Jan. 5, 2026
Meet Physicians Insurance's First Physician President/CEO
From Physicians Insurance
On Nov. 1, Physicians Insurance A Mutual Company welcomed David Carlson, DO, as president and chief executive officer, as Bill Cotter stepped down to begin his retirement. Dr. Carlson has served on PI's board of directors since 2018 and as chair from 2019 to 2023. As the first physician to sit at the head of PI's executive table, he comes to his new role with a unique dual perspective, informed by decades of clinical and business experience.
A board-certified family practice physician, Dr. Carlson has held several senior executive roles at major health systems, including MultiCare Health System in Washington, Hospital Sisters Health System in Illinois, and Conemaugh Health System in Pennsylvania, roles in which he also oversaw those health systems' captive insurer organizations. He was most recently vice president of medical operations-King County at Virginia Mason Franciscan Health.
Here, Dr. Carlson introduces himself to WSMA members and sheds light upon the perspectives he will bring to his new role with Physicians Insurance.
WSMA Reports: You will be the first physician CEO of Physicians Insurance, a company that was formed by physicians for physicians. What's one takeaway from your experience as a practicing physician that you think will inform your leadership?
Dr. Carlson: Having cared for patients, I'm accustomed to absorbing as much information as possible in short amounts of time to quickly make important decisions. At the same time, I am comfortable making decisions when we don't have all the answers at once, because we rarely do. Early in my career, a mentor said, "If you don't have the answer yet, listen harder." So, I listen a lot and I focus on continually taking in new information. Given the quickly shifting dynamics we face in medicine, I think this is important.
In addition, while in leadership and overseeing captive organizations, I gained experience in efforts to improve the day-to-day landscape of care delivery and in prioritizing patient safety to improve outcomes. There are a lot of moving parts to care delivery today, but with the right support in place, both internally and externally, I'm optimistic about the quality and safety of care. I'm excited to bring my experience as a health care insider to a medical professional liability insurer that cares so much about supporting its members' needs during both the good days and the bad days.
Are there any unique trends impacting the medical professional liability insurance industry today that Washington physicians should be aware of?
Probably the most powerful trend is the pending updates to damages caps. Related to this is the dramatic impact of social inflation, which has jurors deciding on incredibly high damage awards, in turn raising expenses across the board for health care. It's not financially sustainable or good for patient care in the long run. It's imperative for PI to continue participating in the dialogue of damage caps, seeking solutions that contribute to a stable marketplace and that support overall care quality in cities and rural areas. The ~$250,000 caps from decades ago are certainly due for an update, and PI advocates for reasonable caps.
Early settlement demands from plaintiff attorneys are another rising trend. This is where a claimant receives an early, aggressive letter from a plaintiff attorney intended to create fear and division regarding the defense approach while demanding an outsized settlement before the medical facts have even been reviewed. In such instances, PI recommends that a defendant works closely with their claims team to navigate the demand with an appropriate legal response that is in their best interest.
With medical professional liability rates going up, many of our members are advocating for tort reform. For years, that goal has remained elusive due to the political makeup of Washington state. What type of reforms do you see on the horizon to improve the cost of coverage?
PI participates in advocacy work across the legislative, judicial, and regulatory environments to protect physicians, hospitals, and their patients. By advocating for reasonableness in all aspects of reforms, whether that's updating damage caps or statutes of limitations, for instance, we work to create a sustainable health care landscape that is affordable for patients and where quality care persists in cities and rural areas alike. Our best chance at success in our desired reforms, especially in political environments like Washington's, is to maintain a broad- based approach that benefits all parties through the support of an accessible and quality health care system. We will continue with advocacy strategies that benefit the whole of health care so that liability expenses, and corresponding medical professional liability rates, can remain reasonable.
Coming out of a health system, you know how overwhelmed many physicians are feeling. How can Physicians Insurance help today's practicing physicians and their insureds?
Physicians Insurance has kept the physician's perspective at the center of its work since its formation almost 45 years ago. A lot has changed in health care over those decades, but attentive support and a commitment to excellence in claims management are still among the best ways we can help physicians. The organization is continually looking out for rising trends and meeting the needs those trends create. PI exists to create peace of mind for physicians by being the experts they need in their corner, with unwavering financial resources, guidance, and claims expertise.
Looking forward, what does the future hold for Physicians Insurance?
PI will continue doing what it does very well in protecting its members, first and foremost. We will continue to look at our growth and healthy diversification options that support our ongoing strength and relevance. We are here to be the best medical professional liability insurer in Washington, in our region, and in the country. How we grow and support our members is critical.
I'm an optimist-the glass is nearly always full. We have rough waters to sail with all the challenging trends in the medical community, but the good news is that PI has the strategies to deal with the threats we're facing, including the purpose-driven mentality to keep our members at the center of our work. That is our job every day.
This article was featured in the January/February 2026 issue of WSMA Reports, WSMA's print magazine.