When a Claim Came Against The Medical Director?

May 29, 2018

Medical Malpractice Insurance for Standard Clinicians and Surgeons

The Doctors Insurance Agency provides standard Medical Malpractice Insurance Policies for physicians with relatively clean claims history practicing in accordance with the American Board of medical specialties: that is to say The Doctors Insurance Agency (working with The Doctors’ Company) provides Medical Professional Liability Insurance for physicians’ clinical and / or surgical practice.

There are many areas where our physicians become involved (e.g. Endoscopy Center ownership, Ambulatory Surgical Center, Medical Review, Independent Medical Exams, etc. etc.) These can all require a separate medical malpractice policy.

One of those areas of independent contract opportunity is Medical Director Work, these contracts offer interesting work, supplemental income for physicians and naturally, the doctor wants to keep this risk, this insurance outside of their medical group insured on a separate policy.

Medical Director of Same Day Health Care Facility:

One of the areas of confusion (in addition to the important and universally asked question: How am I insured for this as a medical director?) which Medical Malpractice, medical professional Liability insurance is going to cover me if I’m sued doing my job as a Medical Director for a same day facility (ambulatory Surgery Center)

The other questions is: What is my job?

Some areas that should be included and the reason for a separate Medical Director Professional Liability Insurance policy are:

  • assist with the scheduling of cases to ensure that the needs of the anesthesia department and the facility are met;
  • make sure that an anesthesiologist is on the premises until the last patient leaves the facility;
  • oversee the recovery areas and ensure the medical standards are functioning properly;
  • discharge patients (optional);
  • serve as chairman of the quality assurance committee and participate on other committees;
  • attend and contribute to the professional staff and board of directors meetings;
  • work with the same-day surgery program on the development of policies and procedures, by-laws, and protocols of the facility;
  • perform whatever administrative or supervisory functions are required to make sure the facility is in compliance with licensure and/or certification and accreditation needs.

Clearly, there are other areas where medical directors can assist the program. Often special projects will come up that need their invaluable input in the decision-making process.  Some similar job responsibilities for Skilled Nursing or Adult Care Facilities/Homes.

These positions come with significant exposure to liability that often are not covered by Physician Medical Malpractice Insurance Policies.

(Sample of supervisory claims commonly attached to Medical Directors)

In a recent Skilled Nursing Facility lawsuit a Patient was end of life with Alzheimer's Dementia. Family requested Morphine to promote comfort. Treatment was given and then after patient had passed, the family stated that they did not want the end of life care and that they had demanded that he be sent to the hospital. They were suing the facility, stating that the facility neglected to follow their wishes and the patient died as a result of their neglect to do so. They claim that the Medical Director was negligent for not supervising the nursing staff regarding this issue.

What to do to Prevent Similar Claims

We recommend to start a process of giving a family a formal comfort care order set, so that they know exactly what they are agreeing to before placing their relative on comfort measures as well as creating a document log showing that they clearly understood. This process will reduce the risk of further misunderstandings dramatically. We also recommend to document in the chart the name of the family member who agreed to use comfort relieving measures at end of life.

The Doctors’ Insurance Agency provides comprehensive, affordable Medical Director Professional Liability Insurance Policy designed specifically for your insurance needs. Sometimes medical directors assume they are covered by the facility. Many Professional Liability Insurance Companies that specialize in providing medical malpractice insurance for conventional practices often do not want to ensure the work of the medical director because that work is outside of the group.

BUT. What if I’ve had claims on my own Individual Medical Malpractice Insurance Policy that make me an unfavorable (or Uninsurable Risk) to the Medical Director Underwriters?

This is when our 25 years and professional experience, national brokerage partners and years of building relationships with Surplus Lines HealthCare Facility and Physician Liability Insurance companies can help you. We can work with our underwriters: The Doctors’ Insurance Agency will not stop at just one or two or three declinations. Resourceful Agent Representation will help you obtain a medical director liability policy even if you have open or large loss claims.

We will work with risk retention groups, surplus lines carriers, experienced underwriters that write a broad range of healthcare professional liability insurance. We understand the difference between a clinical surgical claim and administrative policy. Often times there are years between a closed large loss settlement and this new nonclinical administrative opportunity. It is our job at The Doctors Insurance agency to understand the risk, to understand the difference , the relative pricing and the effects of a properly placed deductible in order to get a policy issued.

The Doctors Insurance Agency specializes in helping you obtain affordable, complete insurance protection as an independent Medical Director, we has been working for years with Admiral, Evanston and Lloyds of London to deliver the right policy for the work you’re doing.