"Rogue" Physicians and Liability Claims

The Claims Journal website recently had an interesting article talking about “rogue” physicians and their impact on medical liability insurance claims.

What is a rogue physician, you may ask? The article described a rogue physician as one who has problems doing things legally or ethically, or involving, more specifically, liability claims for criminal acts, disruptive behavior, sexual misconduct, and/or billing fraud, to name a few –so, not your usual liability claims. These are not claims related to an innocent or accidental error. This is a whole different kind of claim. A presentation by Linda E. Jones, executive vice president at RCM&D Healthcare, at the American Society for Healthcare Risk Management meeting this past November detailed these physicians and their behavior.

And, rogue physicians seem to be a growing problem. Many of these physicians seem to be repeat offenders, having many past liability claims. Jones said that she thinks communication with patients tends to be a problem for these physicians. I think it is much more than that. To be a repeated offender of the kind of offenses listed above, seems to indicate a physician who thinks he or she is above the law, or not to be held to the same standards as other physicians. Jones warns that these physicians may become the target of a class action lawsuit –if enough patients complain and/or are repeatedly offended.

The consumer advocacy group Public Citizen says that the many offenses by these physician are rarely handled well by any disciplinary body. The organization found that 55 percent of physicians who had their clinic privileges revoked had no state licensing action taken against them. The group wonders if state boards are responding properly to disciplinary reports from hospitals and if, as required by federal law, state medical boards are actually getting these reports. We wonder how these physicians feel about having to use their liability coverage so much.