesting information:

http://www.judicialhellholes.org/tag/medical-liability/

 

[Vandalia]

Sorry. I thought it was a bit odd that you, of all people, would make that mistake.

Now, you don't think that the government might be trying to setup a system to drive all physicians into being government employees do you?

Personal immunity from any malpractice claim can be a pretty attractive employment benefit these days. However, to anyone considering such a position, the critical point - as every post in this thread has mentioned - is to make absolutely sure your position actually does have sovereign immunity. If it comes to a malpractice case, any trial lawyer worth his salt is going to try to do everything possible to show that the physician is NOT covered by sovereign immunity - for obvious reasons. And the law/standards can be very different in every state. Don't trust anything a potential employer says without verifying it.

I generally rate lawyers as slightly above drug dealers, but when it comes to an employment contract, that is the time to hire one. Trying to save $500 can end up costing a tremendous amount of money in the long run.

 

[EMIM2011]

Just to clarify, the ad I saw doesn't really sound like a straight-up government job (e.g., prison). It's the University of Florida College of Medicine Jacksonville:

"UF Health-Northside will begin as a 28 bed full-service, free standing ED (...). Phase 2 of this project will include the addition of 99 inpatient beds (...). Join the University of Florida Faculty and earn an extremely competitive community-based salary as a UF assistant or associate professors (...). Enjoy the full range of University of Florida State benefits including sovereign immunity (...)."

So, obviously its a job at a State facility. But this really mean that everyone who basically works in Academics and their affiliated facilities in Florida has sovereign immunity and thus total personal immunity?

 

[Vandalia]

Just to clarify, the ad I saw doesn't really sound like a straight-up government job (e.g., prison). It's the University of Florida College of Medicine Jacksonville:

"UF Health-Northside will begin as a 28 bed full-service, free standing ED (...). Phase 2 of this project will include the addition of 99 inpatient beds (...). Join the University of Florida Faculty and earn an extremely competitive community-based salary as a UF assistant or associate professors (...). Enjoy the full range of University of Florida State benefits including sovereign immunity (...)."

So, obviously its a job at a State facility. But this really mean that everyone who basically works in Academics and their affiliated facilities in Florida has sovereign immunity and thus total personal immunity?

Like I said, that is where it can get complicated. Almost certainly, the answer is yes in the case you describe. Where I worked last - a residency program at a state university medical school, we did have sovereign immunity. The setup (state-owned physician practice corporation) was confirmed by the state Supreme Court to be covered by the sovereign immunity doctrine.

However, as I said, beware that the trial attorneys will continue to do everything possible to prove that the immunity does not exist in that type of practice. That is why an attorney needs to examine your employment contract, and s/he can tell you how solid the immunity argument is in that particular state. Most likely, the issue has been litigated before the state Supreme Court and they have already ruled that type of practice model is covered by the immunity doctrine. My point is to not rely solely on what the add says. Almost certainly what they say is true. However, if you are an EM physician, you should know not to rely on almost.

 

[anonymousEM]

UF (and specifically UF Jacksonville) faculty do have complete sovereign immunity. The physician group's immunity has transferred to other sites where a contract is held to provide physician services (Winterhaven, FL) and with the new Northside expansion as well. This is one benefit of working for the state. Both of these positions have sovereign immunity and an academic appointment. For now, neither regularly have residents and pay is somewhere between academic and straight community positions (though I'm not aware of what's being offered for the Northside-only contracts). Some ups and some downs.

I think USF has a similar arrangement, but I think in their case with the TeamHealth contract as well there are exceptions dependent on whether a resident is involved in the patient care or not? Can't speak very intelligently on anyone other than UF.

 

[dchristismi]

I happen to work for UF, and have this protection. It's nice. It basically says that any suit is the patient vs the Board of Regents at UF, and no suit would be reported to the national practitioner database. We also happen to have an occurance-based shallow-pocket policy, just in case, but basically the state legislature would have to vote to approve any award greater than what we have. (100/300) They can go after you for "willful and wanton" but it's much harder to prove.

Anonymous, do I know you?

 

[Apollyon]

Anonymous, do I know you?

Isn't that a bit more than ironic?

 

[WilcoWorld]

I've had 2 jobs for state institutions and my understanding of the protection this confers is as follows:

If a malpractice suit is brought by someone I treated at "University Hospital" the regents of the university will be named as defendants, and I will only be named as a respondent. As dchristimi mentioned above, I won't get reported to the NPD.

In most cases, the regents will settle, and part of the settlement agreement will prevent the plaintiff from going after the individual practitioners.
IF the case goes to court AND the plaintiff wins, THEN they CAN choose to file another suit against me as an individual. This is fortunately quite rare.

So while it's highly unlikely that I'll loose my own money to malpractice (which is also highly unlikely for a community doc with decent medal coverage), I am still subject to depositions and the Psychological joys of having my management picked apart with a fine-toothed comb.

So it's a very good deal, but it's not impenetrable.

 

[EMIM2011]

Does anyone know how sovereign immunity protection works for Miller/university of Miami physicians - my understanding is that this extends only to the ones working at Jackson Health, is that correct?

 

[deleted480308]

in florida sovereign immunity (read as malpractice immunity) also applies to providers donating time in charitable settings to patients who have gone through a very specific screening process. I used to do that screening process at the free clinic I worked at there

 

[EMIM2011]

This sounds like there is some extension of this to Miller physicians, but it is somewhat murky about its extent:
"Florida Governor Rick Scott, flanked by dozens of UM faculty physicians at Jackson Memorial Hospital on Friday, ceremoniously signed a law that extends sovereign immunity protection to private university physicians who treat patients at public hospitals."
http://med.miami.edu/news/governor-scott-signs-sovereign-immunity-bill-at-um-jackson

 

[southerndoc]

Someone with whom I work previously worked in Florida. According to him, if you see a patient in a teaching setting in a university hospital, then you get sovereign immunity. If he saw the patient independently (i.e., no resident or student), then sovereign immunity did not apply.

 

[SkiingDocMD]

I know it's not the same, but are there similarities between "sovereign immunity" and jobs that go through arbitration processes, like Kaiser?