Physician Shortages, Gone Country

Practicing Medicine in a Rural Context

Physician Shortages Gone CountryMost of us who work in and around the medical field are aware that for some years now we’ve been experiencing a physician shortage relative to need, and that recent legislative moves and demographic trends are likely to exacerbate the problem.  With millions coming into the total patient pool under the Affordable Care Act, an aging baby boomer population, and less young people opting for a career in medicine the challenges ahead are substantial.  But what often doesn’t get as much attention is the specifics of whom this affects.

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Disability Insurance: Are You Covered?

Disability InsuranceGet an additional $3M or more as a tax-free lump sum.

Disability insurance is one of those things most of us don’t often think about.  But, for doctors especially, there are particularly good reasons to consider it carefully.  The specifics of what doctors do and what could constitute disability in their line of work, combined with the often substantial salaries of those in the medical field combine to make disability insurance even more valuable to doctors than to the average person.  However, those same factors can make getting the right kind of disability coverage particularly difficult for doctors as well.

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Medical Malpractice Stress Syndrome

Medical Malpractice Stress SydromeAs we’ve previously talked about here, the unfortunate reality is that a lifetime spent in medicine most likely means facing at least one medical malpractice lawsuit.  According to a frequently cited 2011 New England Journal of Medicine article, authored by a group of respected Harvard researches, a physician in a low risk specialty has a more than 75% likelihood of being sued by the age of 65.  For those in high risk specialties the number is over 95%.  It truly is almost a given for surgeons, ob/gyns, and others in high risk fields.

While we often hear about the financial difficulties that a malpractice claim poses and the problems surrounding malpractice insurance in such a litigious environment, we would do well to consider the other costs that being sued carries for physicians–specifically, the mental, physical, and relational costs.  Those costs are substantial, and the healthcare community is now beginning to realize just how substantial they are.

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Spotlight: Risk Avoidance for Hospitalists

Malpractice Risks for HospitalistsHospitalists: Their Role and Who They Are

Over the past couple of decades, and increasingly moreso recently, hospitalists have come to play an important role in the health care community.  While there have always been doctors who worked primarily in hospitals, the position has only recently come into its own as a unique and increasingly well-defined specialty (the term was actually first used in an August 1996 article in the New England Journal of Medicine).  More than that, it is now the fastest growing specialty in the country with over 35,000 physicians among its ranks.

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Got BOP?

In our newest blog post, we break out the Business Owner’s Policy.

Got BOP? Looking at Business Owner's Policy.One of our goals at eQuoteMD is to help doctors and medical professionals think about the kinds of routine challenges and decisions they have to face every day, not just in terms of medical malpractice insurance, but in the broader course of a life in medicine.  Sometimes that may mean looking at questions of legislation or litigation, technology, or market trends, but other times it’s the more mundane things that nevertheless make a real difference both financially and practically.  Today we’re looking at one of the latter; today we’re considering the humble BOP or Business Owner’s Policy.  It may not be sexy, but it’s something that many of you have or should have, and it’s every bit as valuable as your malpractice insurance in certain circumstances.

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A Medical Malpractice Reform Roundup

medical malpractice reformDespite then Senator Barack Obama’s support for medical malpractice reform in 2006, when he co-authored an article for the New England Journal of Medicine with Hillary Clinton highlighting its importance, the healthcare reform bill that we ended up with does little to nothing to address malpractice reform.  On one hand, that is frustrating to many of us in the healthcare industry who want to see stronger protections for doctors, and a more equitable system for addressing malpractice costs.  On the other hand, though, passage of the ACA has seemingly spurred some states toward pursuing their own malpractice reforms, whether because of incentives in the ACA itself, or just because it is now clear that for the time being malpractice reform is a state issue.

That said, there is at least one buzzworthy story at the federal level when it comes to malpractice reform. On February 27th, Reps. Andy Barr (R-KY) and Ami Bera (D-CA) introduced a bipartisan bill, H.R. 4106, or the Saving Lives, Saving Costs Act, in the House that would introduce a safe harbor model for Medicare and Medicaid providers.  Under the provisions of the bill standards of care would be developed by a panel of experts, and doctors, by documented adherence to these standards, could shield themselves from liability.  The bill was referred to the Energy and Commerce Committee and the Judiciary Committee for consideration.  While we expressed some reservations about a safe harbor system in a recent post, at least as a magic bullet solution to the problem of defensive medicine, it will be interesting to see if this bill gets any traction and, if so, how it performs.  You can read more about the bill here.

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Defensive Medicine: Arbitration, Is it Feasible?

Defensive Medicine ArbitrationOver the past several weeks here at eQuoteMD we’ve been taking a look at the issue of defensive medicine, defined as the practice of ordering medical tests, procedures, or consultations of doubtful clinical value in order to protect the prescribing physician from malpractice suits. In other words, defensive medicine describes the result of the feeling that many physicians have that rather than using their best professional judgment there are tests, diagnostics, procedures, and more that they simply must do and order so that if they find themselves in a malpractice lawsuit they have a better chance of avoiding liability.  We’ve also seen that defensive medicine is nearly universal in the U.S according to physicians’ self-reporting, is a real frustration for doctors, and is costing a tremendous amount.

This will be our last post in the series, but if you’ve missed any of the previous ones you can read about tort reform, patient compensation systems, safe harbors, and disclosure, apology, and offer (DA&O) systems by following these links.

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Defensive Medicine: Is Apologizing the Answer?

Defensive Medicine Patient and Doctor

Over the last few weeks we’ve been considering the problem of doctor’s feeling pressured to practice defensive medicine and the costs associated with that as well as some of the proposals that have been made to combat these problems.  As we’ve noted in previous articles simply put defensive medicine is the practice of ordering medical tests, procedures, or consultations of doubtful clinical value in order to protect the prescribing physician from malpractice suits.   And it is costing us an estimated $650-$850 billion dollars a year.  In previous posts we’ve considered the merits and challenges of tort reform, no-fault patient compensation systems, and the safe-harbor model that uses approved clinical guidelines to direct and shield doctors from liability.

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Defensive Medicine: Safe Harbors as a Solution

Defensive Medicine Safe Harbors as a SolutionToday’s is the third post in our ongoing series on defensive medicine, its costs, and measures that have been proposed to combat it.  In the first post we introduced defensive medicine, defined as the practice of ordering medical tests, procedures, or consultations of doubtful clinical value in order to protect the prescribing physician from malpractice suits.  We also reviewed some of the findings of a recent survey in which the vast majority of doctors in the U.S. reported practicing defensive medicine to an estimated tune of $650-850 billion a year, or 26-34% of the total annual cost of healthcare in this country.  Finally, in that post we looked at tort reform which is the most commonly proposed means of reducing the practice and cost of defensive medicine.

But as necessary and important as tort reform may be last week’s post, like today’s, focused on another solution that has been proposed: patient compensation systems which utilize administrative panels of experts to determine whether a patient should be compensated apart from questions of fault and apart from the court system.  Of course, as we noted, this is a pretty extreme proposal and not one that is likely to be adopted widely in the near future.

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Defensive Medicine: Are Patient Compensation Systems the Answer?

In this series we are looking at defensive medicine, or “the practice of ordering medical tests, procedures, or consultations of doubtful clinical value in order to protect the prescribing physician from malpractice suits.” In our last post we considered the cost of defensive medicine and the most commonly proposed solution, tort reform.

With surveys showing that 70% to upwards of 90% of doctors report practicing defensive medicine and a price tag estimated to be somewhere in the $650 – $850 billion range it’s clearly a major issue for the health care community. But as we saw last time it’s also a complex problem, and while tort reform almost certainly has a role to play in limiting defensive medicine, we also tried to show that tort reform will likely work best if it is one part of a larger strategy. In these next few posts we want to discuss several other proposals that have been made for mitigating the practice of defensive medicine. To be clear, we are not necessarily advocating for any of these proposals. Today’s in particular is a fairly radical suggestion. We are just trying to give you a lay of the land in terms of suggestions that have been made for dealing with defensive medicine.

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