030702, June 2003, p. 38, http://www.gao.gov/
Complaints; The State Board Now Takes an
new.items/d03702.pdf. The authors suggest that
Average of 2 ½ Years to Resolve Cases," Los Angeles
physician-owned companies may have advantages
Times, March 17, 2008.
in underwriting, as they may have "intimate
62. Grant and Alfred.
knowledge of local doctors and hospitals and the
legal customs and climate."
63. Shirley Svorny, "Should We Reconsider
Licensing Physicians?" Contemporary Policy Issues
72. William B. Schwartz and Daniel N. Mendel-
[now Contemporary Economic Policy] 10 (1992):
son, "The Role of Physician-Owned Insurance
3138; Shirley Svorny, "The Changing Role of
Companies in the Detection and Deterrence of
Licensure in Promoting Incentives for Quality in
Negligence," Journal of the American Medical
Health Care," in American Health Care: Government,
Association 262 (1989): 134246.
Market Processes, and the Public Interest, ed. Roger D.
73. Vermont Medical Malpractice Study Commis-
Feldman (Oakland: Independent Institute, 2000).
sion, "Medical Malpractice Study Committee Meet-
64. Todd M. Ebersole, "Emerging Theories of HMO
ing Minutes, January 26, 2005," p. 3, http://www.
Liability for Negligence of Its Network Providers,"
bishca.state.vt.us/InsurDiv/medmal_studygroup
Orange County Lawyer 41 (1991): 3033; David L.
/Jan26meeting/minutes_Jan26.pdf.
Trueman, "Managed Care Liability: Current Issues
74. Milliman Consultants and Actuaries, "Item
and Trends," in Health Law Handbook, ed. A. Goslin
10: `Whether Any Efforts Have Been or Should Be
(Eagan, MN: West Publishers, 2006), pp. 11174,
Undertaken to Reduce the Incidents of Medical
191; Patricia M. Danzon, "Tort Liability: A
Malpractice through the Underwriting Process";
Minefield for Managed Care?" Journal of Legal Studies
Vermont Medical Malpractice Study Commis-
26, no. S2 (1997): 491519; William M. Sage,
sion, "Medical Malpractice Liability Insurance in
"Enterprise Liability and the Emerging Managed
Vermont; A Report to the General Assembly,"
Health Care System," Law and Contemporary
Exhibit 61, pp. 7084, http://www.bishca.state.
Problems 60, no. 2 (1997): 159210.
vt.us/InsurDiv/medmal_studygroup/exhibits-
65. Trueman.
secs/medmal_Section4.pdf.
66. Ebersole; Trueman.
75. State of California Department of Insurance,
Application for Approval of Insurance Rates by
67. Ibid.
Professional Underwriters Liability Insurance
Company (Doctors Company Insurance Group),
68. Ibid.
Filing number 06-2574, Filed April 17, 2006.
69. Medical Liability Mutual Insurance Company,
76. Sloan and Lindsay, pp. 21230.
"Physicians and Surgeons--New York State:
Premium Discounts," http://www.mlmic.com/por
77. Karen Edwards, "Texas Court Rules Podiatry
tal/UnderWritingPSNYS.aspx.
Scope of Practice Includes Ankle," Podiatry Online,
http://www.podiatryonline.com/main.cfm?pg=
70. See Frank Sloan and Lindsay Chepke Medical
pro_development&fn=Texasdecision. Emphasis
Malpractice (Cambridge, MA: MIT Press, 2008), pp.
added.
21230; Derek A. Weycker and Gail A. Jensen,
"Medical Malpractice among Physicians: Who
78. 45 CFR Subtitle A (10-1-06 Edition), Part 60
Will Be Sued and Who Will Pay?" Health Care
(pages 14047), http://www.npdb-hipdb.com/leg
Management Science 3 (2000): 26977. Sloan and
islation/Final_Regulations_Title_IV.pdf. However,
Chepke cite a 1985 survey by Schwartz and
a 2000 report on the National Practitioner Data
Mendelson, that found most companies employ
Bank by the U.S. Government Accountability
surcharges, but few physicians are subject to sur-
Office found substantial underreporting. Most
charges, as malpractice claims are concentrated
troubling to the report authors was underreport-
among a small subset of physicians. William.B.
ing of disciplinary actions (relative to malpractice
Schwartz and Daniel N. Mendelson, "Physicians
settlements or judgments). The authors note that
Who Have Lost Their Malpractice Insurance:
disciplinary actions are better indicators of clini-
Their Demographic Characteristics and the
cian competence and should be a primary focus of
Surplus-Lines Companies that Insure Them,"
data-gathering efforts. The GAO also noted severe
JAMA 262 (1989): 133541.
problems related to data quality, problems with
completeness, timeliness, and accuracy. Federal
71. U.S. General Accounting Office, "Medical
agencies themselves have ignored the requirement
Malpractice Insurance: Multiple Factors Have
to report payment of malpractice claims in cases
Contributed to Increased Premium Rates," GAO-
against government doctors. Officials decided not
16