Malpractice Insurance for Surgeons

The most notable trend in general surgery today is the shift to high-tech, expensive, minimally invasive surgery, including laparoscopic surgeries and, more recently, robotic-assisted surgeries. Robotic-assisted surgeries may offer a solution to concerns that laparoscopic surgeries, while beneficial to patients, cause physician pain and may shorten the career spans of surgeons due to repetitive-stress injuries like carpal tunnel syndrome. However, robotic procedures are in their nascent years and the small body of research on these surgeries must be expanded before conclusions can be drawn as to their cost effectiveness and benefit to patients.

Because general surgery is considered a high-risk specialty, as are all surgical specialties, general surgeons must pay comparatively high premiums for medical malpractice insurance. (Anecdotally, one general surgeon reports borrowing $73,000 a year to pay for malpractice insurance.) The American Society of General Surgeons, a medical society for general surgeons, opposed President Obama’s healthcare reform plan partly on the grounds that it did not include sweeping reforms of the medical liability system.

Largely as a result of the changes in the medical malpractice climate for general surgeons, practitioners of the specialty are rapidly disappearing. According to an article in the publication General Surgery News, there were 26-percent fewer general surgeons per 100,000 people in the U.S. in 2008 then there were in 1978. An American Medical Association survey highlights the particular effects of the pressure on general surgeons. Over 80 percent of general surgeons said they “would not encourage children or their own children to go into medicine,” and 67 percent would not go into medicine themselves if they could choose again. Across all specialties, only 64 percent and 52 percent, respectively, of doctors gave these responses. After completing surgical residencies, many more doctors are choosing to undertake further training in a subspecialty rather than practice general surgery. Further compounding the problem of the loss of general surgeons, some studies suggest that older doctors are more willing to work long and inconvenient hours than their younger counterparts, indicating that it will take more than one new general surgeon to compensate for the work that was being done by a single retiring surgeon.

This trend toward a general surgeon shortage has serious implications. The general surgeon is one of the most important parts of the team of doctors that is responsible for patient care. In rural areas, the loss of a single general surgeon can shut down an entire small- to medium-sized hospital. In order to reverse the trend, general surgeons should support the efforts of their medical societies to advance the cause of medical liability reform. Without a change in the malpractice climate, a shortage in general surgeons will pose a significant threat to the healthcare system, particularly in rural areas.

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Important Resources for Surgeons

Surgery: MedlinePlus
The International Museum of Surgical Science
American Osteopathic Board of Surgery
The American Journal of Surgery
Surgery On Sunday
General Surgery Articles
WHO: Safe Surgery Saves Lives