private practice residency?

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eggscal99

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does anyone here have experience as a PP / 1099 / carry your own malpractice group trying to establish an anesthesia residency program? how would the malpractice aspect change going forward? From the academic places I've worked in the past, the academic attending malpractice is always covered by the hospital, so if patients sue, they're suing the hospital, not the individual attending. I certainly wouldn't feel comfortable carrying own malpractice and cover a$$ for residents... who might knock off a tooth... and then I bear the sole legal/financial responsibility, and it goes on my malpractice record for the rest of my career?! would you have to have a W2 / hospital employee setup in order to establish a residency program?
thanks for wisdom in advance.

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From the academic places I've worked in the past, the academic attending malpractice is always covered by the hospital, so if patients sue, they're suing the hospital, not the individual attending.
What you say is true only in the VA/federal system and (some) state university hospitals with sovereign immunity. As a rule, there is no immunity in private academic places, and that includes many of the big university programs. So you've been sheltered from the reality of most academic physicians.

Even if you were employed by the hospital (unless a state employee), you could still be sued. Consult your local laws.
 
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Patients can most definitely sue ME for the actions of my residents,fellows or CRNAs when I am supervising them. The set up you describe is not common in the academic world from my experience and depends on your state and how you're employed. You'd have to be a state or government employee.
Though I have seen patients drop the physicians after the initial shotgun blast, or take reasonable settlements and sue the hospital for systems based issues hoping to get the very deep pocket settlement. I've also seen a surgeon dropped from a suit because they liked him while suing the OB that they didn't like even though the bad outcome related to complications from surgery. They argued that the surgery shouldn't have been necessary if the OB had done things differently. Shady, but perhaps their best chance for a win.
Edited for clarification.
There have been posts on this in the past if you search.

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Il Destriero
 
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Patients can most definitely sue ME for the actions of my residents,fellows or CRNAs when I am supervising them.
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Il Destriero
Thanks for the insight. I now feel a lot more grateful for the attendings who let me try intubating as a med student. I don't want to sound like an a$$hole, but may I ask what, then, would be the incentive for attendings to let med students / residents do more procedures while absorbing all the risks for letting them try, when you know you could do the procedure much, much safer and quicker, besides the desire to teach and benefit the future of the profession? I've seen / heard my share of failed intubation / anoxic brain injury, broken teeth, central line in carotid, PTX, etc. Not to bash trainees but complications do occur, even for seasoned attending.
 
I let med students intubate because, most of the time feeling generous and noble, it's my idealistic job/responsibility as an attending training new physicians. I often feel that in today's climate, the medical profession is lost as a traditional master/apprentice relationship and that med students' education suffers. I do take on liability for complications, which in bread and butter practice is a sore throat and very remotely chipped teeth. That said, it requires good clinical judgement to let a med student try things and to know when to immediately take over. And it all depends on the med student. I've had MS4 going into something like pathology/IM/FM who have an intubation success rate of 0% over 4 weeks and couldn't care less, where as a few MS3 going into EM or anesthesia have 100% success rate during their last 3 weeks of a month-long rotation.

And for full disclosure, there is absolutely no monetary incentive in my practice to let med students do anything except watch me work. The stipend med schools pay is about 1/10 of their monthly tuition costs.
 
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