Hospitalists, A Unique Malpractice Risk

Hospitalist Malpractice Insurance brings different needs for insurance.

The Doctors’ Company,, and The Doctor’ Insurance Agency can help you insure your group of Hospitalists.

It is surprising to me how much premium can be wasted, specifically in purchasing tail insurance for hospitalists who come and go off of these roster policies.   Roster policies refer to the types of coverage which require 24 hour/7 day per week coverage.   If we develop the premium in a way that does not trigger expensive, prohibitive tail bills, we (our agency) feels that we can help you plan and grow.

The number of hospitalists has jumped significantly over the past years, as hospitals and physician groups have experienced how convenient it is to have this supplement to the hospital and physician care.

 Hospitalists are a growing specialty:

And, one of the realities of this specialty is that as the number of hospitalists grow, so  do the number of lawsuits filed against these physicians.  Frequency, which has held the cost of claims down in general over the past several years is increasing, in this and other primary care specialties.

 The Doctors Insurance Agency understands Hospitalists Insurance

Medical Malpractice Insurance Companies, (like The Doctors’ Company) are just now separating the evaluation of hospitalists' risk from their claims experience with other specialties.  One of the first, most helpful trends in tracking claims is to separate the loss according to the actual specialty…in this case:  Hospitalists.  The Doctors’ Company can help hospitalists design their coverage in a better way.

And, the losses can and should be separated to reflect their unique experience; up until the past few years, hospitalists, who are typically trained as internists, were insured at the same rate and with the same premiums as primary care physicians in private practice. As the underwriters and actuaries begin to develop a deeper understanding of the risk faced by hospitalists, the schedule and the interaction with patients, , the companies  may begin to factor that into their coverage and their premiums.

 Hospitalists Bear More Risk than Internal Medicine

The Doctors’ Company’s Patient Safety Director: Robin Diamond has commented on this:

"We have seen a slightly higher frequency in number of claims and severity in cost of claims in lawsuits against hospitalists,' says Robin Diamond, RN, JD, senior vice president and chief patient safety officer at The Doctors Company, The Doctors’ Company believes that  as hospitalists continue to fill more roles within the hospital and higher demands are placed on them, the risk for being sued may also increase.  However, this does not mean that the premiums and the tail should continue to be an impediment to the business.  Administrators can get into some intensive contests to recruit physicians; with the cost of either nose or tail the deals can be made or broken.  A Roster, ‘RVU’ premium methodology can eliminate this obstacle making it easy to add physicians to your group.

 Because the hospitalist field is relatively new, the data is still collecting, actuaries and underwriters are just now separating the losses by this subspecialty.  There has been little formal research as to how it stacks up against other specialists and internists for liability risk. In general, surgeons and obstetricians/gynecologists are more likely to be sued than internists, pediatricians, or psychiatrists -- and also hospitalists…Hospitalists are much lower so far than some of these higher rated surgical specialties.

 Rating the Hospitalists by the RVU’s

\Hospitalists are now the fastest-growing specialty in medicine, with almost 35,000 physicians, according to the Society of Hospital Medicine, which also endorsed The Doctors’ Company.  This endorsement allows The Doctors’ Company to insure these medical groups at an even lower discounted premium.  These discounts added to our Roster, RVU rating method makes The Doctors’ Company an unbeatable solution for professional liability for hospitalists.

 No Tail for Hospitalists

Our agency, The Doctors’ Insurance Agency, has worked with hospitalist groups, in many specialties to lower their premium.

By working with your administration as a partner, we have added up to eight physicians in a single policy year.  The premium for the Hospitalist Group grows in direct proportion to the billable services.  Unlike many claims made malpractice insurance policies, these hospitalist policies do not generate a unique tail premium every time you add a physician.  Avoiding the high cost of tail insurance for urgent care centers and hospitalists is one of the most important functions served by developing premium in this way.  The group grew to three hospital contracts while only increasing premium by $ 50,000 in one policy year.

It is altogether right, appropriate that the premium should be developed using different measures for hospitalist groups.  "The exposure is obviously different for an internist in private office practice than for a hospitalist," said P. Divya Parikh, director of research and loss prevention of the Physician Insurers Association of America (PIAA). "We're encouraging insurers to weigh that risk in determining how they designate hospitalists and how they provide coverage.

Although the field of Hospitalists are still growing, and the manner of attaching a fair premium for one or for a group of hospitalists is still emerging,  There are more and more of these types of practitioners on the horizon:  "This is still a work in progress for insurers.  PIAA studied over 93,000 closed claims over a 10-year period. They isolated 312 claims just for hospitalists, although there is some overlap because some physicians functioning as hospitalists aren't identified as such.   Of those 312 claims, 63 -- or about 20% -- resulted in some indemnity payment.; This is about average for all risks, but trending on the high end of the specialties.




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