Hospitalists find rate and relief for medical malpractice insurance

Rate and Relief in the context of a conversation of medical malpractice insurance means competitive premiums and a solution to the costly tail at time of cancellation.  The Doctors’ Insurance Agency has been working with The Doctors’ Company nationwide to develop creative premium solutions to the unique challenge of hospitalist medical malpractice insurance coverage.

As one of our start up Hospitalist policyholders expressed to us: “how do we budget for this unknown commodity of providing insurance for future claims to every physician who doesn’t work out.”

With The Doctors’ Company, we have been able to work closely with underwriting to develop custom malpractice insurance programs that solve this problem and more for Hospitalists. 

Do not overcharge malpractice premium for hospitalist groups!

The magic formula is to rate the physicians for their pure risk, the actual time they work, rather than the number of FTE’s or the number of physicians necessary to staff, to maintain the 24-7 requirement; to allow for quick growth of the roster of physicians, (a sort of rapid underwriting process for hospitalists joining the group)

And, if it is possible, the goals was to write a policy that builds in the cost of tail into the premium, allowing for physicians in the group to cancel the policy and be assured that the future claims for the services provided during their tenure at the group will be covered.

The underwriting management of The Doctors’ Company understands he risk because they are the largest insurance company in the country providing medical malpractice insurance to physicians; The Doctors’ Company is the endorsed carrier for the Society of Hospital Medicine, which allows us to apply an additional discount to the premium.

The premium for hospitalists is developed by reporting the total relative value units to the underwriter, the RVU’s are then divided by American Group Practice Association average of RVU’s per Hospitalist (broken down by specialty) and then that figure is multiplied by the territory, state, and specialty premium.

After that calculus, we apply further claims free and risk management discounts so that the hospitalists are both incented to continue learning and rewarded for the positive claims results. 

To Review the definition of Hospitalists using the Chicago Sun Times as a Source:

Health Aware: Growing hospitalist specialty provides inpatient care

You’re admitted to the hospital after a car accident; Will you know what your nurse is talking about when he says the hospitalist is on her way to your room?  If you haven’t been hospitalized in recent years, this will seem like a new player in the health care paradigm:

— a specialist in the care of hospitalized patients.

A hospitalist visits each of these patients at least once daily during their stay. Hospitalized pediatric patients of the group’s physicians are seen by the Pediatric Hospitalists Group.

Hospitalists bring patients a number of benefits:

  • ·         Experience in caring for hospitalized patients with complicated cases.
  • ·         Convenient access for patients, families and staff who have questions about the patient’s condition and care.
  • ·         Ability to respond quickly to problems, such as the need to modify treatments, discuss treatment protocols.
  • ·         Coordination of care with other doctors and care providers, and input into discharge planning.
  • ·         Providing  valuable input on hospital committees that focus on patient safety and quality of care.

The use of hospitalists has sharply risen since the term was first introduced in 1996, partly because of efficiency and cost-effectiveness.  Physicians with regular patients in the hospital are relieved of the duty to make rounds after hours (often when those rounds are not convenient, providing service when they are exhausted).

The Doctors’ Company is aware of this; and works hard to help manage the risk of a claim. One method of reducing the premium is to focus on managing clinical and administrative risk, cutting down on the errors that cause the injury, dissatisfaction and braking down of the relationship.

The Doctors’ Company offers a 31 page report on how to better manage the risk of hospitalist medical malpractice insurance.  One of the key topics to discuss in this area is Communication.

Communication among team members must be clear and complete. Faulty communication can occur in a variety of settings. For example, patient care may be jeopardized when the admitting physician provides too little information to the hospitalist or when the hospitalist provides too little information to a specialist. Patient care may also be jeopardized when nurse-to-nurse, nurse-to-physician, or physician-to-physician

communication lacks critical data.

Communication Errors lead to medical errors:

Poor physician-patient communication has been identified as one of the root causes of medical errors that leads to patient injury. In the context of physician-patient relationships, communication is rated as one of the most important aspects of medical treatment. Several recent surveys concluded that although patients are generally satisfied with the overall competency of care they receive, they feel that effective physician-patient communication is sometimes lacking. Physician Patient Staff Relationships are integral to the successful communication of the group.

One hospitalist group with which we have become very familiar is aware of this dynamic, they spend hours building teams, underscoring their mission of safety and defining their group’s purpose:


  • Teamwork has come to the forefront as the most effective way of catching individual errors before they occur and of mitigating system failures.
  • Teams are better equipped to handle challenges within a department, and decisions made through teamwork are significantly better than the decisions of an individual.
  • Encourage communication with your patient and other health care team members by telling them, “If you see, suspect, or feel that something is not right, please speak up.”

By working with the physician hospitalist  groups, bringing our underwriters close to the administrators and clinical leaders of our hospitalist groups, we are saving them premium and eliminating the cost of tail.




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