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obtaining approval from the office and upon the following conditions:Ø Establishment of a Medical Malpractice Risk Management Trust Fund to provide coverage against professional malpractice liabilityØ Employment of professional consultants for loss prevention and claims management coordination under a risk management program Other important guidelines to remember include:Ø The liability of each member for the obligations of the fund is individual, several, and proportionate, but not joint.Ø Each member has a contingent assessment liability for payment of actual losses and expenses incurred while the member’s policy was in force.Ø If one or more members fail to pay an assessment, the other members are liable on a proportionate basis for an additional assessment. The fund, on behalf of said members who paid the additional assessment, shall institute legal action to recover the assessment from members who failed to pay it.Ø If the assets of a trust fund are at any time insufficient to comply with the requirements of law or if a judgment against the fund has remained unsatisfied for 30 days, the trust fund must immediately make up the deficiency or levy an assessment upon the members for the amount needed to make up the deficiency. If the trust fund fails to make such an assessment, the office shall order the fund to do so. If the deficiency is not sufficiently made up within 60 days after the date of the order, the fund is deemed insolvent and grounds exist to proceed against the fund.There are many considerations to take into account when deciding whether to self-insure. Generally, physicians take this route when medical liability insurance is unavailable or unaffordable. It is important to seek legal guidance before choosing to self-insure. PART III - AN OPTION YOU MIGHT NOT HAVE CONSIDERED Florida law provides another option that is often overlooked. A physician may well fall under Section 458.320(5)(a)-(g) which allows physicians to meet the financial responsibility requirement without holding liability insurance. Most people consider this an exemption for physicians who only work 20 hours a week or less. But upon careful reading of the statute a physician may find an applicable exemption. Subsections (5)(a)-(e) state that a physician is exempt from the requirements set forth above if he or she meets one of the following criteria:Ø Practices exclusively as an employee of the Federal or State governmentØ Holds an inactive licenseØ Holds and practices pursuant to a limited licenseØ Only practices in conjunction with his or her teaching duties at an accredited medical school orØ Is not practicing medicine in this state Subsections (5)(f)1.-7. state that a physician is exempt from the financial liability requirements if he or she meets all of the following criteria:Ø Has practiced for more than 15 yearsØ Practices no more than 1,000 patient contact hours per yearØ Has no more than 2 claims in the last 5 years of more than $25,000Ø Has no convictions related to the practice of medicineØ Has had no serious actions against their license (including any action resulting in a fine $500 or greater)Ø The licensee has submitted to the department an affidavit affirming compliance with these requirements andØ Posts a notice to patients in the office regarding not carrying professional liability insurance or provide a written statement that must state the following:“Under Florida law, physicians are generally required to carry medical malpractice insurance or otherwise demonstrate financial responsibility to cover potential claims for medical malpractice. However, certain part-time physicians who meet state requirements are exempt from the financial responsibility law. YOUR DOCTOR MEETS THESE REQUIREMENTS AND HAS DECIDED NOT TO CARRY MEDICAL MALPRACTICE INSURANCE. This notice is provided pursuant to Florida law.”While most doctors work more than 1,000 hours per year, the question to be asked is: how many of the hours worked include patient contact hours? If your practice amounts to less than 1,000 hours of patient contact per year, you may want to look further at this option.Section 458.320(5)(g) further allows a physician to be exempt from carrying liability insurance if the physician agrees to meet the following criteria:Ø Upon the entry of an adverse final judgment in a professional liability case the physician must pay the plaintiff the lesser of the amount of the judgment or $100,000 (if the physician does not have hospital privileges) or $250,000 (if the physician does have hospital privileges) within 60 days of the judgment becoming final.Ø If the judgment is unsatisfied, the licensee will be subject to discipline unless if within 30 days the physician:1. Shows proof of satisfied judgment or 2. Furnishes proof of time appeal with either a copy of a supersede as bond or an order from the court staying execution on the judgment pending disposition of the appeal.Once the Department of Health becomes aware of an unpaid judgment, it must notify the physician that he or she is subject to disciplinary action if he or she does not meet the above listed requirements. The Department must immediately suspend the license of a physician if he or she is unable to demonstrate that one of these conditions has been met. The Department then has 30 days in which to file charges against the physician. The case then proceeds through the disciplinary system. The license must stay suspended until the required amounts set forth above are paid by the physician. Once the judgment is met, the restrictions on the physician’s license must be removed.In addition to the above requirements the physician must post a sign in his or her reception area or provide the statement to all patients stating:“Under Florida law, physicians are generally required to carry medical malpractice insurance or otherwise demonstrate financial responsibility to cover potential claims for medical malpractice. YOUR DOCTOR HAS DECIDED NOT TO CARRY MEDICAL MALPRACTICE INSURANCE. This is permitted under Florida law subject to certain conditions. Florida law imposes penalties against noninsured physicians who fail to satisfy adverse judgments arising from claims of medical malpractice. This notice is provided pursuant to Florida law.”*It is important to remember that choosing this option does not release the doctor from having to pay any judgments entered against him or her.While this option is certainly not for everyone, it may be beneficial for some physicians who are being forced by the current medical liability crisis to make difficult decisions. Keep in mind that it is always a good idea to obtain individualized legal advice when making these decisions. Additionally, the physician may submit to the department a request for an advisory opinion regarding his or her qualifications for exemption.This article is presented for educational purposes only and should not be taken as a substitute for legal advice, which should be obtained from personal legal counsel. Nevertheless, the FMA hopes that the information provided here and in its other publications continues to assist physicians in answering many of their most common legal questions allowing them to treat patients, instead of addressing legal concerns. Last Update: September 2013 QUESTIONS COMMONLY ASKED BY PHYSICIANS1. I recently received a subpoena from an attorney for medical records. It was not issued by the court but rather was only signed by the attorney. Do I have to comply?Answer:Yes. The Florida Rules of Civil Procedure provide that an attorney can sign a subpoena - they do not have to be issued by the court.2. Does a doctor have to have a staff member present when he is conducting a physical examination of a member of the opposite sex?Answer:No. There is no statute or administrative code provision that requires an individual be present in addition to the doctor during such examination. However, it is strongly