A tale from the front: The medical liability crisis in Pennsylvania

AMA Leader Commentary. By Donald J. Palmisano, MD, Nov. 17, 2003.

AMA LEADER COMMENTARY

A few words about current events in medical practice

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A message to all physicians from AMA President Donald J. Palmisano, MD.

If you ever want to see a recipe for a medical liability system disaster, look no further than Pennsylvania. Because if ever a medical liability system had all the ingredients to destroy the practice of medicine -- Pennsylvania's liability system does.

Fortunately, the Pennsylvania Medical Society and the county medical societies have been fighting the good fight for state medical liability reform. It's a battle with incredibly high stakes for Pennsylvania's health -- and its physicians.

Since January 2001, more than 1,400 Pennsylvania physicians have either closed their practices, limited services or left the state because of unaffordable medical liability insurance, according to the PMS.

Between 1997 and 2002, Pennsylvania lost 600 general surgeons (36% of the state's total), 145 orthopedic surgeons and 35 neurosurgeons (16% of the total in each group). Of 67 counties, 20 are experiencing physician shortages, and nine more are at risk.

The crisis threatens the next generation of Pennsylvania physicians. According to the PMS, Pennsylvania ranks 41st out of 50 states in the percentage of physicians younger than age 35, even though the state has eight medical schools.

What makes Pennsylvania such a hostile environment for doctors? It is an ideal environment for trial lawyers playing the medical liability lottery.

According to a report from the U.S. House Judiciary Committee on the Help Efficient, Accessible, Low-cost, Timely Healthcare Act (HR 5), Pennsylvania has the second highest payout in the nation for medical liability lawsuits, totaling more than $350 million in 2000 alone, or 10% of the national total.

Jumbo awards, including those for pain and suffering, drive up medical liability premiums. That's a fact supported by a number of studies, including a recent report from the General Accounting Office.