Be Aware of Potential Liability Exposure from Practice Clinicians

Fully licensed physicians are not the only medical professionals offering healthcare to a growing patient pool.

Indeed, it would be unrealistic to expect all medical institutions to pay for physicians to fill every position in a hospital or clinic.

This is one of many factors that necessitates the use of advanced practice clinicians (APCs), whose combined medical expertise provides value to medical institutions and their patients at a lower cost. While APCs, including nurse practitioners (NPs) and physician assistants (PAs), offer skilled work in a variety of settings, they are also prone to increasing risk for both supervising physicians and institutions.

This risk highlights the need for liability insurance for all members of a medical team, including APCs. But why does the risk exist in the first place?

Laws and Regulations

Every state in America has a different approach to laws and regulations surrounding what APCs can and can’t do. The legal scope of an APC’s duties can alter, as in any other regulated profession, depending on even minor legislative tweaks.

Furthermore, the interpretation of laws can vary depending on whom you ask.

For instance, a regulation that uses the phrase “in collaboration with a supervising physician” may, in practice, mean “under the supervision of a supervising physician.” In half of the 42 states that allow NPs to prescribe medications, those NPs must do so under the supervision of a licensed physician. But this regulation may not be fully understood or adhered to and can be interpreted in a variety of different ways.

Healthcare entities failing to utilize the skills of APCs within the scope of these oftentimes opaque legal definitions can open them up to litigation. This litigation doesn’t just extend to the APCs themselves; it often targets the supervising physician in charge of the APC and the entity for which he or she works.

Understanding Liability Concerns

Between 1991 and 2007, APCs were 12 times less likely than physicians to be the target of malpractice litigation, which APC advocates cite as a reason for their continued and increased employment. Even so, the fact remains that a mistake by an APC could leave supervising physicians and healthcare entities liable.

As the scope of an APC’s practice expands, so too does the risk that the APC might incur. In some states, APCs are now allowed to assist in major surgery, conduct a minor surgery, diagnose patients and prescribe medications. Over the past 10 years, the number of APCs endowed with these responsibilities has also increased.

While the support of APCs has been invaluable for many healthcare entities, it cannot rid the profession of malpractice suits. The fact that more APCs are involved in major medical procedures means that preparing for potential liability issues is more important than ever for all parties involved.

How to Mitigate Risk

First and foremost, insurance coverage is vital to the risk mitigation effort. But coverage of select members of the medical team may not be enough. It is true that supervising physicians and healthcare entities bear the brunt of malpractice suits even if the care in question was administered by an APC. Allegations can range from “failure to accurately diagnose” to “failure to follow collaborative or standard of care arrangements,” but it is the higher-ups that receive the most blame.

That is not to say, however, that APCs are never the target of litigation. In some (usually rural) areas in the United States, APCs represent the only medical professional available within a reasonable distance, meaning that the right coverage is essential even for APCs.

It is also important to remember that not all insurance carriers are the same. APCs, physicians and healthcare entities should seek out those carriers with extensive knowledge of liability exposures in healthcare.

Healthcare entities failing to utilize the skills of advanced practice clinicians within the scope of oftentimes opaque legal definitions can open them up to litigation.

Among other things, the insurance carrier should understand the complexities of state law, especially when it comes to the scope of an APC’s practice. All APCs on a healthcare entity’s insurance coverage should be listed. General insurance carriers may not fully comprehend these complexities, leading to gaps in liability coverage.

Knowledgeable insurance brokers can help find the robust coverage required to stave off risk. Instituting quality compliance practices can also help avoid risk.

Conclusion

While APCs unquestionably provide value from a medical perspective, one must not lose sight of the legal risks that may be lurking in the background. Errors in the medical field are natural, but as the stakes of those errors become increasingly higher for APCs, it is important to have the right coverage to protect them and the other members of their medical team from risk. The best way to obtain that coverage is to find an insurance carrier (usually through a knowledgeable broker) that specializes in liability exposure.

Topics Lawsuits Legislation Medical Professional Liability