[FLCRNA2B]

What is the average cost of CRNA malpractice?

[yoga crna]

Rates are determined on a state by state basis. Probably the average is around $6000 per year for $1/3 million coverage. It is a lot more than what you pay as an RN.
Yoga CRNA

[Pepino]

If the captain of the ship doctrine no longer applies to the supervision of anesthetists, why then the incongruity between md and crna liability insurance premiums? It appears insurance carriers still hold anesthesiologists accountable for all actions of the team relative to the premiums charged. (The difference in premiums cannot be attributed to safety since both providers produce equally safe outcomes.) I suspect it, at some level, reflects the increased exposure mds encounter relative to supervision of multiple concurrent anesthetics.

[yoga crna]

Pepino,
What incongruity are you discussing? If you have the information, please post the average malpractice premiums for physician anesthesiologists in the country,

I know many anesthesiologists who pay considerably less than I do. I have never had a claim in 44 years of practice, but that doesn't seem to matter with the insurers.

It is my personal opinion that many patients are reluctant to sue CRNAs because of the excellent anethesia care they give. I get gifts from my patients and they have their friends request me, because they get indidualized attention. Also many of the anesthesia mishaps that lead to lawsuits are because of lack of vigilance. CRNAs are noted for watching their patients carefully and monitoring closely and not being on the phone, computer or in the coffee room.

Peppino, it would be interesting to know a little bit about you. It is my sense that you are not a CRNA or prospective one. I would love to debate this topic with you. Are you up to it?

YogaCRNA

[yoga crna]

Pepino,
I went back and reread your post. One thing you forgot, the anesthesiologist who supervises 4 concurrent cases gets paid for each of those cases, except by Medicare where there are different rules. Just think four concurrent cases (non-Medicare) 100% pay x 4= a lot of money and someone else to do all of the work.

Thank God, the last anesthesiologist who was in my operating room was on the OR table and I was giving him an anesthetic. I don't need anyone telling me how to do anesthesia and if I want another pair of hands, I will gladly pay another CRNA to help me. It is a matter of economics, not safety.

Yoga CRNA (getting cranky over this medical direction stuff)

[deepz]

Originally Posted by Pepino

...why then the incongruity between md and crna liability insurance premiums? ....

One possible reason: National Practitioner Data Bank says MDAs are sued with 7 times the frequency of CRNAs.

deepz

[Gotosleepy]

deepz, the statement you are using about the national practitioner data bank is a gross distortion that was used by the AANA in 1998/1999. If you look at the national practitioner data bank reports (available at http://www.npdb-hipdb.com) you can see for yourself. The AANA reports that MDAs had 7x more suits than CRNAs over 7 years (3500 vs 425). However, this is incorrect since they lumped ALL physicians with anesthesia-related complications into that number of 3500 (which include anesthesia-related complications in offices performed by plastic surgeons, in ERs by ER docs, etc...). What further blurs those numbers is that the numbers represent numbers of reports that led to payments - and does not reflect the number of reports of suits brought agains MDAs vs CRNAs.

The incongruity between MDA and CRNA malpractice premiums, is that most states (due to very successful trial lawyer lobbyists) require a minimum coverage for physicians... While in some states physicians can choose to opt-out and go "bare", most states dictate a minimum of 5million dollars of coverage up to a minimum of 10million dollars of coverage (primarily to help with "tail" coverage - ie: you do a general anesthetic for a crashing c-section, you could technically be brought to court for medical complications of the child during the child's first 18 years of life - which some lawyers may pin on the anesthesia as well as the OB). So what has happened is that trial lawyers have become more and more successful at getting high damages and thus really hurting the insurance companies. Most have closed down, and there are very few medical malpractice companies left - and they can now dictate even higher premiums for high coverage. There are no such "requirement" laws for advanced practice nurses (yet...), and therefore, they are relatively cheaper to cover.

The average malpractice premium, depending on length of practice, number of suits in last 3/7 years, and type of practice (pain management adds more) is between $45,000 (primarily seen in states where tort-reform and caps have passed: ie: california) and $85-95,000 (florida for now).

the difference in insurance has absolutely nothing to do with responsibilities: because it doesn't matter if you cover 4 rooms vs 1 room. However, i would agree that the risk of being sued increases by the number of cases done per day.... but the insurance companies don't look at that when they decide premiums.

[deepz]

Originally Posted by Gotosleepy

......it doesn't matter if you cover 4 rooms vs 1 room. ...

I'd have to guess that you are a resident MDA, out trolling. Welcome to the CRNA BB. I'm personally familiar with the insurance requirements of several states and none that I know of have the 5 mill/10 mill figures you mention. 1 mill/3 mill is standard; no one wants to be the deep pocket. And of course CRNAs, CNMs, etc. *ARE* required to be covered, not just physicians; otherwise, realistically, no facility would allow us to practice.

Depending on the State, C-Section children can sue you up to age 21.

The numbers I refer to are current, not from '89, and as to a 'gross distortion,' well, your bias is showing, doctor.

deepz

[yoga crna]

It appears that this board is being invaded by someone who wants to take facts and distort them to their own advantage. It doesn't work that way and you better figure out a better way to argue.

I can't understand your point. What are you trying to prove? Are you saying that the reason why MDAs pay more for insurance premiums (not a necessarily true assumption) is because they have more responsibility. The way I see it, administering anesthesia requires the same responsibility no matter who does it. You should also realize that malpractice insurance rates quoted for CRNAs are primarily for those in private practice and not for employed anesthetists. Most employed anesthetists are covered by their employer and do not have individual policies.

At one point in my career, I sat at the table during negotiations with a malpractice insurer who was determing premiums for nurse anesthetist insurance. They use complicated actuary data and potential risk information to determine rates. Their formulas are complex and are state specific.

If you want to pay less in malpractice insurance premiums, consider becoming a CRNA instead of an MDA.

YOGA CRNA

[Pepino]

"I would love to debate this topic with you. Are you up to it?"

Admittedly, no.

Interesting though, assumptions are made regarding identities/backgrounds that are, (in my case), incorrect; I enjoy the anonymity this board affords its posters.

As well, a debate substantiated by anecdotal data gleaned from one's practice could probably be considered a "straw man" argument...certainly, though, it has its place in a discussion forum.