Focus on Three Areas to Reduce Liability Involving Advanced Practice Providers, Speaker Suggests

​The issue of advanced practice providers, such as nurse practitioners (NPs) and physician assistants (PAs), "is really starting to reach us in the professional liability audience," said Robert Thompson, RT, JD, MBA, LLM, AIC, ARM, ARE, RPLU, CPCU, director of education, MMIC, speaking September 27, 2016, at the annual conference of the American Society for Healthcare Risk Management in Orlando, Florida. "We are recognizing that there is major liability risk," he said. However, "a lot of this is coming about because of employment trends, not the capabilities of these professionals." A 2014 survey found that 35% of clinics have NPs and 30% have PAs, and job growth between 2015 and 2022 is projected to increase by 34% for NPs and 38% for PAs, compared with 19% for healthcare occupations overall. On average, 7.9% of MMIC claims involve advanced practice providers. Among claims involving advanced practice providers, allegations commonly relate to diagnosis (35% of claims), medical treatment (24%), and surgical treatment (18%). Overall, about 51% of cases involving advanced practice providers occur in outpatient settings, 32% occur in inpatient settings, and 17% occur in the emergency department. Contributing factors often identified in these cases include clinical judgment (74% of cases), technical skill (32%), and communication (31%).