Hospitalists Liability and Risk Management: The important job of understanding the malpractice insurance market

In an article in A. M. Bests’ magazine, the author says that insurance company representatives, agents and brokers have to perform three important functions:

·       Do the transaction in the markets (which can be a very delicate balance, working hard to push the underwriters to rate the risk competitively without incurring more than 100 % loss ratio, which is to say, almost as much paid out as collected in!)

·         provide service to clients (which sounds easy and trivial and intuitive, but not always, surprisingly executed by the agents and company representatives. We all get busy, and we don’t always understand what our clients want, why they want it and, why on earth they need those answers so soon!

·         offer high end, specific, consultative strategy and advice.

Broker and Agent Business Advice about purchasing medical and healthcare liability insurance

Paraphrasing, Lori Chordas, the author of this article from the section of The Leaders Issue of A.M. Best Magazine says that the ideal of providing really good service changed from rhetoric  to reality after the 2007 – 2009 economic crisis.

Clients were not just appreciative of good consultative advice in order to navigate their businesses through these difficult times.  The consulting and guidance became really mandatory; Brokers from Marsh, Hub International and representatives from the Council of Insurance Agents and Brokers all say that the agents and brokers who are going to make it in this new environment are going to provide solutions that account for geographic spread, innovations in technology and new risks for businesses everywhere like management liability and cyber data breach.

The task of placing the insurance

Insurance is , even for small companies, one of the largest expenses on the general ledger.  As we learned yesterday when meeting with one of our Urology Medical Groups, the administrators and board member physicians are expected to have strategies to not only protect and push up the top line, but to manage the bottom line through the use of outsourced, (and, largely free of charge) vendors, advisors and contract workers finding solutions that hold the line on expenses.

Helping Hospitalist medical Groups grow while managing the risk:

Insurance Advisors today, must specialize and develop a deep understanding of their field of choice in order to help develop solutions that bring these ideals to their clients (of affordable solutions that manage the new risks of liability).  One of the areas that The Doctors’ insurance Agency has chosen is the area (still new in many aspects of Hospital Medicine.

Ken Cerar, CEO of the Council of Insurance Agents and Brokers says that the future is bright for agencies and brokers who specialize and learn to bring solutions in that area of expertise to their clients.  This can be a day to day, certainly ongoing relationship.  The days of just managing the transaction are gone, companies and clients are expecting proactive, creative solutions to their business problems.

The malpractice insurance solution for a hospitalist group

Regardless of whether it is a nonprofit recreation community center,  a publicly owned healthcare clinic or a  foundation of physicians, the doctors have  to find agencies with the knowledge to find the right fit in the market…In this changing time in health care, with so many different practices presenting, agencies that profess their expertise have to introduce comprehensive and affordable solutions.

The Doctors’ Insurance Agency is proud of our long standing tradition of representing The Doctors’ Company as one of our primary  health care malpractice  and facility Liability insurance carriers.

Hospitalists and Telemedicine Groups seem to be two of the fastest growing areas in health care and not surprisingly TDC is at the center of one of these.  The Society of Hospital Medicine endorses The Doctors’ Company ( as the malpractice insurance carrier of choice for their member physicians.  With the cost and challenge of staffing hospitalist groups and competing for hospital contracts, the hospital’s medical groups rely on The Doctors’ Insurance Agency, and our nine licensed representatives to find them policies that cover them completely.

The Doctors’ Company  works closely with our growing insured base to understand what causes the increased frequency in hospitalist medical malpractice claims.

In an online magazine entry of Fierce Health Care:

We read that in a study released this week by the Society for Hospital Medicine, researchers say that a lack of understanding of the two-midnight rule has a negative impact on patient care and patient finances. The hospitalists argue that the rule disrupts their workflow, damages the physician-patient relationship and impacts their clinical decisions.

The Two Midnight rule to reimbursement in hospitalist medicine.

The two-midnight rule requires that physicians deem the patient's condition as serious enough to require at least two overnight stays. Patients who aren't formally admitted may remain under outpatient or observation status- which can result in their not qualifying, which would leave patients with high out-of-pocket expenses.

Hospitalists urge a short-term solution involving more emphasis on provider and patient education. Patients especially need to understand the difference between admission as an inpatient so that they can hit the two midnight criteria.

The Doctors’ Company, for example says in one of their risk management bulletins that in order for Hospitalists to better manage the risk of a lawsuit, the physicians and hospitals must work together to manage poor outcomes, adverse responses to medication and missed diagnoses.

Imperative Conversations:

As the first medical professional liability insurer to establish a patient safety department, The Doctors Company remains the leader in developing innovative tools that can help you reduce risk and keep your patients safe.

Transitions in hospital care are what defines hospitalist medicine.  Good communication between providers during these sensitive patient transitions is so important.  with  strict protocol between the physicians and the hospitalists taking over the claims involving these breakdowns may be avoided or drastically reduced.

The human factors such as fatigue, distractions, and reliance on memory—are common causes of hospitalist medical malpractice claims.  Standardizing the handoff process has been shown to lower rates of what the hospitalists who study these events refer to as “perceived near-miss events and adverse outcomes”.

we look forward to working with any of our clients to help  develop the proper rating methodology  to determine a true FTE usage for your group and instead of an antiquated and inappropriate and incongruous per physician premium.


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