May 2005

Do you really need malpractice insurance?

by Timothy Feuling, CBS President

What are the chances you'll ever be sued?

It's impossible to say for sure, but one thing is certain ‑‑ as the number of lawsuits increase, it's growing more and more likely that you could end up in court facing an accusation of malpractice.

For years, many DCs dismissed the need for malpractice insurance, feeling secure in the knowledge that, as a drug‑free and non‑invasive approach, chiropractic was extremely safe. If they were confident in their competence as a chiropractor, they assumed they wouldn't ever hurt a patient and therefore they wouldn't be sued.

Back then, most DCs had small family practices, where they knew most of their patients by their first names and were friends and neighbors with many of them. Who is going to sue a friend, right? Plus, at that time, chiropractors were viewed as the "poor cousins" in the health care field and therefore weren't considered particularly attractive targets for big lawsuits. Most doctors of chiropractic could be in practice for 30 years and never face a lawsuit.

Ah, the good old days. Sadly, times have changed, and not for the better.

Today, despite their best efforts at forming positive relationships, most doctors have larger practices and many ‑‑ if not most ‑‑ of their patients are strangers. Even being a competent doctor doesn't protect them as it did in the past. Most chiropractic malpractice claims don't involve adverse events or negative side effects. Instead, they involve one of the following issues:

*** Failure to diagnose or refer a medical condition or ailment

***  Providing care that is not considered "medically necessary" (often the correction of subluxations)

***  Over utilization (normally based on limitations implied in the Mercy Guidelines)

***  Billing disputes

***  Alleged sexual misconduct

And that's not even counting the frivolous suits. The growing incidence of unfounded complaints and lawsuits ‑‑ especially those filed as a 'get rich quick' scheme, has gained national attention. Even President Bush commented on the fact that "junk and frivolous lawsuits discourage good docs from even practicing medicine in the first place."

Although there's no reliable information on chiropractic claims, the Physician Insurers Association of America estimated that, in 1995, approximately $737 million was spent by medical doctors to defend against meritless claims.

The risks of practicing without the safety net of malpractice insurance were spotlighted in a 2003 comedy by playwright Mary Jane Taegel called "Going Bare," which is the term used to describe practicing without insurance. In the play, an obstetrician/gynecologist is sued for $4.2 million ‑‑ shortly after he discontinues his expensive malpractice insurance policy! At first, he assumes the case will be dropped once the plaintiff realizes he's uninsured.

"I thought (the plaintiff's attorney) would back off when there was no big insurance company to go after," his lawyer tells him. "Unfortunately, he seems perfectly happy going after a rich doctor." Although the doctor protests that he's not rich, his attorney isn't optimistic.

"With an insurance company picking up the tab, we'd take it to court in a minute" he explains. "Without malpractice insurance, we can't risk it. Naturally, we'll try to settle for as little as possible."

The $65,000 the doctor saved by not paying an insurance premium could, in the end, cost him "everything I have, plus a few million I don't."

Not exactly good economic sense, is it?

Luckily, most chiropractors will never face a $4.2 million lawsuit, but claims are growing rapidly and if the accusation concerns a major adverse reaction, such as a stroke, the multi‑million dollar claim isn't an impossibility.

Could you afford to pay even a $4.2 million claim out of your own pocket? What about a mere $1 million? That's the median malpractice award, according to Jury Verdict Research company. How about $235,000 ‑‑‑ the median payment for a judgment as of 2000? While you might be able to pay a quarter of a million dollars to a plaintiff, would you have to sell your home or cash in your children's college fund to do it? And if you're lucky enough to have a million dollars or more in assets, the judgment might very well be higher.

Obviously, one lawsuit can bankrupt even the most successful DC who isn't properly protected with malpractice insurance. That's a high price to pay in order to avoid the cost of a policy.

Of course, if you're careful ‑‑‑ and very lucky ‑‑‑ you may go your entire career without a lawsuit, but the black cloud of litigation hangs over every DC's head. As Dirty Harry would say, "Do you feel lucky? Well, do you?"

That's why the number one reason to buy malpractice insurance is simply peace of mind. It's a great feeling to have a billion dollar insurance company standing behind you, willing to spend huge sums of money to investigate your case and defend you from frivolous claims.

Without that safety net, you face the possibility of having to spend your own hard‑earned cash on a lawyer (billing in 6‑minute increments at $250 to $500 an hour) who may or may not know anything about chiropractic. Even if you win the case, you could end up broke.

Why take the chance? Get a good insurance policy today and protect your assets.

(Timothy J. Feuling is president of Chiropractic Benefit Services (CBS) and a member of the Board of Directors of the World Chiropractic Alliance. He assists doctors in maximizing their practices through the proper choice of insurance and related services. Doctors may contact him with questions, comments, and requests for insurance quotes at 2950 N. Dobson Rd. Ste. 1, Chandler, AZ 85224, by phone at 800‑883‑0412 or by e‑mail: feuling@cbsmalpractice.com.)