Doctors with multiple malpractice suits become insurance company medical directors

Editor’s Note

An investigation by the nonprofit organization ProPublica and the Capital Forum revealed many doctors with a history of malpractice cases now serve as insurance company medical directors—a role with major influence on decisions that impact patient outcomes.

According to a December 15 article in ProPublica, the organizations used regulatory filings to access information about medical directors at insurance companies, and checked these names against malpractice databases and court filings. Specific findings include:

• 12 insurance company doctors had either paid multiple malpractice payments, made a single payment of more than $1 million, or had been disciplined by a state medical board. 
• One medical director can rule on more than 10,000 cases per year – in some cases, without ever opening patient files, as was discovered in an investigation of Cigna. These directors can deny life-saving treatments due to expense, driving families into bankruptcy to cover treatments or causing them to forgo needed care due to costs. 
• A small group (2%) of doctors with multiple malpractice suits represent 40% of malpractice claims, indicating particularly low-quality care. As insurance company medical directors, these doctors earn $300,000 to $400,000 annually.