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June 2002
Volume 66 |
Number 6
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| Another Malpractice
Insurance Crisis Brewing for Anesthesiologists? |
Karen B. Domino, M.D., Chair
Committee on Professional Liability
Recent media is full of reports speaking of marked increases
in medical malpractice insurance premiums and the impending crisis
in availability of malpractice insurance.1-3
Although obstetricians and surgeons have been most affected, malpractice
insurance premiums for anesthesiologists are predicted to increase
in the future. As superbly discussed by Edward Mills on page 13
of this NEWSLETTER, medical malpractice insurance premiums
are increasing. Factors cited include large jury awards, increased
defense costs, competition within the insurance industry (causing
artificially low rates in the previous five years) and stock market
losses due to economic slowing. As a result of the growing disparity
between the escalating costs and diminishing revenues, several
malpractice insurance companies no longer offer or have reduced
the availability of malpractice insurance. The withdrawal of the
St. Paul companies, the nation's second largest malpractice insurer,
and the liquidation of PHICO in Pennsylvania have especially impacted
anesthesiologists.
In order to assess the current impact of changes in malpractice
insurance premiums on anesthesiologists, the ASA Committee on
Professional Liability polled ASA component societies. Responses
were obtained from 37 out of 50 states, revealing a possible malpractice
crisis for anesthesiologists in 15 states (40 percent of respondents)
[Table 1]. Premium increases for the current
year were observed in 70 percent of states responding to the survey,
with an average increase of 38 percent (range of 5 percent to
100 percent). Escalating malpractice insurance rates have been
noted in Alaska, Florida, Illinois, Missouri, Nebraska, New Jersey,
Ohio, Oregon, Pennsylvania and West Virginia and are spreading
to adjacent states. In contrast, premiums have been unchanged
in states with tort reform such as California.
When we compared the current rates, through a telephone survey
of malpractice insurers, to rates from St. Paul described in a
1985 NEWSLETTER,4 the average rate is
essentially the same in 2002 as it was in 1985 ($18,000). When
adjusted for inflation, the current premium value is markedly
lower than in 1985, the peak of the preceding insurance crisis!
Malpractice insurance premiums in the 1990s were lower due to
the reduced risk classification for anesthesiologists and market
forces. ASA patient safety initiatives and the Closed Claims Project
are credited for the lower risk for anesthesiologists. However,
premiums in several states, including Maryland, Nevada, Texas
and West Virginia, are significantly higher in 2002 than in 1985.
These findings suggest that the current volatility is likely to
spread as the social, economic and marketplace factors driving
up costs continue. History repeats itself!
References:
1. Treaster JB. Malpractice rates are rising sharply:
Health costs follow. The New York Times. September 10,
2001:A1.
2. Campbell CA. Jersey physicians run for coverage.
The Star-Ledger (Newark, NJ). February 18, 2002:1.
3. Treaster JB. New York doctors facing big jump
in insurance rates. The New York Times. March 22, 2002:A25.
4. Cheney FW. Professional liability survey results
reveal insurance statistics. ASA Newsl. 1985; 49(5):1.
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Karen B. Domino,
M.D., is Professor of Anesthesiology and Adjunct Professor
of Neurological Surgery, University of Washington School of
Medicine, Seattle, Washington. |
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