Tort crisis gamble: Physicians weigh odds of going bare

A tactic first implemented nearly 20 years ago is getting a second look.

By Tanya Albert, AMNews staff. April 5, 2004.

Berwyn, Ill. -- Along a stretch of 1950s-style brick buildings in west suburban Chicago, a bright white banner with "Patients First" in bold red lettering catches the eye. The solo physician's motto: "Fees so reasonable you don't need insurance."

And neither does the doctor running the 6-month-old family practice.

Family physician Mark Macumber, MD, gave up his medical liability insurance last year after realizing he would need to shell out $40,000 to continue seeing patients at a city health clinic, a service he did in addition to his full-time employed position.

"I'm not advocating everyone should do it, but it is drawing attention to a problem," Dr. Macumber said. "As long as we keep paying the premiums, companies will keep charging them."

"Going bare" is not an option for every physician, but an increasing number are considering it, despite some obstacles.

At least 13 states require physicians to carry liability insurance in order to keep their medical license or to qualify for state liability reforms such as caps, according to the American Medical Association and state medical societies.

Also, hospitals often require that minimum levels of insurance be held by physicians on their medical staffs, and health plans typically require insurance of their panel members.

AMA policy allows each hospital medical staff to determine for itself whether it will require liability coverage for member physicians.

And some Florida physicians, particularly those in high-risk specialties, have gone bare since the last liability crisis in that state nearly two decades ago. Now as rates there once again skyrocket, family physicians and internists are joining the ranks of those gone bare.