The Limits of Employer Policies

Under employer-provided coverage, physician assistants often share limits with the physician and all other healthcare providers—all of whom may be named along with a hospital or private practice in a medical-malpractice lawsuit. Although physician assistants are dependent practitioners and may be covered under their employer's policy, they still have personal risk for negligence attributed to them in a malpractice lawsuit and all or part of a plaintiff's award or settlement. Unfortunately, their interests may not be a high priority when the healthcare facility looks at how to defend itself and negotiate a settlement.

In addition, many large hospitals and medical facilities have a large self-insured retention or deductible in their insurance program, which means the facility is responsible for paying the first claims dollars—often $1 million or more—of a loss. This structure gives a facility even more incentive to settle a claim at a lower cost regardless of an employee's individual culpability and the impact the losses may have on their career. In fact, if an employer chooses to settle, physician assistants may have to partially or fully compensate them for all or part of a settlement, and may be held liable for all or part of a claimant's award.

Another factor to consider is that it is common for physician assistants to practice in more than one facility, change employers, or give advice outside the office (i.e., on the soccer field or at summer camp). If a claim is filed in any of these situations, an employer policy may not be portable (a portable policy would allow coverage to be continued with the same terms and conditions when the insured changes employers, works in multiple facilities or a claim is made after he/she has left the job). Moreover, consider that when medical facilities consolidate or close, their insurance programs may be altered or be discontinued. These incidents leave gaps in a physician assistant's insurance plan.

Another gap that can occur for physician assistants is when there is a license complaint—a disciplinary action that goes before state licensing boards—not just a malpractice lawsuit. Employer coverage rarely includes coverage for defense of a license complaint.

Finally, consider that when third-party administrators are handling claims involving multiple healthcare providers, they may not communicate with a physician assistant or involve them in claims handling as they do with the medical facility or the physicians. This can leave a physician assistant in the dark, without a “seat at the table”—and without their interests being protected.

Advantages of A Personal Policy

Physician assistants are better served when they have their own personal policy and insurance partner to advocate for their best interests in and out of court. With personal medical-malpractice insurance, physician assistants can get this personal advocate, tailoring a policy to suit their needs and hiring individual attorneys when needed.

As individual practitioners, physician assistants need an insurance partner who will keep them involved throughout the court process to best defend themselves. An involved insurance partner will help with pre-suit discovery, medical review panels, depositions, mediations and arbitrations, and the disposition. They will also be available to help with questions or concerns of claim issues that arise, such as records requests or attorneys inquiries.

In a personal insurance plan, physician assistants can ensure that their defense costs are covered in a license complaint, that they have portable coverage that follows them to multiple locations with a consistent level and format, and that they have direct access to risk-management tools that can help prevent claims before they happen—helping them to avoid the courtroom altogether.

For example, risk-management resources can educate them about how to run a successful practice and how to avoid claims of malpractice, such as tips to successfully manage a medical record, guidance to follow state regulations of healthcare facilities, access to safety manuals and practice checklists.

Before finding themselves in the midst of a claim with only employer-provided coverage, physician assistants should ask this central question: If a claim arises that names me, a physician and my facility, whose interests would my facility's attorney put first?

A personal policy can answer that question.