Skyrocketing medical liability premiums may pose a threat to physicians, but they actually hurt patients of all ages and incomes -- particularly those who already struggle with financial or geographic barriers to health care.
That was among the insights offered to the U.S. House of Representatives Small Business Committee by AAFP President-elect Larry Fields, M.D., of Ashland, Ky. Fields shared his experience -- and that of his peers -- in testimony presented during a June 14 hearing titled "Are Skyrocketing Medical Liability Premiums Driving Doctors Away From Underserved Areas?"
Liability Premiums Threaten Patients, Says Academy
AAFP Leader Tells House Small Business Committee About Malpractice Insurance Crisis
By Leslie Champlin
6/15/2005
"When physicians cut services and staff because of high liability premiums, "those who suffer the most are our patients," AAFP President-Elect Larry Fields, M.D., tells the House Small Business Committee. Explaining the effects of skyrocketing premiums for malpractice insurance are, from left, Delorise Brown, M.D., from the Cleveland Medical Center; Fields; Winston Price, M.D., president of the National Medical Association; Elena Rios, M.D., president of the National Hispanic Medical Association; and Wilbur Colom, a trial attorney from Columbus, Miss.
Rep. Donald Manzullo, R-Ill., chair of the committee, called the hearing to explore the impact of the rising premiums on underserved urban and rural areas. Eleven committee members also attended the hearing, including Donna Christensen, M.D., D-Virgin Islands, a family physician and delegate to the House.
Ballooning medical liability premiums, Fields told the committee, are threatening the viability of the medical practices on which rural and urban underserved areas depend.
"A large percentage of family physicians work in small and medium-sized practices of four physicians or fewer," he said. "Our practices are typical small businesses that operate with very tight financial margins."
Those margins disappear with rising medical liability premiums. A family physician has only a few options: Eliminate services, reduce staff, borrow to cover current costs or sell the business to a larger organization.
Often, with such situations, "those who suffer the most are our patients," Fields said. "They are your constituents who no longer have a medical home; who can no longer find the friendly, familiar faces that humanize medicine and provide a safe haven in the complex world of 21st-century medicine; or who can't find the obstetric services they need."
Fields pointed to the experience of Julie Wood, M.D., who left her small hometown practice in Macon, Mo., to continue her full-service family medicine practice at an academic health center in the Kansas City, Mo., area, where her hospital could pay her liability premium. Wood made that decision after her insurer raised her annual premium from $19,000 to $71,000. The result: The poor in her home community lost obstetrical and primary care because they couldn't afford the two-hour drive to her new office.
"Some people can drive the two hours to see Julie, but what do we tell the people who can't afford to do that?" Fields asked.
He linked the nation's health care disparities with rising liability premiums: "I have to tell you … disparities will never end unless physicians in this country are freed to do the right thing for our patients, each and every one, each and every time -- free of a system that allows any lawyer who can chase down a victim and dig up an expert to drag a physician through the courts for five years, all the while demanding that the physician pay ever higher liability premiums, and at the end of the day pays next to nothing to the alleged victim."
Fields asked the lawmakers, "Continue to try and find ways to free American medicine to be what I know in my heart it can be." He pledged, "I promise you the full support and assistance of America's family doctors in your work. And I promise you a health care system the likes of which the world has never seen."
