Feature Medical Litigation

Are soaring US malpractice rates just a memory now?

BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h394 (Published 27 January 2015) Cite this as: BMJ 2015;350:h394
  1. Leigh Page, freelance writer, Chicago, Illinois, USA
  1. leighpage{at}comcast.net

Having faced record numbers of lawsuits and soaring insurance premiums at the start of the century, US doctors have now seen a decade of relative calm. Leigh Page reports on why Americans sue their doctors in peaks and troughs and when the next peak might come

From 2000 to 2003, US physicians saw massive increases in their malpractice insurance premiums. Rates doubled in some cases. For neurosurgeons, premiums started topping $300 000 (£198 000; €258 000) a year—equal to the price of a new house.

Some doctors had to take out loans to pay their premiums. Many took to the streets, demonstrating for malpractice reform in state capitals. Some even participated in work stoppages.

Twelve years later, those anxious times are a distant memory for most US doctors. Except in certain areas, such as New York, premiums have generally been dropping since 2005, and malpractice insurance seems to be in the middle of the longest period of relatively stable or lowering rates in recent history. Have we entered a new era, in which premiums stay low and prices fluctuate very little?

This seems to be the case, according to Rob Francis, chief operating officer of The Doctors Company, a doctor owned malpractice carrier in Napa, Calif. Francis reported that the number of lawsuits handled by his company has fallen 40% since the crisis, and premiums have dropped similarly. He asserted that current prices have become “the new baseline,” meaning that premiums would stay around the current level, rather than jumping back to higher levels from the past.

The insurance market runs in cycles, so the current “soft market” characterised by low premiums would have to end, Francis said, but he doesn’t think it will happen for at least three more years. “We are probably into the middle of the soft market, or maybe past …

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