Fairway Insurance, a small California insurance company has launched a first-of-its-kind malpractice policy specifically designed for holistic/integrative physicians.
The new policy was developed in collaboration with the American College for the Advancement of Medicine (ACAM), with input from other holistic organizations. It is designed to meet a longstanding need for a full-scope malpractice policy that also covers intravenous vitamin infusions, chelation, prolotherapy, and a host of holistic/natural treatments typically excluded from conventional malpractice insurance.
Fairway introduced the policy last Spring, in California, with a broader roll-out continuing throughout 2009. It is currently available in 18 states (AZ, CO, FL, GA, ID, IL, IA, KS, MD, NE, NM, NY, NC, OH, SC, WA, NE and MT), with introductions into further states planned later this year. Roughly 1,000 physicians have bought in so far.
The new plan is the fruit of several years’ work between Fairway, a team of holistic physicians, and lawyers with expertise on medicolegal issues in holistic/integrative care.
“We got input from all the various associations in the holistic and integrative fields,” said Peter Muran, MD, founder/director of the Longevity Healthcare Center, an integrative clinic in San Luis Obispo, CA. Dr. Muran worked closely with Dave Thorson, Fairway’s president, to design the plan.
“Dave provided the boiler plate aspects of the policy, and then we sought consultation with ACAM’s ‘Legal Quartet,’ a team of four lawyers who specialize in defending holistic/integrative physicians. We will continue to seek input from ACAM, the Institute for Functional Medicine and other organizations, and we will to continue to bring new things into the coverage policy. It’s a living, breathing thing,” Dr. Muran told Holistic Primary Care.
Alan Dumoff, JD, a member of ACAM’s Legal Quartet, will be a featured speaker at Holistic Primary Care‘s upcoming “Heal Thy Practice: Transforming Primary Care” conference in Tucson, June 5–7.
Arbitration, Not Court
Not only will it provide unprecedented coverage of “alternative” healthcare services, the Fairway policy could reduce the hassle factor in the event of a medicolegal action, and will likely save physicians considerable money, to boot.
That’s because the new plan is based on an arbitration model under which patients sign an arbitration consent form stating that if there is a claim, the legal process will take place in an alternative dispute resolution office, not a courthouse. In an arbitration model, the doctor need only attend a trial when he or she is testifying, explained Mr. Thorson.
Because it avoids the courtroom, arbitration safeguards against potential damage to a physician’s reputation. “It’s all very private. In a public courthouse trial, a physician may be perceived as having done wrong, even if he or she wins the case—which, incidentally, happens 80% of the time,” Mr. Thorson said.
“Without arbitration, the doctor has to be in court sometimes for 3 or 4 weeks just to select a jury even before the trial begins. I’ve seen doctors go through trials and come out not wanting to practice medicine anymore.”
Arbitration has other advantages. “You can pick your arbitrator, you cannot pick your judge [in a court case]. So it’s a better deal for doctors,” said Mr. Thorson. Bear in mind, however, that the plaintiff also has a say in the choice of arbitrator, so there can be some conflict. Generally, though, these resolve quickly.
Arbitration cases are much less volatile than court cases, and if compensation is awarded, payouts are much smaller. “In California, the largest award in an arbitrated case was $1.5 million. The largest jury court payout was $66 million.”
The cost savings with an arbitration model are substantial. Going to arbitration typically costs 40–50% less than going to court. This means that malpractice insurance based on arbitration, like Fairway’s new policy, is much less expensive than conventional plans.
Physician-Owned
The cost of the integrative medicine policy will vary by state and by type of practice, but Mr. Thorson said physicians should expect it to be 20–25% less than their current coverage. Most integrative doctors can expect to pay less than $10,000 per year. “We take the leading insurer in your state, look at their structure, and then apply a 20% reduction since we’re shifting to an arbitration model. There’s big savings.”
Fairway is essentially a physician-owned mutual insurance group. “We make good money. We’re profitable and we’re over-reserved, but rather than paying out dividends, we put the money into lowering premiums for our physician members,” said Mr. Thorson. The main objective is to enable more physicians to practice holistic/integrative medicine.
Mr. Thorson said he became interested in integrative medicine a few years ago when his son, then in the 8th grade, “blew out his knee playing lacrosse.” The Thorson’s family physician, Dr. Mark Gordon an integrative doctor and active member of the American Academy of Anti-Aging Medicine (A4M), treated the boy with growth hormone to speed the healing.
“My son recovered in half the expected time. We have an orthopedic surgeon on our advisory board, and he was amazed. So I got interested in what these A4M and ACAM doctors were doing. I found doctors who were smart, serious, and using what seemed to me very valid therapies.”
Insuring the Future
This began to change how he viewed his own health. “When you start eating right, detoxifying, getting your systems back into balance, a lot of things start to clear up. I’ve been through it myself. I began to feel much better after working with Dr. Gordon for a while.”
At the same time, Mr. Thorson learned that some integrative physicians were under attack from state medical boards, and that much of what they practiced was excluded from standard malpractice plans. “I thought to myself, ‘Why wouldn’t we want to insure these guys? They’re lower-risk doctors!’ We feel strongly that integrative medicine is the future. We’re the first insurer to really move forward on this.”
Dr. Muran and Mr. Thorson both agreed that physicians should ask a lot more of their malpractice insurers than they usually do. In fact, most physicians don’t even know which aspects of their practice are actually covered and which are not. Sometimes this leads to nasty surprises.
“Lots of doctors buy malpractice but they don’t ask the companies what’s covered. They don’t do their homework,” said Mr. Thorson. “Call them and ask them what’s covered. You really need to know—especially if you’re using modalities that fall outside the usual scope of conventional practice.”
Battling the Boards
In some states, including Texas, California and Arizona, medical boards have been increasingly aggressive toward integrative/holistic physicians, and Mr. Thorson believes that in many cases, the boards are acting unfairly.
“Some of these boards take the attitude that if you’re not peddling pharmaceuticals, you should be going to jail. Our new policy offers medical board defense coverage as an add-on. It’s a big risk for us but we believe that by standing together, we can fight these guys. We’ve learned that from ACAM and IFM. If we use the same attorneys, and share what we know wins, we don’t have to start from scratch each time.”
To this end, Fairway will be sharing case outcomes with the various integrative medical organizations. “We’re creating a library of information to be owned by the associations, and available free to member physicians,” Mr. Thorson said.
Fairway is domiciled in Washington, DC, and Dr. Muran said that federal healthcare policy makers are aware of and interested in what the company is doing.
“We’ve gotten some interesting response from legislators. They want annual updates about integrative medicine, especially the cost savings. If we can show the government that integrative medicine saves money, what’s the risk? There’s no risk in getting healthy. We need to stop the persecution of doctors that help people get healthy.”
For more information about the Integrative Medicine Insurance Plan, visit www.thorsonins.com, or call 800-846-7766 and speak with either Stacey Schwenk (x108) or Vince Polimeni (x142).
