Monday, May 18, 2015

The Kiss of Death

Malpractice insurers look with suspicion on doctors who operate pain clinics or diet clinics or who perform botox injections or liposuction. My brother saved $12,000 on his premium when he gave up obstetrics – and that was twenty years ago. Doctors pay a fat surcharge if they engage in controversial practices, perform legitimate if risky procedures, or have personal difficulties such as an alcohol problem or numerous malpractice suits.

None of this applies to me. From a malpractice carrier's viewpoint, I’m easy money. I see perhaps one fifth as many patients as an office doctor. Being travelers, they’re younger and healthier than average. Even better, most are foreigners who don’t sue.

Except for writing large checks, I ignored this area until a letter arrived in 2003 from my malpractice carrier. It was a routine survey with questions about the nature of my practice: hours of operation, employees, office locations, number of patients, hospital affiliations, procedures.

I made certain they understood that I was a full-time housecall doctor who cared for a small number of healthy, unlitiginous patients.

A few weeks later the company cancelled my insurance. It was a big shock. When I applied to other carriers, all turned me down. I contacted an insurance agent who was very helpful and obtained a policy from a company in Illinois that specializes in difficult cases. It cost five times what I had been paying.

My record remains squeaky-clean, but each year when she applies to the regular carriers, they decline. They won’t insure a housecall doctor, she explains.

How does this affect my competitors? It doesn’t. They visit hotels as a sideline, usually from an office practice. If asked, none would deny that they make housecalls, but no carrier forbids them, and they’re so uncommon that applications for malpractice insurance don’t ask about them. .

Boasting that I am America’s only fulltime housecall doctor produces flattering feedback, but it was the kiss of death to tell my malpractice carrier. Perhaps they remember celebrities from Michael Jackson to Elvis Presley whose lurid deaths seem to include a doctor who made home visits.

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