The cost of disruptive and unprofessional behaviors in health care.

RATIONALE AND OBJECTIVES: In an era of decreased reimbursements and rising expenses, academic health care systems are seeking alternative sources of funding. We hypothesized that the costs associated with disruptive physician behavior represented a source of potential savings and hence a possible financial stream which could be redirected to support other academic activities. MATERIALS AND METHODS: To test this hypothesis, we reviewed costs associated with disruptive behavior in clinical and education settings and estimated their savings in academic health care systems. RESULTS: In a 400 bed hospital, the combined costs for disruptive physician behaviors (due to staff turnover, medication errors and procedural errors) exceed $1 million. CONCLUSIONS: Reducing disruptive physician behavior in academic health care systems is a potential funding stream with the added benefits of improved patient safety, reduced medical errors and improved medical student/resident education.

In today's uncertain financial environment, how difficult will it be for you to collect on your disability insurance policy?

Disability insurance companies are in tough spot. The down economy, lack of profitability from the sale of new policies, and significant increase in the number of physician claims filed over the past several years have resulted in financial chaos. Many disability insurance companies are vanishing or feeling pressure to release reserves just to stay afloat, and unfortunately this materially affects claimants in the manner in which their claims are administered.

Disabled doctors: the insurance industry seeks a second opinion.

This article focuses on disability in the professional work force, especially among physicians, and includes a background on private disability insurance in the United States, a discussion of problems experienced by the insurance industry over the past few years, a review of relevant case law on private disability, and legal and clinical issues involved in performing independent medical evaluations.

Increased physician disability claims causing 'crisis'. High utilization of disability insurance may leave physician groups fewer options in the future.

With physician claims on the rise, disability insurers are adjusting rates, provisions and benefit plans that are offered to those in the medical field. Physicians are being hit the hardest, experiencing premium increases, benefit reductions and stricter qualifications for coverage. There are only a few carriers who have not changed their rate structures and benefit plans. Now is the time to review the quality of your disability programs and establish how your carrier is reacting to this trend.

The value of liability in medical malpractice.

In this paper I estimate the strength of medical providers' incentive to avoid negligent medical care, taking account of the facts that many victims of medical malpractice do not file claims, many nonvictims do file claims, legal costs are high, and the legal system makes errors. Despite these problems, the negligence system creates a strong financial incentive for medical providers to avoid substandard care: The average cost of negligence is $135,000 per malpractice claim involving negligence and $3,500 per occurrence of negligent medical care. These substantial penalties suggest that if liability were abolished without adopting effective alternative sanctions for negligent medical care, the number and cost of medically caused injuries and deaths could rise sharply.