NCPA - National Center for Policy Analysis

More Doctors Going "Bare"

January 28, 2004

With medical malpractice insurance premiums climbing steeply, a growing number of physicians are taking a radical step: They're canceling their coverage altogether.

Going bare, as it is known, or "self-insuring," means that doctors, not insurance companies, are responsible for legal fees and any judgments or settlements if they're sued. For patients it means potentially less money if their doctor botches the job.

Many of the physicians going bare so far practice in Florida, which consistently has some of the highest malpractice insurance rates in the nation and is known for its activist doctors:

  • More than 5 percent of Florida's roughly 47,700 active medical doctors don't have malpractice insurance coverage, up from 4 percent a year ago, according to the Florida Department of Health statistics.
  • In Miami-Dade County, in South Florida, nearly 20 percent of the county's 6,360 active medical doctors are bare.
  • The phenomenon is most common in high-risk specialties such as neurosurgery and obstetrics, but even primary-care physicians are forgoing insurance.

As premiums edge beyond the reach of physicians in other states, doctors elsewhere are studying, and in some cases adopting, the option. As a result, some in the medical profession expect the phenomenon to continue to spread.

Nobody knows for sure how many doctors are bare nationwide. The American Medical Association has changed its policy to reflect the growing number of uninsured physicians, especially from Florida. In the past, the doctors' group recommended that physicians carry sufficient malpractice insurance to protect themselves and their patients. But in December 2002, AMA policy makers voted to cut the recommendation and leave the decision to doctors.

Source: Rachel Emma Silverman, "So Sue Me: Doctors Without Insurance," Wall Street Journal, January 28, 2004.

For WSJ text (subscription required),,SB107524226412113275,00.html


Browse more articles on Health Issues