Four Emerging Medical Malpractice Risks
Risk Management
By: Bob Yergey, EVP | Senior Risk Advisor
Concierge medicine, telehealth, nurse practitioner and physician assistant practices, and off-label prescribing have fundamentally changed how many providers interact with patients.
These models can improve patient access, convenience, and outcomes, but they can also create professional liability exposures when providers move beyond their area of expertise or fail to follow established protocols.
As healthcare continues to evolve, understanding where these exposures exist has become increasingly important. Beyond increasing the likelihood of a claim, they can affect how insurers evaluate a practice, potentially influencing the availability, cost, and scope of medical malpractice coverage.
Because medical malpractice insurance is a specialized market, providers should work closely with experienced advisors who understand both emerging healthcare risks and how those risks may affect coverage. The following are four areas creating new professional liability challenges for healthcare providers today.
For example, an internal medicine physician provided chiropractic-style treatment for a patient’s chronic back pain over 18 months, rather than referring the patient to an orthopedic specialist. The delayed referral ultimately contributed to the patient's condition worsening and resulted in a professional liability claim for the provider.
Point of risk: Failing to recognize when a condition requires specialized evaluation or treatment can lead to delayed referrals, increased likelihood of worsening conditions, missed diagnoses, poor outcomes, and professional liability claims.
For this reason, many telehealth protocols require an initial in-person visit before ongoing virtual treatment begins. Establishing a baseline understanding of the patient can help providers make more informed treatment decisions and identify when an in-person evaluation is necessary.
Point of risk: Telehealth can also create regulatory challenges when patients move across state lines. While virtual care allows physicians to continue treating them, providers must ensure they remain properly licensed in the state where the patient is receiving care. Failing to do so can create both compliance and professional liability concerns.
For example, when a psychiatric patient receiving care via telehealth required emergency hospitalization, both the treating nurse practitioner and the collaborating physician were named in the resulting claim for negligence and not following protocol.
Point of risk: As collaborative care arrangements become more common, physicians must understand that accepting a supervisory role also means accepting additional liability exposure.
The growing use of GLP-1 medications for weight loss is one of the most visible examples. Many physicians assume that informed consent forms provide significant protection in these situations, but patients continue to file claims even after acknowledging potential risks and signing extensive disclosures.
Point of risk: Every time a physician prescribes an off-label medication, they take a risk. Even when consent forms are in place, physicians are still getting sued.
Consistency matters. In the event of a malpractice claim, attorneys often review similar patient files to determine whether care was delivered consistently. Providers who apply the same clinical standards, documentation practices, and follow-up procedures to every patient can generally make a stronger case for defending their decisions.
Finally, make sure medical malpractice coverage aligns with the services you provide. As practice models evolve, so will coverages, exclusions, and limits. Working with a broker who specializes in medical malpractice can help providers understand how changes in their practice affect coverage and identify coverage gaps before they become problems.
Contact us today to learn more about managing medical malpractice risk and ensuring your coverage aligns with your practice.
Concierge medicine, telehealth, nurse practitioner and physician assistant practices, and off-label prescribing have fundamentally changed how many providers interact with patients.
These models can improve patient access, convenience, and outcomes, but they can also create professional liability exposures when providers move beyond their area of expertise or fail to follow established protocols.
As healthcare continues to evolve, understanding where these exposures exist has become increasingly important. Beyond increasing the likelihood of a claim, they can affect how insurers evaluate a practice, potentially influencing the availability, cost, and scope of medical malpractice coverage.
Because medical malpractice insurance is a specialized market, providers should work closely with experienced advisors who understand both emerging healthcare risks and how those risks may affect coverage. The following are four areas creating new professional liability challenges for healthcare providers today.
1. Concierge Medicine
Because concierge physicians are privately retained by patients, they may be more inclined to manage conditions themselves rather than refer patients to a specialist. Problems can arise when a patient’s needs exceed the physician’s training or expertise.For example, an internal medicine physician provided chiropractic-style treatment for a patient’s chronic back pain over 18 months, rather than referring the patient to an orthopedic specialist. The delayed referral ultimately contributed to the patient's condition worsening and resulted in a professional liability claim for the provider.
Point of risk: Failing to recognize when a condition requires specialized evaluation or treatment can lead to delayed referrals, increased likelihood of worsening conditions, missed diagnoses, poor outcomes, and professional liability claims.
2. Telehealth
Telehealth has expanded access to care, particularly for routine conditions that are easily treated without testing. However, the absence of regular in-person examinations can make it easier to miss both related and non-related symptoms that could be detected during an office visit.For this reason, many telehealth protocols require an initial in-person visit before ongoing virtual treatment begins. Establishing a baseline understanding of the patient can help providers make more informed treatment decisions and identify when an in-person evaluation is necessary.
Point of risk: Telehealth can also create regulatory challenges when patients move across state lines. While virtual care allows physicians to continue treating them, providers must ensure they remain properly licensed in the state where the patient is receiving care. Failing to do so can create both compliance and professional liability concerns.
3. Independent Nurse Practitioner and Physician Assistant Practices
When physicians agree to serve as collaborating providers for nurse practitioners and physician assistants, they are also ensuring appropriate oversight and adherence to established protocols. Their license depends on it. When supervising physicians are not on site regularly, and have limited visibility into day-to-day patient interactions for the independents they oversee, they can be named in a claim even if they never directly treated the patient.For example, when a psychiatric patient receiving care via telehealth required emergency hospitalization, both the treating nurse practitioner and the collaborating physician were named in the resulting claim for negligence and not following protocol.
Point of risk: As collaborative care arrangements become more common, physicians must understand that accepting a supervisory role also means accepting additional liability exposure.
4. Off-Label Prescribing
Off-label prescribing is common and often medically appropriate. However, when providers move beyond FDA-approved indications, they may face greater scrutiny when patients experience adverse outcomes.The growing use of GLP-1 medications for weight loss is one of the most visible examples. Many physicians assume that informed consent forms provide significant protection in these situations, but patients continue to file claims even after acknowledging potential risks and signing extensive disclosures.
Point of risk: Every time a physician prescribes an off-label medication, they take a risk. Even when consent forms are in place, physicians are still getting sued.
Managing Malpractice Risk
The common theme across these exposures is that liability increases when providers move beyond established protocols, responsibilities, or areas of expertise. Following established standards of care remains one of the most effective ways to manage medical malpractice risk.Consistency matters. In the event of a malpractice claim, attorneys often review similar patient files to determine whether care was delivered consistently. Providers who apply the same clinical standards, documentation practices, and follow-up procedures to every patient can generally make a stronger case for defending their decisions.
Finally, make sure medical malpractice coverage aligns with the services you provide. As practice models evolve, so will coverages, exclusions, and limits. Working with a broker who specializes in medical malpractice can help providers understand how changes in their practice affect coverage and identify coverage gaps before they become problems.
Contact us today to learn more about managing medical malpractice risk and ensuring your coverage aligns with your practice.