What percent of your salary do you pay in malpractice?

[random1234]

I'm just curious if it's as bad as they say...I know money is a sensitive subject so no exact numbers have to be given, but about what percent of your overall salary goes towards malpractice insurance, yearly? just so us med students have a better idea.

2%? 5%? 10%?

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[Smurfette]

There is no good answer to this. Several factors make a HUGE difference:

1. what (sub)specialty you do. Certain fields have higher rates than others. Certain procedures carry higher risks even within a field (for example, in general surgery, vascular is a separate "rider", as are certain plastic surgery procedures or bariatric procedures according to my carrier).
2. what state/county you live in. Tort reform and other factors make a BIG difference. Rates are several times (5+) higher in the state where I trained, compared to where I currently practice, because where I trained is more litigious than where I am now.
3. Prior malpractice history.
4. Are you in academics or employed (your employer generally pays malpractice costs for you) or in private practice? How does the practice pay for malpractice/overhead costs and determine salary ?
5. How long have you been in practice? Longer = more patient history = more opportunities to be sued = higher rates.
6. What type of insurance coverage do you have currently and did you have in the past? Do you need to buy separate tail insurance when you change jobs (this is an added cost)?

 

[Winged Scapula]

I'll give you some numbers (in addition to the excellent info from Smurfette above ):

I pay about $40 K per year in malpractice. This includes a rider for shared liability (ie, if my partners gets sued and the practice is named).

My rates stabilized after five years in practice. I am in a high liability specialty but it does not require an additional rider like plastics, Vascular or bariatrics.

The rate is between five and 10% of my income.

My state does not have tort reform. I have friends in other states that do and they pay less than half of what I do.

 

[maxheadroom]

Surprising that AZ does not have tort reform.

I'm in academics. I have no idea what my malpractice rates are. I think that my University practice is self-insured (which is common for university practices and large multi-specialty practices).

 

[Winged Scapula]

Surprising that AZ does not have tort reform.

The Arizona Constitution states that no law shall be enacted which limits the amount of monetary compensation for a patient's death or injury. Therefore any tort reform would require a change in the state constitution which, of course, has been fought by the Arizona Trial Lawyers Association.

Given the political conservativism of the state, it is somewhat surprising but the rates of successful lawsuits are so low here that perhaps that's one reason why it appears to be on the back burner.

 

[blue2000]

I'm in CA. We have tort reform. I am in my third year of practice as a rural general surgeon. I pay about 12K/year, but it is increasing as I haven't even hit the statute of limitations for med mal claims.

 

[Winged Scapula]

I'm in CA. We have tort reform. I am in my third year of practice as a rural general surgeon. I pay about 12K/year, but it is increasing as I haven't even hit the statute of limitations for med mal claims.

I thought the limit was two years from date of occurrence? I was under the impression that you usually maxed out on your premiums at 3 to 5 years because of that.

 

[Smurfette]

I thought the limit was two years from date of occurrence? I was under the impression that you usually maxed out on your premiums at 3 to 5 years because of that.

Maybe in CA, but some other states are 3-5 years from discovery of the occurrence.

 

[Winged Scapula]

Maybe in CA, but some other states are 3-5 years from discovery of the occurrence.

****. Lol.

In Arizona, it's two years to file from the date of the cause of the action, fortunately. I guess I assumed most of the states had similar rules except in cases of pediatrics.

 

[blue2000]

In CA it's either 3 years from occurrence or 1 year from discovery of occurrence.

 

[mendoza]

There are some opinions that well established communication between patient (and his/her family) and physician lowers the rate of being sued dramatically..

What do you think?

 

[A400]

That's only partially true. You should always communicate with the patient and the family. And very few are as good as I am with communication. Good communication is an art form.
But I know it may have little to do with their ultimate decision to sue or not. The decision to sue has so many components such as the obvious one of outcome, but just as important are things like family dynamics, family finances, what stage of life the patient is in, whether they have a crazy/hysterical spouse/child/etc. So you can see that good communication is but one small part -- but often the only thing that you have any control over.

There are some opinions that well established communication between patient (and his/her family) and physician lowers the rate of being sued dramatically..

What do you think?

 

[A400]

To get back to the original thread question:

As a busy vascular surgeon in PA, I pay $60-70,000 in malpractice. This is actually down from 10 years ago when a fully established vascular surgeon could pay approx. $100-110,000. (As noted elsewhere, you pay less the first 2 or 3 years after you start. ) That means that, depending on your overall revenue and the current malpractice premium, anywhere from 15-30% of your gross income would be going to malpractice.
The premium number came down due to PA enacting malpractice reform in 2002-2004. The big changes involved need for certification for a lawsuit, cases couldn't be arbitrarily taken to Philadelphia with its juries, and that the insurance amount needed was $500k. The 2nd layer of insurance for $500k-$1 million is then covered by a state fund. There are several instabilities with the current situation: 1) many of the provisions actually sunset after 2007, and then has been renewed yearly since then 2) At some point to be determined by an insurance commissioner (political appointee), the 2nd layer of state coverage will be reduced to $250k and then $0, meaning that your primary coverage will need to go up correspondingly 3) What is currently covered by the state fund is thought to be underfunded. (The money for this fund came from a charge to all physicians and some tobacco tax money. Some of that money has been used for other purposes - sort of like the money "borrowed" from social security by the federal government).
At some point, these unstable dominoes will fall. When they do, the state likely will return to 2003 when it had the highest per capita/physician malpractice awards and the premiums will go back up.
Cheers.