Do physician assistants get sued?
Of course, they do, but based on seventeen years of data from the National Practitioner Data Bank, nationwide physician assistant malpractice demonstrates lower malpractice incidence and average payment amounts compared to MDs and advance practice nurses!
Can I get a Whoot Whoot for PAs!
PA Malpractice Incidence
There is one malpractice payment for every 32.5 PAs while there was one for every 2.7 physicians. That is, the composite payment rate for physicians was twelve times that of PAs over the full study period.
Average Malpractice Payment Amount
PA average and median payments for malpractice lawsuits were less than that of physicians and advanced practice nurses (APNs).
- The average and median APN payments were the highest at $350,540 and $190,898.
- The average and median physician payments were $301,150 and $150,821
- The average and median PA payments were $173,128 and $80,003.
The physician adjusted mean payment was 1.74 times higher than PAs but only 0.86 that of APNs. The physician adjusted median payments were 1.89 times that of PAs but only 0.79 that of APNs.
Why are advanced practice nurse malpractice rates higher? Are they reckless practitioners?
It is speculated that advanced practice nurse median payments are higher than that of physicians and PAs because the proportion of APNs who work in the high-risk specialties of anesthesia and obstetrics is higher.
The proportion of malpractice payments for nurse anesthetists (47%) and nurse midwives (25%) was 72% of total APN payments.
Reasons for Disciplinary Action
The most common reason for disciplinary action by state and federal monitoring bodies was the same for all three provider types.
The most common disciplinary action was a licensing action (suspension or termination of license) by licensing authorities and the most common reasons for the licensing action were for unethical conduct and alcohol/substance abuse.
Top Reasons for PA Malpractice Claims
The most common reasons for Advanced Practice Nurse malpractice claims were for obstetric and anesthesia errors. This is due to the disproportionate number of APNs who practice in these specialties compared to physicians and PAs.
If these are excluded, the top-ranking reasons for malpractice payments were the same for PAs and APNs. In order, they are:
- Errors in diagnosis
- Errors in treatment
- Medication errors
- Surgical errors
For physicians, they were in order errors in diagnosis, surgery, treatment, obstetrics, and medication.
What can PAs can do to avoid medical malpractice?
The following is an excerpt from the book Becoming A Physician Assistant by Jody Tomic PA-C. Download it for free on Kindle Unlimited:
How PAs Can Avoid Malpractice
Many lawsuits against PAs and their supervising physicians cite the failure of the PA to contact the physician.
The PA may fail to recognize the significance of a finding on the history and physical examination and not see the need for contact. Comprehensive protocols, as well as ongoing education, can help minimize this risk.
A physician assistant may be apprehensive about disturbing their supervising physician with frequent questions. Both the supervising physician and the PA must cultivate a collaborative relationship, so the PA feels comfortable asking any questions necessary to provide excellent patient care and safety.
The PA should always have reliable contact information for the supervising physician.
A preceptor of mine told me about a PA who was monitoring a man hospitalized with the flu. The man complained that he was having trouble breathing, and the PA was afraid to bother her supervising physician at home. It turned out that the man had developed Guillain-Barre Syndrome. GBS often follows a minor illness, such as a lung infection or gastrointestinal infection. Most of the time, signs of the infection have disappeared before the symptoms of GBS begin. It can result in ascending paralysis that may affect the diaphragm, requiring breathing assistance. The patient died, and the PA and physician were sued.
Obviously, the physician should encourage communication from his/her PA because he is liable for their errors. The PA should realize that he or she can also be sued. So, even if the doctor is testy about being called, do it anyway.
If communication with your supervising physician is bad, you should take steps to remedy the situation, including finding a new job. Patients’ lives depend on your communication and teamwork.
Most of the time, doctors cover iPAs under their malpractice insurance. You should definitely have a dialogue to confirm this.
The question also arises whether mid-level practitioners should obtain their own malpractice insurance. When the employer is your only insurer, your best interest may not be your employer's best interest.
With personal malpractice coverage, you have an attorney who represents you, not your employer. Some basic types of malpractice insurance are “Claims Made” and “Occurrence.”
Claims Made insurance covers you for incidents that occur during the term of the insurance, only if they are reported during the coverage period. Occurrence coverage covers you for incidents that occur during the coverage period, regardless of when they are reported. So if a patient sues you one year after the incident occurred and your Claims Made policy has lapsed, you will not be covered. You might want to discuss this with your employer. It’s a good idea to take some continuing education courses on risk management.
Good documentation, excellent communication, and detailed protocols for emergency situations are all important ways to avoid exposure.
Finally, if you feel uncomfortable performing a procedure or prescribing a medication, listen to your intuition and get help. If you aren’t sure about anything, ask. The only stupid question is the one that isn’t asked.
How to Get More Information on PA Malpractice Insurance
I often receive emails from PA school graduates and practicing PAs regarding malpractice insurance and supplemental coverage.
Personally, I have never purchased additional coverage above that provided by my employer. But there are times where you may need to purchase your own plan, or you may want to speak with someone to see if the coverage you have is enough.
The AAPA has a resource page and has partnered with an insurance vendor. This may be an excellent place to start.
At a minimum, make sure you have a hard copy of your insurance policy, understand your coverage levels, and keep this copy in a safe place. If you have been at an institution for a while, call HR or speak with the office manager and make sure your policy is active and up-to-date. I worked for a year without coverage once and had no idea!
Take-home point: Don't rely on office managers to protect your future and that of your loved ones!
- Expert pages: Physician Assistant Malpractice History