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 thirty years ago. Doctors pay a fat surcharge if they engage in controversial practices, perform legitimate if risky procedures, or have personal difficulties such as numerous malpractice suits.

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

Except writing for a large check every year, 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, nonlitigious patients.

A few weeks later I opened a certified letter cancelling my insurance. It was a terrible 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 three times what I had been paying.

Each year when she applied to the regular malpractice carriers, they declined. They won’t insure a housecall doctor, she explained.

How did this affect my competitors? It didn’t. They cared for 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 was America’s only fulltime housecall doctor produced flattering feedback but got me the kiss of death from my malpractice carrier. Perhaps they remember celebrities from Michael Jackson to Elvis Presley whose lurid final moments involved a doctor who made home visits.