Special Edition – Let’s Cover That – AAPA Micro Session w/ Randy Danielsen on PA malpractice claims

Introduction

Randy Danielsen recently spoke at the AAPA conference in Nashville, focusing on the topic of malpractice claims involving Physician Assistants (PAs). The presentation aimed to educate PAs on the intricacies of malpractice, negligence, and the standard of care, using real-world examples to illustrate key points. This blog post will summarize the key takeaways from the presentation, including the importance of liability insurance for PAs.

What is Malpractice?

Danielsen clarified that malpractice is essentially negligence on the part of a clinician. With the increasing role of PAs in healthcare, they are becoming more susceptible to malpractice suits. Malpractice occurs when a PA fails to meet the standard of care, causing harm to a patient. In such cases, a lawsuit may be filed to recover damages.

The Healthcare Quality Improvement Act

According to the Healthcare Quality Improvement Act of 1986, all malpractice payments must be reported to the National Practitioner Database. Danielsen cited research showing that PAs were defendants in 26 claims without the involvement of physicians or nurse practitioners. The most common areas where PAs are sued include lack of adequate supervision, untimely referral, failure to diagnose, and inadequate examination.

Elements of Negligence

To win a negligence case against a PA, a patient must prove three elements:

1. The PA owed the patient a duty of care.
2. The PA breached that duty.
3. The patient was harmed as a result of the PA’s actions or failure to act.

Case Studies

Case 1: Dermatology Practice

A 76-year-old female with an itchy rash was misdiagnosed, leading to her death from Stevens-Johnson syndrome. The PA, dermatologist, and primary care physician were all sued. The court found the PA not liable, emphasizing the complexity of diagnosing such conditions.

Case 2: Family Medicine Clinic

A 51-year-old male suffered from tendon lacerations after a sheet of glass fell on his foot. The ER doctor and the PA in the family medicine clinic were sued for missing the diagnosis. The PA was found to have met the standard of care during the follow-up appointment, as she had no reason to suspect tendon damage requiring urgent referral to an orthopedist. After years of discovery and expert witnesses, the PA was dropped from the case, although the experience of being sued was still stressful.

Liability Insurance: Occurrence-Based vs. Claims-Made

Danielsen also discussed the importance of liability insurance for PAs. There are two main types:

1. Occurrence-Based: Covers you for any malpractice case filed during the time you worked for a company, even if you’ve left the company.

2. Claims-Made: Only covers you during the time you work for the company. If you leave, you’ll need “tail coverage,” which can be expensive.

When to Get Tail Insurance

If you have occurrence-based insurance, you don’t need tail insurance. If you have claims-made insurance, you should get tail insurance just before leaving the practice to cover you further on. The cost of tail insurance can be substantial, so it’s something to consider when choosing between occurrence-based and claims-made insurance.

Asset Protection and Additional Coverage

Danielsen advised PAs to consider getting their own insurance in addition to what their employer provides. This ensures that you have your own advocate in case of a lawsuit. He also recommended consulting with financial advisors and attorneys for asset protection strategies, such as putting your home in a trust.

Conclusion

Danielsen’s presentation at the AAPA conference serves as a crucial reminder for PAs to be vigilant in their practice. Understanding the legal landscape and the elements that constitute negligence can go a long way in safeguarding against malpractice claims. Additionally, having the right type of liability insurance is essential for financial protection. As the role of PAs in healthcare continues to e