The national headlines on malpractice insurance were staggering 10 years ago. Media reports catalogued obstetrician-gynecologists who proclaimed they had to shut down their private practices in the face of runaway premiums. General surgeons and proceduralists decried payments tied to lawsuits they argued were arbitrary and capricious. And the American Medical Association (AMA) made announcement after announcement about states being in a “malpractice crisis.”
In recent years, though, premiums have actually fallen and stabilized at levels that those who track the medical liability industry say are manageable for bottom lines. But, that doesn’t mean otolaryngology, where surgeons are in the top half for premiums paid, isn’t feeling the pressure. “I see no relief in sight in spite of all the changes that are taking place in medicine with the Affordable Care Act,” said Michael Setzen, MD, immediate past president of the American Rhinologic Society (ARS) and chief of the Rhinology Section at North Shore University Hospital in Manhasset, N.Y. “The issue of malpractice doesn’t seem to be a priority.”
Otolaryngologist Ryan Sewell, MD, JD, of the University of Nebraska Medical Center in Omaha, is working on it. He has begun a project with The Doctors Company, a large medical malpractice insurance company based in Napa, Calif., to track endoscopic sinus surgeries, which most otolaryngologists agree tend to be the most litigated surgery. “We’re trying to get to have a more complete data set to be able to provide better information, not only about what injuries occurred, which is typically what’s happened before, but to try to give people some idea of which patients are going to be higher risk for malpractice claims,” Dr. Sewell said. “The third revision sinus surgery claim that’s going to put you at four-fold risk of having a medical malpractice claim…. I think that’s the kind of data that’s lacking not just in our field but in all fields.”