A recent study by CNA Financial has found that Nurse Practitioners (NPs) are at the heart of more malpractice lawsuits than in years prior. The insurance firm, along with the Nurses Service Organization, analyzed 287 closed liability cases against NPs, NP practices, and NP students between 2012-2016 in excess of $10,000 (referred to as an indemnity payment). This data was compared to a 2007-2011 report of 200 closed cases with the same indemnity payment amount.
MedPage Today, a online resource for medical news and trends, notes that the most recent study found that:
- NPs in 4 specialty areas paid the most claims:
- Primary care & family practice nurses (> 50% of claims)
- Behavioral health nurses (15% of claims)
- Gerontology nurses (12% of claims)
- Certain office types paid more claims:
- Physician offices
Nurse practitioner offices
- Nursing homes
- The largest payouts came as a result of failure to properly monitor patients, with average payouts at $449,500. The second most frequently cited cause was diagnostic errors, with an average payout of $283,263.
Use of Nurse Practitioners on the Rise
For years, health care experts have cautioned that a shortage of primary care physicians could lead to a critical problem of access to care. According to The Association of American Medical Colleges, by the year 2030 we will face a physician shortage of between 40,000 and 100,000 doctors. An increasingly common solution is the practice of staffing more NPs at offices, clinics, and hospitals and encouraging patients to voluntarily see them for both annual checkups and problem-focused visits instead of a physician.
Since the passage of the Affordable Care Act in 2010, more Americans have health insurance than ever before. In August of this year, the number of insured Americans hit the highest number in history, meaning there are more insured patients visiting doctor’s offices, hospitals, and clinics and therefore more patients demanding healthcare. This increased demand for healthcare versus the number of practicing physicians has caused a shortage in many areas, creating more opportunities for NPs to function as primary care providers.
A February 2016 article by Modern Healthcare cites data from the American Academy of Family Physicians. According to their analysis, the average family medicine physician has attended a 4 year college, a 4 year medical school, plus a medical residency program and has gone through 21,000 hours of post-graduate training. The same article states that an advanced nurse practitioner “has between five to seven years of education and only 5,300 hours of post-graduate training.”
Modern Healthcare also notes that many physician groups feel that the lesser training and education required of NPs does little to reduce the true burden of shortages and in fact increases costs associated with providing care. The same medical journal cites studies by Mayo Clinic that show a relationship between the use of NPs and higher numbers of ordered diagnostic imaging tests and specialist referrals than with physicians.
Finally, the CNA study encouraged NPs to follow 3 simple rules to reduce liability claims:
- Practice within the requirements of your state’s nurse practice regulations
- Document patient care
- Never alter a record after the fact