Most folks I talk with about medical care think that when they go to a hospital, the health care providers treating them are employees of the hospital. And when things go wrong giving rise to a claim of medical negligence, folks think the hospital is on the hook for the bad actions of the doctors, nurses or other providers who were negligent.

Except, that’s not always how it works these.

Typically, nurses, CNAs, techs, therapists, scribes, and administrative personnel are employed by the hospital. The hospital would typically be responsible for their actions because they are employees.

However, many physicians (and mid-level providers like ARNPs and PAs) who practice in a hospital – any many of them only practice in a hospital, and often only in that hospital – are actually not employees.

Rather, often they are either independent contractors, or employed with a group that contracts with the hospital to provide particular physician services to that hospital.

Here are some examples:

When you go to the ER, often these days the physicians and mid-level providers who treat you there are not employees. If that doctor orders imaging to be taken, those images are likely read by another doctor who is similarly not employed by the hospital. If you require inpatient hospitalization, often times the hospitalists – those doctors whose practice *is just providing medicine in a hospital* – are part of a group of hospitalists that contracts with the hospital to provide such services.

Need surgery? That surgeon may not be an employee of the hospital, and the anesthesiologist likely isn’t as well. Does that surgeon want to send a specimen to have a pathologist look at it? That pathologist may just be an independent contractor as well.

So why does this matter?

For one thing, bringing a claim against one defendant (i.e. the hospital) is typically easier than bringing it against two or three or four. For another, depending on the nature of the injuries, it may be the case that the doctor herself has limited insurance proceeds that are insufficient given the magnitude of the harm.

Fortunately, in Washington there is law that, in certain situations, the hospital may be liable for the actions of non-employee physicians. This is known as ostensible or apparent agency. Although the law itself is a bit confusing, the essence is that if you go to a hospital, and you reasonably believe that the doctor treating you is an employee of the hospital, a jury may find that the hospital is liable for the actions of the doctor. Even though he or she is not an employee.