When a medical-malpractice lawsuit hits a hospital, clinic orprivate practice, the facility and the physician are not the onlyones at risk. Physician assistants and other “physician extenders”can be targeted alongside a physician or facility when suits arefiled.

What's more, the U.S. Department of Labor estimates that thenumber of physician assistants will grow 39 percent by 2018.According to the American Academy of Physician Assistants (AAPA),as patients and lawyers realize the prominent role that physicianassistants have in patient care, physician assistants are atincreasing risk of being targeted in medical-malpracticelawsuits.

When there are medical-malpractice settlements or rewards, theaverage indemnity payment for physician extenders, a category thatincludes physician assistants and nurse practitioners, was$174,871. This is higher than the average indemnity amount thatphysicians paid, according to the Physician Insurers Association ofAmerica.

Given these trends, it is increasingly important that physicianassistants are aware of their exposure to medical-malpracticelawsuits and have adequate professional-liability insurancecoverage. Although physician assistants may think they are coveredby employer-provided coverage in a lawsuit, these policies oftenfall short of protecting them and their assets.

The Limits of Employer Policies

Under employer-provided coverage, physician assistants oftenshare limits with the physician and all other healthcareproviders—all of whom may be named along with a hospital or privatepractice in a medical-malpractice lawsuit. Although physicianassistants are dependent practitioners and may be covered undertheir employer's policy, they still have personal risk fornegligence attributed to them in a malpractice lawsuit and all orpart of a plaintiff's award or settlement. Unfortunately, theirinterests may not be a high priority when the healthcare facilitylooks at how to defend itself and negotiate a settlement.

In addition, many large hospitals and medical facilities have alarge self-insured retention or deductible in their insuranceprogram, which means the facility is responsible for paying thefirst claims dollars—often $1 million or more—of a loss. Thisstructure gives a facility even more incentive to settle a claim ata lower cost regardless of an employee's individual culpability andthe impact the losses may have on their career. In fact, if anemployer chooses to settle, physician assistants may have topartially or fully compensate them for all or part of a settlement,and may be held liable for all or part of a claimant's award.

Another factor to consider is that it is common for physicianassistants to practice in more than one facility, change employers,or give advice outside the office (i.e., on the soccer field or atsummer camp). If a claim is filed in any of these situations, anemployer policy may not be portable (a portable policy would allowcoverage to be continued with the same terms and conditions whenthe insured changes employers, works in multiple facilities or aclaim is made after he/she has left the job). Moreover, considerthat when medical facilities consolidate or close, their insuranceprograms may be altered or be discontinued. These incidents leavegaps in a physician assistant's insurance plan.

Another gap that can occur for physicianassistants is when there is a license complaint—a disciplinaryaction that goes before state licensing boards—not just amalpractice lawsuit. Employer coverage rarely includes coverage fordefense of a license complaint.

Finally, consider that when third-party administrators arehandling claims involving multiple healthcare providers, they maynot communicate with a physician assistant or involve them inclaims handling as they do with the medical facility or thephysicians. This can leave a physician assistant in the dark,without a “seat at the table”—and without their interests beingprotected.

Advantages of A Personal Policy

Physician assistants are better served when they have their ownpersonal policy and insurance partner to advocate for their bestinterests in and out of court. With personal medical-malpracticeinsurance, physician assistants can get this personal advocate,tailoring a policy to suit their needs and hiring individualattorneys when needed.

As individual practitioners, physician assistants need aninsurance partner who will keep them involved throughout the courtprocess to best defend themselves. An involved insurance partnerwill help with pre-suit discovery, medical review panels,depositions, mediations and arbitrations, and the disposition. Theywill also be available to help with questions or concerns of claimissues that arise, such as records requests or attorneysinquiries.

In a personal insurance plan, physician assistants can ensurethat their defense costs are covered in a license complaint, thatthey have portable coverage that follows them to multiple locationswith a consistent level and format, and that they have directaccess to risk-management tools that can help prevent claims beforethey happen—helping them to avoid the courtroom altogether.

For example, risk-management resources can educate them abouthow to run a successful practice and how to avoid claims ofmalpractice, such as tips to successfully manage a medical record,guidance to follow state regulations of healthcare facilities,access to safety manuals and practice checklists.

Before finding themselves in the midst of a claim with onlyemployer-provided coverage, physician assistants should ask thiscentral question: If a claim arises that names me, a physician andmy facility, whose interests would my facility's attorney putfirst?

A personal policy can answer that question.