It’s Time to Reset the Medical Malpractice Insurance Conversation

Richard E. Anderson, MD, FACP

In the mid-1970s, malpractice lawsuits and skyrocketing jury awards caused commercial insurance companies to raise physicians’ malpractice rates by as much as 400 percent. The practice of medicine was deemed to be “uninsurable.” Thousands of physicians faced cancellation of their policies. As a result, doctors came together to form their own companies to provide affordable and sustainable coverage. However, today’s physicians need more.

We spoke with more than 800 doctors, practice managers, and group administrators across the country last year. The message was clear: In addition to requiring strong professional liability protection, practices of all sizes also need their insurer to be a proactive partner to help them navigate the challenges ahead.

It is time for our industry to reset the conversation around medical malpractice insurance. We believe we should serve the medical profession by partnering with those who provide care—so that doctors can focus on making decisions based on the best outcomes for patients, rather than on threats of litigation, invasive regulation, or financial loss.

The industry needs to focus on the positive aspects of what we do for physicians by taking the “mal” out of malpractice. We will do this by collaborating with practices and systems to reduce the likelihood of lawsuits, by defending doctors inside and outside the courtroom, and by helping them navigate today’s healthcare landscape.

Evolving to meet changing needs

As healthcare continues to undergo unprecedented change, practicing medicine has become increasingly complex. Faced with a tangle of contradictory regulations, rapidly changing system and reporting mandates, the disruptions of digitization and consolidation, and ever-present cyber threats, those who practice medicine have never been under greater pressure.

In this environment, medical malpractice insurers must evolve to meet the changing needs of the profession. Practitioners struggling to heal patients and stay in business need more than an insurer that simply reacts to claims.

We should offer tools and services that provide guidance. For example, we have created an extensive library of articles and resources openly available to all healthcare providers to help them understand and comply with electronic health record requirements, become familiar with the risks of telemedicine, and stay informed about drug safety laws. We share these articles and resources with healthcare providers worldwide in a number of ways, including social media. We have also initiated online conversations about medicine in the changing healthcare environment through our hashtag #advancegoodmedicine.

Every piece of information that supports practicing medicine safely and effectively in this changing environment has special value. Practices and systems are looking for insurer-led participatory education and coaching, like rare-event simulation, to improve patient safety and reduce the threat of litigation. Our foundation recently provided grants for hands-on medical simulations, institutional- and physician-level process improvements in healthcare delivery, and improved safety systems as a core part of medical education.

Today’s medical malpractice insurance buyers also expect a comprehensive array of tools to help them stay current with emerging best practices in patient care. For example, we analyze data captured from our claims experience with more than 79,000 members and translate it into actionable reports that are shared free of charge with all healthcare providers. We have published reports on cardiology, anesthesiology, emergency medicine, orthopedics, obstetrics, hospital medicine, internal medicine, plastic surgery, and electronic health record claims. In upcoming reports, we will focus on opioid prescription, psychiatry, advanced practice provider, pediatrics, and hospital-based claims. These studies are designed to promote patient safety and minimize liability exposure. The analysis uncovers the newest plaintiff allegations, reveals the most important factors that potentially lead to patient injury, and discusses—in detail—the shared aspects of claims. Physicians nationwide have already begun using the data in these studies to make changes in their practices that benefit patients and reduce the risk of adverse events.

Starting a new conversation

Another reason to reframe the conversation about medical malpractice is that the term “malpractice” is a misnomer. Over 80 percent of our claims are closed with no indemnity payment. It’s time to stop focusing on the inaccurate term “malpractice” and instead emphasize the positive measures insurers take to help doctors, practices, and systems reduce claims. The industry can join in this effort by sharing data and by engaging in collaborative patient safety and risk management programs.

Changing the way we talk about malpractice insurance is the first step in demonstrating our understanding of the contemporary experience of medical practice and becoming a proactive partner that meets rapidly evolving needs.

The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each healthcare provider considering the circumstances of the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.