The PA vs MD section of our site is not intended to cover debates; rather the “vs” in the title is meant to describe the issues that crop up when a student tries to decide between the two professions. Today, however, debate at least enters into it. I’m talking about physician assistant malpractice. Better you should go into this field knowing the reality.
Do PAs Get Sued?
It’s a common misconception that “PAs don’t get sued because they are the physician’s responsibility.” Actually, there are three facts of medicine and law that govern who will be sued:
- PAs, though supervised by physicians, can and do make errors for which their supervising physicians are not responsible. This happens when the PA consults with the physician who provides adequate supervision, but the PA then fails to carry it out properly or at all.
- In America, you can be sued for anything. If I want to, I can sue you, dear reader, for causing me emotional trauma because you did not comment positively on my amazing post on what to ask when you shadow a PA. That doesn’t mean the suit will actually go anywhere, but I can still give it a whirl if I want to waste my money on legal fees.
- When a patient is damaged medically, they usually sue anyone and everyone who could possibly have had anything to do with it. It ain’t pretty, but it’s reality.
Do PAs Need Malpractice Insurance?
Yes, they do. Depending on where you work, some or all of your insurance may be picked up by your employer. A quick check with the AAPA’s preferred medical liability insurance carrier (CM&F Group, Inc.) shows the approximate cost for PA medical liability (malpractice) insurance is between $2,000 and 6,000 per year. Seems like a lot, doesn’t it? But in this PA vs MD question, PAs definitely count themselves lucky. A quick check of similar liability coverage rates for physicians turns up an astounding $11,000-$55,000 per year (2009, most recent data). As you might expect, the rates are dependent on a number of factors, the biggest of which is the practitioner’s specialty. The highest rates are for PAs and MDs who are involved in either surgery or obstetrics (The moral here is that dropping babies is costly).
But here’s what everyone really wants to know…
Are PAs More “Dangerous” than Doctors or Nurse Practitioners?
As usual, I’m inviting a PA vs MD flame war here, but I think facts should outweigh opinions. First it really depends how you define the question, so I’ll be a little more specific: are PAs responsible for more malpractice suits and bigger malpractice judgments than MDs or APNs? (Recall that an APN is an Advanced Practice Nurse, which includes nurse practitioners). According to at least one study of 17 years of malpractice data, the answer is no. PAs are no more “dangerous” than MDs and APNs. To quote the abstract:
a) the overall incidence and ratio of malpractice claims per provider was no greater for PAs and APNs than for physicians over a 17 year period; b) the average and median malpractice payments of PAs were less than that of physicians while that of APNs were greater; c) the trend in median payment increases was less for PAs than physicians and APNs, and higher for APNs than physicians; d) PAs did not negate their cost effectiveness through the costs of malpractice; e) the rate of malpractice incidence increased for PAs and APNs over the study period but remained steady for physicians, but was consistent with the change in numbers of active providers; and f) the reasons for disciplinary actions against PAs were similar to that of physicians and APNs.
Evaluating the PA vs MD malpractice question, we need to ask, “Do PAs make honest mistakes?” Of course. “Do PAs do dumb, negligent things to their patients?” Sure, some do, just as some doctors do dumb negligent things to theirs. Thankfully, it seems that PAs don’t do these things more often, or worse (value of damages) than members of similar professions. According to the AAPA, “As more patients, their friends, and malpractice lawyers become aware of PAs, they see a potential malpractice target if they believe they’ve received a poor standard of care.” Thankfully, so far as we can tell, the truth is PAs hold their own.