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Mid-Level Provider Risk for Medical Malpractice

A recently published article in the August 21, 2015 The Standard, an insurance industry magazine, addresses areas of concern regarding medical malpractice claims for mid-level providers, including physician assistants, nurse practitioners, certified nurse midwives and certified nurse anesthetists.

According to Coverys, a Massachusetts Medical Professional Liability insurance company, risk for claims is ranked from highest to lowest related to the following:

  1. Diagnosis
  2. Obstetrics
  3. Medication
  4. Medical treatment
  5. Anesthesia
  6. Surgery
Diagnosis-related concerns lead the list of claims filed, the majority of which in the last five years have been cancer-related. A breakdown in any one of the following processes could lead to a problematic outcome:
  • Initial evaluation of the patient – history & physical
  • Ordering appropriate diagnostic tests
  • Patient follow-up
  • Receipt & transmittal of test results
  • Appropriate referral management
Suggested steps to take to reduce mid-level provider claims:
  • Have proctor requirements in place to supply training for functions once exclusively performed by physicians.
  • Establish guidelines to help mid-level providers through complex diagnostic scenarios.
  • Be sure mid-level providers receive adequate training, including simulation training, to deliver a high level of technical performance.
  • Ensure the ratio of physician to mid-level provider is within acceptable limits.

Pro-active management steps such as these will help offset the risk associated with mid-level providers assuming much of the physicians’ functions.

For more information on professional liability programs for medical practices, go to www.piam.com or www.mmsinsurance.com or call 800-522-7426.

Sourcenote: The Standard, August 21, 2015 issue, author Robert Hanscom, VP of Business Analytics at Coverys.


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