PROFESSIONAMA readies for battle on tort reformThe ambitious plan passed at the Annual Meeting could cost more than $15 million to carry out, with $12 million set for a national ad campaign to educate the public.By Tanya Albert, amednews staff. July 8/15, 2002. ![[map icon]](/amednews/2002/images/gp10708a.gif)
Physicians launched an all-out attack on the medical liability crisis at the American Medical Association's Annual Meeting in June, making liability reform the AMA's "highest legislative priority." They're calling for legislation at the state and federal levels. They want a public education campaign geared to help the public understand how the crisis affects access to care. They want a state-by-state analysis of litigation costs under the current tort system. They want grassroots physicians to call and write their legislators. They want physicians to donate money to political action committees and the AMA Fund for Liability Reform. They want to study a no-fault liability system. And, by December, they want a plan for a national liability reform event, perhaps a rally or march. "I'm tired of small victories," New Jersey delegate Angelo S. Argo, MD, an otolaryngologist, told doctors gathered in Chicago. "What I care about is survival. If we want to be effective, we need to be an 800-pound gorilla." And to be that 800-pound gorilla, doctors know they need others to heed their battle cry. Delegates asked the AMA to recruit others to join them in the conflict they've been fighting periodically over the past 30 years. They want patients to be part of a broad-based coalition of physicians, trade and professional associations, small and large businesses, farmers and others who can educate the public that it will be the one to suffer if physicians can't afford insurance. That's one of the things that helped states such as California, Louisiana and Indiana get meaningful reform. "The greater the number of groups involved, the greater the chance for success," said Georgia delegate Joy A. Maxey, MD, a pediatrician. "If patients say to Congress 'I want that,' it will help to get over the hump in making a change." "When doctors talk about things that affect their pocketbook, no one listens," added New Jersey delegate Carl Restivo Jr., MD, a rheumatologist. "When they talk about the health of patients, lawmakers listen." And physicians have valid reasons for their patients to care. Access to care impactedIn a two-hour session that offered "A View from the Trenches," physicians talked about ways patients are already being harmed by physicians retiring early, moving to another state or giving up high-risk procedures because of liability woes. A woman in Arizona delivered her baby en route to a hospital 60 miles away because a closer hospital -- which she passed -- no longer offered obstetric services. An elderly Texas man fell and injured his head, but the closest emergency department couldn't treat him because a neurosurgeon wasn't available. It took seven hours to find a hospital that could treat him. By that time the man was in a coma. He ultimately died.
The battle over liability costs has been raging for 30 years.
And Mississippi physicians are crossing their fingers that similar stories don't emerge from their home state. There are no level 2 trauma rooms north of Jackson. "Maybe we should put up billboards ... advising patients to drive slowly and drive safely because the next level 2 trauma room is in the next state," said Mississippi delegate George McGee, MD, Mississippi State Medical Assn. president-elect. In a study released at the Annual Meeting, the AMA said 12 states are already in a medical liability crisis and another 30 states are showing signs that they could be headed in that direction because companies won't write insurance policies or don't offer affordable insurance. The AMA identified California, Colorado, Hawaii, Indiana, Louisiana, New Mexico, Rhode Island and Wisconsin as states that are "currently OK." The Association points to effective tort reform in those states that limits how much juries can award for pain and suffering and limits lawyers fees. The AMA wants to see similar legislation passed at both the state and national levels. Lawyers blame mistakesTrial lawyers say that the legal system isn't to blame and that the debate needs to focus on changing the insurance industry and preventing medical errors. But physicians disagree. "I'm from California, " said AMA Immediate Past-President Richard F. Corlin, MD, a gastroenterologist who noted that he pays $7,700 annually for his insurance there while a Miami gastroenterologist pays as much as $40,000. "I know MICRA [California's tort reform law]. MICRA is a friend of mine. MICRA works." The AMA is backing bipartisan legislation introduced in the House of Representatives that calls for a $250,000 cap on noneconomic damages. The bill also calls for limits on attorneys' fees and a three-year statute of limitations in most cases. Sen. John Ensign (R, Nev.) plans to introduce a companion bill in the Senate when he finds a Democrat to co-sponsor it.
12 states are already in a liability crisis; 30 more are headed that way.
Physicians also want to study the concept of a no-fault liability system under which a patient would be compensated for injuries without having to prove malpractice in a courtroom. "The bottom line is patient access to care," said Dr. Restivo who also is on the board of MIIX , a liability carrier in New Jersey that stopped writing policies for physicians. "If you can't pay malpractice insurance, you can't practice medicine. ... The system is broken." Battle won't be cheapBut the effort to forge change will be expensive. The AMA estimates it could cost more than $15 million to create task forces and research impacts and solutions. About $12 million of that estimated cost is dedicated to a national advertising campaign. Physician leaders also said if doctors want to be successful with state and federal legislation, they need to improve their track record when it comes to political action committee donations. Dr. Corlin wrote a $1,000 check as the first contribution to the AMA Fund for Liability Reform and challenged others to contribute to the cause. The fund collected $40,000 in its first day. He said: "We have a chance right now to make amends for past mistakes and prove we have learned our lesson. ... For ourselves and our patients, we need tort reform and we need it now. Be prepared to fight for it. And if you live in a state with a tort reform regime in place, be prepared to protect it." ADDITIONAL INFORMATION:A crisis in the makingThe American Medical Association identified 12 states in the throes of a medical liability crisis. Physicians there are leaving the state, retiring early or abandoning high-risk services because they can't afford or can't find liability insurance. Another 30 states and the District of Columbia are seeing signs of problems. Eight states aren't experiencing problems. States in troubleFlorida
States showing problem signsAlabama
States currently OKCalifornia
Source: American Medical Association What you can doThe AMA is calling for all physicians to get involved in the fight for liability reform. Here's how you can help:
Copyright 2002 American Medical Association. All rights reserved.
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