What would you pay for sovereign immunity?

[namethatsmell]

I have to move within the next year for my wife's profession and some areas we may end up in have terrible malpractice environments.

While some gigs I've looked at offer the equivalent of sovereign immunity where you can't personally be sued (academics, the VA, etc), these places also often pay (way) less than standard community jobs in the same locale. In an effort to make an apples to apples comparison between job prospects, I'm trying to ascribe a monetary value to having this benefit but am having a hard time coming up with a number.

So for other attendings out there, what price tag would you put on having sovereign immunity? $0? $30/hr? $100k/yr? 12 Unibroues a month? There's obviously an emotional component which is difficult to value, but I'd love to hear your thoughts on whatever price you'd give this.

For those who have worked in settings with sovereign immunity, did the immunity from personal malpractice make a big difference your level of stress and job satisfaction? I imagine that having this benefit could reduce burnout.

If you'd prefer to PM that'd be awesome, too. Thanks guys

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[gamerEMdoc]

I didnt practice any different when I was in the military than I do now. I try to practice good medicine in general, not practice out of fear.

On the other hand, I would definitely love to have some malpractice immunity just for peace of mind, because no matter how hard you try, bad stuff sometimes just happens and you are in the wrong place at the wrong time. I'd consider giving up 50K of salary (25-30k take home after taxes) for such a benefit.

 

[BAM!]

I would want to work in a RVU based environment where you can't be sued. Then you could make up for the time spent doing defensive charting by seeing more patients. I'd easily pay $50k a year pretax for this benefit. Then I'd see 2-3 extra patients a shift. I wouldn't even have to cherry pick! I'd also write the taxes off and come out ahead

 

[NinerNiner999]

In emergency medicine (and probably most other jobs), there are several things that employers throw out as "perks." In my opinion, Sovereign immunity (SI) is not a perk but a recruiting tool. In fact, it could even be considered a weapon. We all know that being sued is a real part of our job and that is why we carry malpractice insurance. When you do get sued (notice I said "when" because you will, statistically, be used at least once, probably twice in your career), how secure will your job be when litigation hits the fan? Without SI, you will still have protection, and face a scenario where you are 99% likely to prevail and at worst case settle. With SI, it places your current employment in jeopardy. Realistically, if you aren't named in a suit who is? Your employer? Your hospital? Probably the two groups you least want to disrupt. While it is true that you may leave that job with a clean legal record, it will always be an issue. SI is not a benefit for the small potatoes such as us.

 

[Angry Birds]

This is neither here or there but it is amazing how we can (and will) get sued for working incredibly hard to save lives.

 

[Hercules]

Pretty much zero for me for the reasons Niner described above.


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[BAM!]

So... Is it then common for doctors in Academics and the VA to be fired due to law suits which create conflicts between the doctor and EM group/hospital?

 

[WilcoWorld]

So... Is it then common for doctors in Academics and the VA to be fired due to law suits which create conflicts between the doctor and EM group/hospital?

No. Been in academics for 10 years and have never heard of it happening.

 

[Vandalia]

So... Is it then common for doctors in Academics and the VA to be fired due to law suits which create conflicts between the doctor and EM group/hospital?

Not that I am aware of, and I know some people who have lost large suits. This gets back to one of my fundamental points: no one cares. Everyone from the hospital CEO to the janitor knows that malpractice judgments are a lottery, and no one pays attention to them.

 

[namethatsmell]

Thanks for the responses everybody, really appreciate it.

NinerNiner999 and Hercules, you both bring up interesting points but I gotta agree with Wilco, Bam, Vandalia: I've never known anybody to get fired from academic or VA shops for anything med-legal related and it would seem counterintuitive for a doc to be offered a perk that would lead to termination or loss of contract if the perk was actually used.
For a criminal and/or PR disaster (ie Newman)? Sure, they're gonna cut ties just like any private group probably would.

Niner, the situation you describe seems to entail a true private group (as opposed to an academic group, which is often a state psuedo-employed group) staffing a shop where SI covers the private docs. Does this actually exist?

 

[enalli]

Can someone elaborate on this not-getting-sued-in-academics thing? I know for a fact that faculty at both my medical school and residency have been named in lawsuits.

 

[RustedFox]

Can someone elaborate on this not-getting-sued-in-academics thing? I know for a fact that faculty at both my medical school and residency have been named in lawsuits.

Often times, faculty of state-supported medical schools have sovereign immunity, as they are employees of the state.

 

[WilcoWorld]

I am not a lawyer, but here is my understanding.

If a patient that you cared for at such an institution decides to sue, the individual must first bring suit against the institution. Then there are 3 possible outcomes:
1) Settlement.
2) The plaintiff loses.
3) The plaintiff wins.

-In cases of settlement, the settlement agreement usually includes a stipulation that the individual providers get dropped from the suit. So, you're in the clear.
-If the plaintiff loses the case against the institution, you're almost certainly in the clear, as few lawyers will want to take a case that's already been lost once.
-If the plaintiff wins against the institution sovereign immunity may fail to protect you. This is in the very rare case where a) no settlement is made, b) the plaintiff wins, AND THEN c) the plaintiff decides to go further and sue you individually. This is quite rare, but it could happen if you individually really pissed off the patient/family.

So sovereign immunity is not perfect, but it does offer a lot of protection.

 

[The White Coat Investor]

I have to move within the next year for my wife's profession and some areas we may end up in have terrible malpractice environments.

While some gigs I've looked at offer the equivalent of sovereign immunity where you can't personally be sued (academics, the VA, etc), these places also often pay (way) less than standard community jobs in the same locale. In an effort to make an apples to apples comparison between job prospects, I'm trying to ascribe a monetary value to having this benefit but am having a hard time coming up with a number.

So for other attendings out there, what price tag would you put on having sovereign immunity? $0? $30/hr? $100k/yr? 12 Unibroues a month? There's obviously an emotional component which is difficult to value, but I'd love to hear your thoughts on whatever price you'd give this.

For those who have worked in settings with sovereign immunity, did the immunity from personal malpractice make a big difference your level of stress and job satisfaction? I imagine that having this benefit could reduce burnout.

If you'd prefer to PM that'd be awesome, too. Thanks guys

My malpractice is something like $16K a year. That's what I'd pay. Either way, your time and aggravation and lost sleep is going to happen. And the likelihood of being sued above your limits is so small it shouldn't be considered. So it's really the cost of the malpractice insurance.

 

[The White Coat Investor]

And yes, I've practiced both with and without sovereign immunity. I don't recall having less stress with it.