Understanding Oncologist Malpractice Insurance
Oncologists are sued infrequently by their patients, so the specialty is considered to be low-risk by medical malpractice insurance companies. This may be because oncologists treat patients who have terminal diseases and are resigned to negative outcomes, unlikely to allege physician wrongdoing in the case of an undesirable result. Conversely, in high-risk specialties, like plastic surgery, patients have high expectations and are not accepting of negative outcomes. Whatever the cause of this relative rarity of lawsuits, it results in lower premiums for oncologists. Premiums vary widely based on the location of practice and the specific therapies and procedures performed. Oncologists practicing in states with hostile legal climates, like Florida, pay the most, while premiums are significantly lower in states that are less litigious, like Texas.
Surgical oncology is a surgical concentration, focusing on the surgical treatment of cancer. Whether or not surgical oncology meets the criteria of a subset medical specialty is an area of debate, as many argue that one surgeon cannot be proficient in treating all forms of cancer. Surgical oncology is distinct from oncology, which is recognized as an internal medicine specialty and is divided into subspecialties like radiation oncology, surgical oncology, medical oncology, interventional oncology, gynecologic oncology and pediatric oncology.
Though oncologists are sued less frequently than physicians in other specialties, the number of claims is not insignificant and findings of indemnity can reach very high-dollar amounts. In order to minimize the likelihood of a lawsuit, oncologists should become familiar with areas of practice that present increased exposure to risk. Many lawsuits filed against oncologists are caused by delayed diagnosis of cancer, and oncologists should be particularly careful not to miss second malignancies in patients who are cancer survivors. Suits against oncologist are also common in the areas of chemotherapy dosing, pain control, informed consent, protection of privacy and communication breakdown.
In general practice, and especially in the areas outlined above, oncologists should employ careful risk management. Effective risk management techniques can greatly reduce the likelihood that a lawsuit will occur, and make a victory in court more likely if a suit is unavoidable. First, and perhaps most important, is communication with patients. Patients who sue their doctors often list as a reason for their suit that the physician was uninterested or lacked empathy during the treatment process. Physicians should work to avoid this situation by establishing personal, positive relationships with each patient.
Good documentation is also vital to managing risk. This means keeping a thorough, organized record of each interaction with a patient, including office visits and phone calls or messages. If there is a lawsuit, never alter a patient record after the fact –this constitutes fraud and will result in a finding of indemnity. Other risk management techniques include establishing a system for tracking follow-ups, working as part of a physician team, seeking second opinions and learning the value of apology in medicine.
Though medical liability insurance premiums for oncologists are not at the high end of the range, they are still a significant practice expense. Those oncologists who are concerned about the rising cost of malpractice insurance should become involved in advocacy for tort reform by working with medical societies and other groups to lobby state and federal representatives.
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Important Resources for Oncologists
Oncology Nursing Society
American Society of Clinical Oncology
Radiation Oncology (journal)
Cancer News and Oncology News from Medical News Today
Children’s Oncology Group
American Society for Radiation Oncology