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Inside Medical Liability

Third Quarter 2020


Swift Chairs Association in a World of Challenges

When Jim Swift, DDS, planned to take over as chairman of the Medical Professional Liability (MPL) Association at the annual meeting in May, he had no idea that the global COVID-19 pandemic would transform not just the practice of medicine, but also the foundations of MPL. Dr. Swift, director and chair of OMS National Insurance Company (OMSNIC) and a dental professor in the Division of Oral and Maxillofacial Surgery at the University of Minnesota School of Dentistry, grew up in Manchester, Iowa, and lives and works in greater Minneapolis with his wife and family.

By Amy Buttell


Inside Medical Liability talked with Dr. Swift about his background, the practice of healthcare, and his goals during his two-year stewardship of the MPL Association.

IML: How has your background prepared you to lead the Association board of directors?

Swift: My experiences as a practitioner, researcher, teacher, board examiner, claims evaluator, MPL insurer board member, and with the Association itself have all contributed to my growth and desire to serve. In particular, my experience with OMSNIC, which insures oral and maxillofacial surgeons across the country, is relevant. OMSNIC was founded at the direction of the American Association of Oral and Maxillofacial Surgeons in response to the malpractice crisis of the late 1980s. “I lost my MPL provider at the time, when the MPL company exited the market. My malpractice insurance was provided by the newly founded company (AAOMS National Insurance Company), which was renamed Oral and Maxillofacial National Insurance Company (OMSNIC), in the early 1990’s. I was invited to serve on the OMSNIC claims committee, and with time, ascended to the board of directors, and ultimately became the chair of the board, which led to greater involvement in the MPL Association.

IML: How did the Association, then known as the PIAA, contribute to your perspective on MPL and the growth of OMSNIC?

Swift: I discovered that as a claims reviewer for OMSNIC, I began to learn more about how the malpractice process developed and found it really interesting. I was asked to consider the position of board member and later was elected the Chair. We had recognized early on that as a company providing malpractice insurance in all 50 states to oral and maxillofacial surgeons that we needed to learn more about how MPL functioned. Through the MPL Association, we were schooled on the entire MPL process, which was vital so that we could walk into board meetings and understand what our actuaries and underwriters were saying. We learned what reinsurance was, why it was important to have an AM Best rating, and what we needed to do to get that rating. At the time I called the Association the “University of PIAA” because that was its role—and it is an important one.

IML: What led you to become involved in the MPL Association and assume the chairmanship?

Swift: I think it’s critical to give back, which is why I’ve gotten involved in worthwhile organizations such as the MPL Association. I was asked to consider being a participant in the Association’s first Fellows Program. I jumped at the opportunity. I was privileged to serve on MPL Association committees and participated in a board meeting. I was able to join the board and eventually to serve on our executive committee and then progressed to assume the chair this year. Among my goals as chair is continuing to assure diversity in the profession and in the association, ensure that all members have a voice, and continue our advocacy for our members in vital areas such as tort reform and COVID-19 liability.

IML: Why is diversity so important? Swift: As a member of the dentistry profession, I’m part of a group that isn’t necessarily in the mainstream when it comes to MPL. Medical practitioners significantly outnumber dental practitioners. As a “minority” it’s easy to feel out of place. In recent years, the MPL Association have done a great job broadening its mission to ensure that all voices are heard. To achieve that objective, we need to actively monitor and assure that we achieve diversity by profession, by company size, by gender, by race, and in all ways. IML: How can the MPL Association ensure that diverse voices are heard while achieving a unified voice on important issues?

Swift: We want to ensure that everyone has a place within the organization in terms of our different constituencies, while also maintaining the coherence of the organization as a whole. Our members’ needs are diverse because their companies are all different. That diversity provides significant value in that we can all learn from each other and gain from our interactions, while attracting new members that we can also learn from and that can benefit from being part of our organization. We want to continue to build an organization that is of service to everyone—physicians, dentists, other medical practitioners, healthcare providers, CEOs, accountants, actuaries, underwriters, and other insurance and medical professionals. We all need each other.

IML: How has taking over the chair in the midst of the pandemic changed your outlook for the MPL Association and the future of the MPL landscape in which it operates?

Swift: Anyone who has moved into a post or position at this juncture of COVID-19 had an extra card dealt to them that creates complications. I’m going to have to depend even more on everyone—Association staff and membership. We all have to contribute; everyone has got to be involved in taking us successfully down the path to get through this pandemic and cope with the challenges it brings.

IML: What specific challenges do you see?

Swift: The functioning of practitioners, hospitals, insurers, and the Association itself has been disrupted because there’s no way to effectively plan in the midst of an unpredictable pandemic. COVID-19 is going to help us create new ways of disseminating information and getting people together virtually in ways that involve lower costs and lower risk—that is a positive. However, for the Association and many of our members, the financial strain is definitely a challenge. Dealing with the issues that have arisen proactively will make us stronger as an organization.

IML: What has been the impact of moving MPL Association meetings and conferences online?

Swift: We’ve responded quickly to the need for social distancing by offering many opportunities for our members to participate remotely in webinars and virtual conferences. We’re providing timely, high-quality information. What I miss are the opportunities for face-to-face interactions, the sidebar conversations at meetings that are so enriching. However, we’re exploring options and hope to continue to improve the virtual conference and meeting experience until we can bring that in-person interaction back.

IML: What other efforts do you want to see enhanced so that the Association can be of the utmost service to its members?

Swift: One important aspect of the MPL Association’s role in the industry is our ability to continue to collect, analyze, and publish data from closed claims that make up the Association’s Data Sharing Project (DSP). This project helps us better understand and manage risk management, patient safety, and other important issues. It’s very important to dissect the numbers, analyze where claims are falling, and do what we can to engage in a preventive approach so as to reduce incidents and claims. We have a responsibility, as an association with providers, companies, and carriers to do what we can in this area. It’s important to focus on how can we prevent medical liability incidents and make the practice of medicine safer.

IML: Where can the MPL Association and its members make an impact to improve the profession?

Swift: During the current pandemic situation, we need to be unified to continue to pursue tort reform, which is in all of our best interests. Because the Association is the only organization that specifically represents providers and insurers in MPL, our role is critical. Our government relations staff has made some important progress. It’s not only important to ensure that practitioners who provide care during this period receive appropriate immunity, it’s also important that they have access to appropriate coverage at a reasonable cost.

IML: How do you think the pandemic will continue to affect the practice of healthcare?

Swift: Everyone’s nervous and concerned about the potential to transmit the virus to a patient. The bottom line is that everyone is looking for a specific set of rules to follow that will mean there will be no problems. Unfortunately, there are so many unknowns that it is difficult to guide practitioners and insurers. However, within those limits, at OMSNIC, we are telling our insureds to take into account their judgment and decision making, and make sure that it’s within the standard of care and that they can defend what they’ve done and why they’ve done it to someone else. You need to document, document, document. IML: Are the executive orders and legislative immunity that the federal government and some states have provided helpful in these situations? Swift: Preventing COVID-19 complaints isn’t any different from preventing any other type of claims. If you as a practitioner have concrete and good reasons for doing what you're doing and then document that, you will be in solid shape. That doesn’t mean there won’t be claims, but if there are, you’ll be well positioned to defend them.

IML: Do you anticipate further COVID-19 liability relief at the state and federal levels? Swift: As an Association, we’re really on top of this evolving situation. We’re working with our members to lobby on the federal and state levels to do our best to ensure that robust protections come into place in terms of pandemic liability. Our PAC is actively cultivating pro-tort reform candidates in the upcoming election. We hope that our member companies will join us in these efforts. We are strongest when we speak in one voice.



Amy Buttell is the editor of Inside Medical Liability.