Because of the risks involved, neurosurgeons face higher medical malpractice costs than many other physicians. The field of neurosurgery includes both spinal and cranial disorders related to vascular disease, pain, brain tumors, epilepsy, movement and behavioral disorders and trauma. Neurosurgeons diagnose and assess these conditions, which most often require surgical repair. The goal of neurosurgery is to improve the quality of life of the patients and to save lives. These doctors are well compensated because of the difficulty, delicateness, and astounding complexity of the surgeries they perform, but at the same time they also have much higher insurance premiums than doctors in many other specialties.
A recent study in the New England Journal of Medicine observes that neurosurgeons get sued more than other physicians. As a result, of course, neurosurgeons end up paying premiums for their medical malpractice insurance that are among the highest of any specialties. Premiums fluctuate widely based on the location of the practice as well. States like New York, Florida, and California, that are known to be particularly litigious and to have aggressive legal climates have the highest premiums, while rural states and states that have experienced significant tort reforms tend toward lower premiums. And, in addition to all of those factors neurosurgery cases, on average, pay more to claimants than cases associated with any other specialty.
The severity of malpractice claims in neurosurgery has many people concerned about the practice of defensive medicine, which is often pointed out as one of the factors increasing the cost of healthcare in the U.S. According to a study from March 2015, “Neurosurgeons are faced with a large number of malpractice claims during their careers. The potential imbalance between malpractice liability cost and quality of care has been an issue of debate in several areas of medicine.” The study states that 5% of all physicians face a malpractice claim yearly, while it is over 19% of all neurosurgeons.
According to a study performed by the Association of Neurological Surgeons and Congress of Neurosurgeons the outrageous premiums for neurosurgeons were examined and have a direct effect on the practice. The study showed that half of all neurosurgeons are so afraid of being sued that they are limiting their emergency care or restricting surgery to the spine only. Many of these physicians were considering moving to another state. This could cause issues limiting patient’s access to neurosurgeons, which is what happened in Florida in 2004 when a patient died due to the fact there were no neurosurgeons available in the area. One of the main reasons there was a shortage of neurosurgeons in this area in Florida was due to exorbitant medical malpractice premiums. While there is no crisis today, there are ways to help keep premiums affordable.
Risk management experts recommend several strategies to reduce the likelihood of a lawsuit for neurosurgeons:
- When performing spinal surgery, which is the cause of most malpractice lawsuits filed against neurosurgeons, physicians should be thoroughly acquainted with and follow all risk management best practices.
- Communicate, communicate, communicate – communication is vital! Neurosurgeons should be clear and open with patients and ensure the expectations of the patients are realistic. Communication with co-workers is also crucial – checklists, task management software, and other tools can be helpful in making sure that all lines of communication remain open and available to all involved.
- Thorough documentation is also very important. All cases should be completely documented with all details included.
- Documentation must remain organized to be useful, but in addition to the practical benefits organized documentation will be vital in defending your cause if a lawsuit is ever filed.
- Continuing education is an important component in risk management. Many insurance providers offer substantial discounts to physicians that complete risk management courses. A good broker should be able to help you access these types of discounts and benefits.
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