A total of 5% of respondents reported difficulty with licensure or hospital privileging relating to their malpractice history; 5% reported experiencing a rate change, while nearly 2% had been refused liability coverage based on their personal malpractice claims experience.

Almost 90% of respondents reported that they practice defensive medicine, defined as ordering tests or consultations to avoid potential liability. And 53% felt that defensive medicine influenced their patient management more than 25% of the time.

Tort Reform

Only 4% of respondents reported leaving a state because of its malpractice environment, but 50.4% felt that tort reform is the most important area for ACEP to focus its efforts.

Slightly more than 27% felt that education on the legal system and its effects on practitioners is the most important area for ACEP to focus its efforts.

Respondents were divided on the most effective potential tort reform provision, with 42% favoring health courts, 41.6% limiting malpractice awards, and 11% sanctions against egregious expert witnesses. More than 6% of respondents believed that their states would enact tort reform in the next 3 years, but the majority did not know.

The Most Frequent Recurring Themes Were Wxpert Witness Testimony and a General Sense of Dismay and Betrayal Regarding Malpractice Litigation.

Liability Insurance Coverage

The majority of respondents reported that their malpractice insurance is paid for by their group, while over 30% said it was paid by their hospital. Most liability carriers were commercial (32.3%), while group and hospital captive carriers were almost equally represented at 19.1% and 18.2%, respectively. While 20% of respondents reported a rate change based on their group’s claims experience, 45% did not know.

Fewer than half of the respondents said they had received a copy of their liability policy, and less than 15% had read the policy in its entirety. Nearly 80% believed that they had tail coverage, but nearly 10% did not know, and 33% did not know whether they had the option of purchasing occurrence-based coverage. Some 22% of respondents believed that they did have this option, while 45.3% did not.

Although 29% said that their malpractice insurance contract gives them control over whether to settle cases, a quarter said that it does not, and 45.8% reported that they did not know whether they have this control.

Expert Witness Experience

About a third of respondents reported having served as an expert witness in a malpractice case, with 10% having served three or more times. Approximately 10% have done so for more than 10 years.