Trends in malpractice premiums for dermatologists: results of a national survey.

OBJECTIVE To analyze professional liability premiums in dermatology and factors associated with premium variation. DESIGN This study examines data from a survey of dermatologists conducted in 2004. RESULTS Survey respondents (n = 1095) reported mean medical liability premiums of $10,898 in 2004 (95% confidence interval, $10,295-$11,501). Premiums increased by 24.4% in 2003 and 16.7% in 2004. There was substantial variation by state, and mean premiums were higher in American Medical Association (AMA)-declared "crisis states" than in those states listed as "currently OK" ($11,669 vs $9527; P = .03). Premium growth from 2002 through 2004 was higher in AMA crisis states and in states without $250 000 caps in place for noneconomic damages. Even when excluding payment for cosmetic riders, premium levels were higher for dermatologists spending more than 10% of their time in cosmetic practice ($13,816 vs $10,185; P<.001) or more than 30% of their time in noncosmetic surgery ($12,551 vs $10,453; P = .01). CONCLUSIONS While premiums paid by dermatologists for professional liability insurance in 2004 were well below those experienced by higher-risk specialties, geographic factors and state tort law variation seem to be affecting dermatology premiums in much the same way they affect the field of medicine as a whole.