Volume 4, No. 1 • Spring 1989

Risk Manager Notes Improvement in Anesthesia Losses

James E Holzer, J.D.

To the Editor

In reading the APSF Newsletter, I was struck by how far the discipline of anesthesia has come, particularly in the past five years. I speak not as a clinician, but as a provider of professional liability insurance for over 5,000 physicians in the Harvard system. The results of intensive patient safety activities within the specialty have been, in my opinion, nothing short of remarkable. There is little doubt in my mind that the concerted efforts of the Anesthesia Patient Safety Foundation and its members have largely contributed to the creation of crucial risk management and quality assurance activities in hospitals throughout the country.

All of this, along with improved loss experience among anesthesiologists, is now translating into lower malpractice rates and discounted premiums in many parts of the country. Within the Harvard malpractice insurance program, the premium relativities used in determining the differences among various physician risk categories are being reduced for the third consecutive yew in anesthesiology. This means that effective our new policy year beginning April 1, 1989, anesthesiologists (Premium Class 3) will be paying only half of what they would have been assessed in their old 1985 rating group (Premium Class 5). And when factoring in an “across-the-board” Harvard premium reduction for all specialties in 1989, anesthesiologist’s total premiums will drop by 33% over the 1988 rate! It should be noted that the Department of Anesthesia at Harvard Medical School has been developing and using clinical standards since 1985. These standards are based, in part, on 13 years of historical loss experience for the specialty.

Without benefit of scientific analysis, I am confident in saying that this favorable trend toward improved patient safety would not have taken place absent the invaluable contributions of the Anesthesia Patient Safety Foundation and the membership of the American Society of Anesthesiologists.

As an insurance “outsider” looking in, I can only hope that other clinical specialties find the same encouragement and technical resources that organizations like APSF and ASA have provided to the field of anesthesia. It is my hope that the APSF will continue to serve as a catalyst and valuable resource for strong risk management/ patient safety innovations.

James E Holzer, J.D.

Vice President, Risk Management Foundation Cambridge, MA