The Elephant in the (Exam) Room
Malpractice. Nobody likes to think about malpractice and malpractice insurance however, it is a necessary requirement for both students and all other practicing nurse practitioners. It’s as if we don’t already have enough to worry about by correctly identifying the correct condition, prescribing the appropriate evidence-based intervention that is culturally sensitive than worrying about the malpractice elephant in the exam room!
Two of the larger insurance carriers for nurse practitioners include Nurses Service Organization (NSO) and Marsh. These two carriers are endorsed by the American College of Nurse Practitioners and the American Academy of Nurse Practitioners respectively. Of course, there are other malpractice insurance carriers out there and some Internet searching will give you more options. Most insurers offer deep discounts for students that make it inexpensive to maintain coverage while in school. After completion of school, rates do increase significantly.
A common question that is asked among nurse practitioners is “Should I have my own coverage if I am covered by my employer?” This is a tricky question and there is truly no universal answer that will cover every situation. I chose to carry my own policy despite the fact that my institution covers me as an employee. My reasoning was for an additional layer of security and peace of mind should something happen. In essence, I wanted someone representing me with my interests as their primary focus, not necessarily the institutions’.
Further, malpractice is one part of the risk management scenario. The other part includes professional misconduct and any charges that can be brought against your actual license at the state level and is different from malpractice. State boards have the authority to fine, suspend, and even revoke your license if professional misconduct was found to be committed. This is a good reason to have your own policy since most offer coverage in these events (It is also a reason to have coverage as an RN too since professional misconduct charges can be filed against RNs and other licensed professionals). It is a good idea to be aware of this type of coverage from your carrier at the outset. You can find more information on malpractice insurance for nurse practitioners on the ACNP website and on this Medscape article written by well known nurse practitioner, attorney, and author Carolyn Buppert.
An unfortunate reality that we can expect is that as more nurse practitioners are in practice, more malpractice claims will be filed. Therefore, it is important to review the malpractice data that is published by the carriers to get a sense of the liability landscape. Every state has their own claims data. In addition, each state sets minimum liability coverage. As a result, you will see different rates for different states based on the claims and the amount of coverage required.
Any discussion of malpractice is not intended to scare anyone from clinical practice but is the reality to be cognizant of in the litigiousness society in which we live. With this information, we can practice with some comfort in knowing that you have an advocate should an unfortunate incident occur.
