Going Bare – my take

Medpundit has a post about a doc (FP) who is going without medmal insurance. The implied rationale is that since his net worth is negative (debt), and since suing him looks unattractive (no insurance), this is his plan to not get sued.

A Chance to Cut is a Chance to Cure had previously written about Florida docs who were ‘going bare’, making their hospital the big target, which has some attraction: hospitals are Institutions and not easily attacked, and they generally have squads of attorneys on staff or retainer, making them hard to sue effectively (though it happens often enough).

This is stupid for several reasons, and I’m not a shark plaintiffs’ attorney, I’m sure they’d be glad to explain more reasons. First, from a purely practical aspect, most hospitals won’t let you be on staff unless you’re insured for at least a minimum amount. They aren’t interested in being the deepest pocket, and as we’re (mostly) not their employees they don’t want the multi-mil$ liability.

Second, as was explained to me when I was but a pup, “yeah, you have nothing now, but you will someday, so I’d get a judgement and then renew it every 7 years”. Because your net worth is negative today doesn’t mean it’ll stay that way. Just remember that bankruptcy doesn’t wipe out many jury verdicts.

Third, the nail that sticks up is the one that gets hammered down. This doc is deliberately making himself a target, and might get sued just to scare others into not going bare.

Lastly, say he gets sued. All his legal expenses are out of pocket (mine are covered in my policy), billed at huge numbers per hour (more than an FP collects by far), and there’s no settling for more than you have in savings, because you don’t have it.

I gripe every time I write a (substantial) check for medmal insurance, and I thank my lucky stars I have it.


  1. Yes MOST hospitals won’t allow you on staff without minimal coverage, but if the hospital is faced with losing physicians because they can’t pay their premiums, they may take the risk. This is a problem often faced by smaller hospitals. Having hospitals “help out” with premiums can be dicey as it may violate “anti-kickback” rules.
    Secondly, before most physicians would consider doing this they would (hopefully)set up an ironclad as possible asset-protection plan. The fellow in Dr. Smith’s post doesn’t seem to be planning to have many assets to protect. Easy to do in Florida with its’ unlimited homestead exemption.
    When I compared “going bare” to a “weapon of mass destruction” I meant it as a weapon of last resort. I don’t plan on having to do it, but desperate times call for desperate measures.

  2. Scott Tidwell says:

    I think “going bare” may also have some bad side effects after the recent tort reform. In order to enjoy the “caps” on suits, a medical provider is required to have minimim levels of coverage, phased in over the next few years.


  1. Overlawyered says:

    The doctor who went bare

    Last month Dr. Mark Macumber, a family practitioner in suburban Chicago, made headlines when he announced that he planned to “go bare” and practice without professional liability insurance. (Sarah A. Klein, “Rising rates force docs out on limb”, Crain’…