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Anesthesiology is the most legally curious of the medical specialties. It is a medical specialty with full residency training and formal board certification, yet it is openly practiced by nurses, often in violation of state law and sometimes in violation of the federal laws governing the administration of narcotics. Until recently, it was one of the most costly specialties to insure. The cost of medical malpractice insurance for anesthesiologists has now moderated, due to several factors intrinsic and extrinsic to the specialty.

Anesthesiologists often practice on generally healthy individuals whose next of kin tend to file lawsuits if something goes wrong. Complications of anesthesia delivery are obvious in these patients; they either die or suffer serious brain injuries. If a healthy person dies during surgery or immediately after, the anesthesiologist is suspect. In the 1970s anesthesiologists increasingly became the targets of medical malpractice litigation. Since there are no reliable data on anesthesia deaths, it is impossible to determine if the increase in litigation was secondary to increased bad outcomes or a reflection of increased sophistication on the part of plaintiffs' attorneys. The result was a dramatic increase in medical malpractice insurance rates.

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