BY J.M. BRODIE
Medical liability
insurance turmoil sparks discussions in several states (Online-only
content) U.S. Senate unlikely to act soon
on liability issues, but senators seek debate (Online-only content)
When Marilyn Courtright came to Connecticut 30 years ago, she searched high and low for a physician. She ultimately found Neil Brooks, M.D., of Rockville.
"I have diabetes, and he treated me for that; I have high cholesterol, he treated me for that; I also had a stroke, and he got me through that. I have had several surgeries, and he's seen me through every one of them. I have a lot of faith in him," Courtright explained.
Unfortunately, she is losing her long-time physician. Brooks was scheduled to retire May 2, a victim of the rising costs doctors face in securing malpractice insurance. "I feel very, very sad that Dr. Brooks is retiring," Courtright said. "He's a wonderful doctor."
In Florida, 80-year-old Olive Ogle fears that her doctor of nearly 20 years may also be forced to close his doors because of high malpractice insurance costs.
"When I left his office the other day, I told him, 'Don't abandon the ship. At least not until I die,'" quipped Ogle, a retired high-school guidance counselor. "The malpractice insurance situation is so bad, he's afraid he's not going to be able to stay put."
Ogle's doctor, Charles Barniv, M.D., of Destin, Fla., lost his insurance coverage earlier this year because his carrier left the state. The few remaining malpractice carriers in the state would not insure Barniv for reasons such as these: His physician assistant was involved in an alleged medical error 15 years ago, and Barniv does X-rays in his office.
"The excuses varied depending on whom you talked to, suggesting they were looking for a way to avoid writing any new policies in Florida," said Barniv, who found himself virtually uninsurable. He ended up taking out a letter of credit from his bank to keep his doors open.
At press time, Florida Gov. Jeb Bush had promised to call a special session if the House and Senate in that state failed to approve a $250,000 cap on the noneconomic damages that juries can award to malpractice victims.
For Barniv, such relief can't come fast enough. "Malpractice settlements on pain and suffering are the big piñata," he said.
In January, 74 percent of Americans said that the issue of medical malpractice insurance was either a "crisis" or a "major problem," according to a Kaiser Family Foundation health report released in April.
 What Americans think about medical liability insurance situation Source: Kaiser Family Foundation |
Americans hold individuals who bring lawsuits at least partially responsible for problems with the malpractice system, according to the Kaiser report, "Public Opinion on the Medical Malpractice Debate." Sixty percent of adults polled said the number of malpractice lawsuits is a very important factor in causing rising health care costs.
"You find somebody you want to trust your life with and you kind of want to stick with him," said Destin, Fla., restaurant owner Tim Edwards, another Barniv patient. "I'm 47. I have my own business. I know about human error and how continuity reduces the likelihood of error. There's a great comfort in knowing you are not going to have to re-educate a doctor and hope they really have enough time to learn your history."
In Connecticut, the malpractice insurance crisis has intensified, forcing insurers and physicians to leave the state, according to the Hartford Courant. Connecticut Medical Insurance Co. is one of the few companies that has not bailed out. CMIC paid $42 million to settle claims in 2002, compared with $19 million six years ago. Last year's total included 19 settlements or jury awards of $1 million or more, compared with nine such payments six years ago. As a result, CMIC doctors are paying about 30 percent more in premiums than a year ago.
"Connecticut is now one of the crisis states. In my town, more physicians are leaving their practices," said Brooks in a recent FP Report interview. He was on his way to Hartford to ask key legislators to support policy similar to California's Medical Injury Compensation Reform Act.
"Up here, we are right in the middle of trying to get the full MICRA implemented," said Brooks, AAFP president from 19 98 to 1999. "In 1996, we got several parts of MICRA, but we didn't get the cap. We thought we had gotten a limit on the amount the lawyers collect, but we found that they are simply having their clients sign a waiver which allows for a greater percentage to the lawyers."
He added, "I am retiring now in large part because of the malpractice insurance crisis. It was an extremely difficult decision to make."
To reach writer J.M. Brodie, e-mail mbrodie@aafp.org.
FP Report is published by the
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Copyright © 2003 by
American Academy of Family Physicians.