November 2002 • Volume 8 • Number 11

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Delegates confront need for tort reform

BY JANE STOEVER

No holds barred. The AAFP Congress of Delegates wrestled with the nation's medical liability insurance crisis during the delegates' meeting Oct. 14 ­ 16 in San Diego.

What's it mean to have high jury awards and high liability insurance premiums? For answers, try these comments to a reference committee Tuesday:

• "A year ago, many family physicians in the little border towns in southeastern Arizona dropped their obstetrics coverage. It was costing them more in premiums than they were getting in Medicaid pay," said Arizona delegate Carlos Gonzales, M.D., of Patagonia. "It's a large border area; a large group of people now don't have OB care."
• "We have one remaining company offering malpractice insurance in West Virginia, and it says it's leaving. We will get tort reform, but it will be worthless to us because, in a year, it will be overturned by our Supreme Court," said West Virginia delegate David Avery, M.D., of Vienna. "Trial lawyers own the state."
• "I do colposcopies and endometrial biopsies, and my premiums are rising," said Laura Knobel, M.D., of Walpole, Mass., president of the Massachusetts AFP. "This is about more than obstetrics."

Grassroots action

Some testifying to the reference committee swapped ideas on steps to take to overcome the liability insurance crisis:

• "We need to partner with our hospitals on this," said Mary Elizabeth Roth, M.D., of Southfield, Mich., an AAFP delegate to the AMA. "When I get an action alert on this issue in my e-mail, I send it to every manager in my hospital."
• "The latest Texas Medicine has a tear-out section, 'Tort Wars.' It gives points to discuss with your patients, a letter to patients to copy, even a poster for your office. The AAFP could do something like this for Academy members," said Dale Moquist, M.D., of Bryan, Texas, chair of the AAFP delegation to the AMA. "When 16 of the 19 members on the U.S. Senate Judiciary Committee are trial lawyers, is it any wonder tort reform is stalled in the Senate?"
• "The loss of malpractice insurance at a residency means residents cannot be trained as they should be," said resident delegate Erika Bliss, M.D., of Seattle. "For us residents, this is an emergency. We need to portray this as such to the public."

Resolutions

The delegates considered asking the Academy to form its own national program for liability coverage.

"I don't think the Academy's role is to be an insurance company," said Pamela Kushner, M.D., of Long Beach, Calif., a member of the Commission on Membership and Member Services. "In the 1980s, I was on the AAFP Professional Liability Committee, and the same issue came up, and we decided against it."

On Wednesday, the delegates voted against having the AAFP provide liability coverage. They did ask the Academy to:

• educate physicians, legislators, patients and the public about the critical effects of liability insurance premium increases on access to care and the cost of care;
• continue -- as a high priority and in conjunction with the AMA -- to lobby state and national leaders to pass liability insurance tort reform; and
• collect information that will reflect the impact of the reimbursement and liability climate on infant morbidity and mortality rates.