Florida Hospital: NCH Healthcare to
allow physicians to be self-insured for malpractice
Medical Malpractice
Self/Insurance Plan
Florida Hospital Accepts Self Insured Plan
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By LIZ FREEMAN,
The NCH Healthcare System has adopted an exception to a long-standing policy that will allow physicians with hospital admitting privileges to become self-insured for malpractice purposes when they cannot secure coverage through an insurance carrier.
The decision was made Tuesday with "overwhelming support" of the 25 members of the NCH board of trustees, said Dr. Perry Gotsis, chief medical officer for NCH.
NCH policy requires physicians to carry a minimum of $250,000 in malpractice coverage. There are 500 physicians on the medical staff. The hospital system owns NCH Naples hospital near downtown and NCH North Collier hospital off Immokalee Road.
Allowing physicians to be exempt from the policy and be self-insured is necessary since doctors are starting to face hardships securing malpractice coverage, either because of skyrocketing premiums they can't afford or because they're getting hit with non-renewal notices from insurers.
The consequences are significant: They face closing their practices or quitting high-risk services to patients for fear of lawsuits if something goes awry.
| " Our goal is to Keep
everybody happy ."
Dr. Allen Weiss |
"The board of trustees ... recognized that while the majority of the physicians on the medical staff are able to obtain malpractice insurance coverage, some physicians are encountering significant difficulty in securing adequate malpractice insurance," the board said in a prepared statement Wednesday.
Physicians on the state's east coast for some time have faced the insurance hardships. Now the problem is taking hold in Southwest Florida and elsewhere around the state.
Details of the new NCH policy need to be worked out, but physicians will be required to petition the board of trustees, on an individual basis, for approval to be self-insured, Gotsis said.
To qualify, each physician will have to demonstrate "extraordinary hardship" in their inability to obtain insurance. Each decision will be made on a case-by-case basis.
The policy exception is temporary until a permanent solution is found within the industry, either through tort reform by the state Legislature or by voters passing a constitutional amendment that caps pain and suffering damages awarded by juries in malpractice trials. The Florida Medical Association (FMA) is working toward getting such an amendment on the 2004 ballot.
"Our goal is to keep everybody in practice," Dr. Allen Weiss, president of NCH's two hospitals, said of the policy decision.
The FMA and other medical organizations say the insurance problem stems from a lack of a cap on pain and suffering damages, which has caused companies to quit writing polices in the state or to drop physicians in high-risk specialties, such as in obstetrics and neurosurgery.
Trial attorneys say the culprit is investment losses that insurance companies are facing in the stock market. The attorneys say the companies are raising premiums or canceling high-risk physicians to compensate for the losses.
The local physicians will have to meet state criteria to become self-insured, which means securing a letter of credit, posting a bond or having an escrow account in the amount of $250,000 for each malpractice judgment, Gotsis said.
What will not be permitted is physicians "going bare," which means not having any malpractice coverage, he said.
Currently, NCH is aware that a handful of physicians are in a bind with retaining coverage and their expiration date is Aug. 1. The number could increase as more policies near expiration.
"Over time, if the (insurance) crisis doesn't resolve itself in one way or another, I suspect that number would increase," he said.
Dr. Howard Bourdages, a general surgeon who received a non-renewal notice and whose policy expires Aug. 1, said he was grateful to learn of NCH's decision. He is working to meet the self-insurance criteria.
"For my part, I'm really pleased," Bourdages said of NCH's decision. "The hospital has done a considerable amount of work on my behalf and on the behalf of the physicians. I am deeply appreciative."
The physicians will probably be required to submit their petitions in writing, which will be reviewed by representatives of the board's professionals capability committee. The committee includes physicians, Gotsis said.
"We anticipate the decisions would be made very quickly by the board because we understand the need of the physicians to have something in place," he said. "We are really doing this on behalf of the physicians. We want them to continue practicing medicine."
Gotsis said he didn't know how many other hospitals are allowing physicians to be self-insured, but said hospitals in Miami, Jacksonville, Orlando and Tampa are going in that direction. The Florida Hospital Association has not surveyed hospitals in the state on the issue
