Top five best and five worst states to work locum tenens from a liability perspective

Vlad Dzhashi, MD

In 2018 I was named in a malpractice lawsuit for the first time.

The whole experience was extremely stressful, and since this happened, I started thinking of ways to avoid this mess again in the future.

After doing my research on this topic, the first thing I realized is that a good portion of docs in this country have been sued or will be sued. For example, a 2011 NEJM study showed: “Each year during the study period, 7.4% of all physicians had a malpractice claim.”

The other revelation was that not every state is created equal and there are parts of the country that are literally a “hot mess” when it comes to liability and others are as close to “legal paradise” as they can get.

In fact, you are more than 10 times (!!!) likely to be sued in the “riskiest” state compared to the lowest risk state.

That’s why I’ve decided to collect data and present you the best and the worst states from a liability perspective.

I hope this will help you to choose which states to avoid and which states to look at more closely, whether you work locums or full-time jobs.

👉 Without further ado….let’s announce the “winners”:

Best five states with the lowest malpractice risk:

North Dakota had the lowest rate of malpractice claims against physicians. The state implemented a tort reform by limiting noneconomic damages to $500K.

On top of that, if noneconomic damages exceed $250K, the law requires additional review and approval.

The state of Wisconsin has the second-lowest rate of malpractice claims. It has the cap on noneconomic damages of $750K and also has the state-wide Patient Compensation Fund that would pay for damages exceeding the cap.

Despite Minnesota not having any noneconomic damage caps, it’s one of the best states in terms of physician liability.

The reason for that is the tort reform passed in the 1980’s that requires medical experts to confirm the claim has merit. This significantly decreased the number of frivolous lawsuits in the state.

The aloha State has a $375K cap on noneconomic damage and all initial claims are reviewed by a “conciliation panel.”

The Tar Heel State comes fifth in the ratings. It has a cap on noneconomic damage of $500K.

Now, let’s look at the worst states:

The worst five states with the highest malpractice risk:

New Jersey is the worst state in the country in terms of physician liability.

There is no cap on noneconomic damages and the number of claims is extremely high.

Louisiana may come as a surprise to many, especially given the fact that a lot of neighboring states are considered to be physician “friendly” and the fact that the state has $500K cap on noneconomic damages AND Louisiana Patient Compensation Fund.

That said, the state is known to have one of worst liability climates in the country.

Pennsylvania has no cap on noneconomic damages and has one the highest malpractice insurance premiums in the country.

The Sunshine State is known to be one of the worst states for physicians from a liability perspective. This is despite a noneconomic damage cap of $500K.

New York is the fifth on the list. Not surprisingly, the cost of malpractice insurance here is one of the highest in the country.

Differences within the state:

Please note that the risks are not spread equally within each state, as certain counties may have higher malpractice rates compared to the rest of the state. Anecdotally, this is usually the case for the “affluent” counties.

Take-home message

Fortunately, locum tenens allows you to do gigs anywhere in the country. But…before you consider working in any state, it is a good idea to check where the state stands in terms of the liability risks.

Vlad Dzhashi, MD

Best five states with the lowest malpractice risk:

The worst five states with the highest malpractice risk:

Differences within the state:

Take-home message

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