Friday, December 21, 2007

Reduce Malpractice Premiums: Show Plaintiff’s Bar You Mean Business

Everything must degenerate into work if anything is going to happen.

Peter F, Drucker, 1900-2006

In my last blog, I brought attention to the fact that the lowest malpractice premiums are in a tier of Northern Midwestern states – Minnesota, Wisconsin, Iowa, and the Dakotas.

As I looked at this 2007 data from the Medical Liability Monitor, I asked myself – Why does this swath of states have such low premiums?

Having spent 1975 to 1990 as editor of Minnesota Medicine, I decided to find out. I called Chuck Meyer, an internist who now serves as editor-in-chief of Minnesota Medicine. He referred me to Mark Odland, a surgeon at Hennepin County Medical Center who has assumed the role of Group Chairman of the Minnesota Medical Insurance Company (MMIC), which directs malpractice traffic for the Minnesota Medical Association.

Here's what Dr Odland said .

• One, malpractice premiums are low in Minnesota because MMIC, which has 101 employees, has very worked very hard for a number of years on programs to keep them low.

• Two, MMIC also manages the physician-directed malpractice businesses of Iowa, parts of Wisconsin, and the Dakotas.

• Three, MMIC defends all malpractice suits, no matter how small or how frivolous, for Minnesota and its sister states.

• Four, MMIC conducts “in-house” investigations of groups having malpractice problems and offers consulting services to practices belonging to the Minnesota Medical Association or sister state associations.

• Five, only 4 to 100 Minnesota physicians is currently being sued, down from 6 or 7 a decade ago.

• Six, lawyers win only 1 of 100 cases brought to trail, and MMIC wins 86 to 90% of cases reaching the courtroom.

• Seven, the rate of “outrageous : million dollar settlements for attorneys like Scruggs of Mississippi or Edwards of North Carolina is extremely low.

• Eight , the Minnesota Medical Association and MMIC conducts aggressive programs, often featuring EMRs and atlity, safety, and patient communication.

• Nine, the purpose of all of the above is to send a powerful message to the plaintiff’s bar that physicians mean business and are taking every measure to document what goes on between doctors and patient, to assure safety and quality, to investigate and defend every case (usually with internal personnel rather than hiring lawyers), and to always take a proactive role in bringing down malpractice claims and settlements.

• Ten , MMIC is working because MMIC works hard at challenging lawyers. The attitude seems to be, “We dare you to make a claim and make it stick.”

What Dr. Odland is saying it this: to lower malpractice premiums, raise the bar to the bar, i.e. raise the price of failure to execute a successful malpractice claim.