By Maury Magids, Founder & CEO, Capson Physicians Insurance
Today’s physicians are under more pressure than ever. Unfortunately, the medical malpractice insurance industry has done little to help its clients. Insurance carriers should be playing a larger role in helping physician clients minimize risk, increase efficiency, and foster patient-centric care.
Roughly every two decades, significant shifts occur in health-care, with real impact on physicians. Throughout the 1970s, a deluge of lawsuits forced entire insurance companies to dissolve or leave medical malpractice insurance altogether. By 2015, US national healthcare will change things once more adding 16 million new patients to the system along with a new standard by which care is measured.
But how will these changes in healthcare ultimately affect physicians and the insurance carriers that provide coverage and protection for their practices? Medical malpractice insurance providers have to acknowledge the need for innovative insurance solutions and the technology infrastructure to support swift and efficient means of acquiring coverage.
As of today, medical malpractice insurers have made little progress streamlining operations, automating costly manual processes, and improving the inconsistency of evaluating risk. Most important, the industry has ignored the obvious, partnering with physicians to help enhance their patient’s experience, which helps reduce and prevent non-meritorious claims from being filed, and keep insurance premiums at manageable levels.
The impact of patient-centric care
Patients have never felt more stressed and less heard than they do today. On average, they get to speak for less than 15 seconds before a doctor interrupts them. One in three patients feel that their doctors don’t spend enough time with them, one in four believe that no single doctor is keeping track of their treatment and over half are unsatisfied with the overall level of care they receive (from Harvard School of Public Health study 5/12).
The situation is so bad now that nearly half of all US physicians state that they would retire early or leave the profession altogether if regulation and economics worsen (New England Journal of Medicine). Private practices are disappearing, as doctors retreat in droves to the safety, security, and relative simplicity of being employees in giant hospital systems—putting a nail in the coffin of the patient-centric practice and replacing them with an endless stream of anonymous technicians.
Physicians are not to blame. They are stuck in a white collar equivalent of the old “factory speedup,” finding themselves pressed to cram more patients into longer hours for lower reimbursements and higher-business costs.
But physicians need to understand why a patient is not happy and what steps to take to ensure that information and communication, not escalation and litigation, become the bedrock of all physicians-patient relationships.
Risk mitigation: a new view
Today, ineffciencies in traditional insurance claims management has the effect of rising defense costs to an average of USD 37,000 per claim. Nine of ten malpractice claims should not have been filed in the first place, and are ultimately resolved with no payment to the patient. But medical malpractice insurance claims are still costly, time consuming, and stressful (non-meritorious claims actually cost more per year than legitimate ones and take months to be resolved).
Medical malpractice insurance carriers need to provide in-house legal counsel (not claims adjusters) to pick up the phone and have a true peer-to-peer conversation with the plaintiff’s attorneys. By engaging a seasoned in-house medical malpractice attorney on the front end, insurance carriers can provide a new approach to help ensure claims are handled quickly, smartly, and effectively.
With so much at stake with today’s claims, an in-house medical malpractice attorney’s involvement from the beginning can ensure the process is fast, smooth, and in the best interest of all parties—often resulting in earlier resolution. By implementing this practice, insurance carriers get good doctors back to practicing medicine faster—where their communities need them most.
Reducing medical malpractice insurance costs
While physician-patient relationships and risk mitigation are contributing factors when discussing keeping premium costs low—we also understand that the medical malpractice industry today is where travel agents were 15 years ago: overpriced, inefficient, and desperately trying to hold on to an outdated price structure and way of doing business by keeping their clients in the dark.
Insurance carriers need to strip all of that away, and offer doctors the simplest choices, online instant quotes, automated processes and operations, clear and comprehensive policies, and none of the hidden fees, exclusions and delays typical in the industry. Insurance carriers who embrace this approach are dragging the medical malpractice industry into the digital future—harnessing physician-friendly technology that allow doctors to find their own solutions to protect their practice and reputation, get quotes in seconds, not weeks, and enjoy pricing that reflects an enhanced business model.