Letters to the Editor - Jan. 5, 2004

Med mal rate article does not reflect the reality of practice in Richmond - Sample logs not a hassle, rather they are a patient safety measure

Med mal rate article does not reflect the reality of practice in Richmond

Regarding "Physicians feel double-digit pain," (Article, Nov. 10):

Your recent article misleads physicians seeking a locality where med mal rates are the lowest.

The average filed rates for several medical specialties in Richmond, Va., are:

Internal medicine: $8,503
General surgery: $31,340
Ob-gyn: $48,083
Neurology-surgery: $54,745

These rates do not include the rates of companies that were active in 1998 but have since gone bankrupt or ceased to write med mal because of adverse financial results.

In the last five years we have lost six major liability insurers and several smaller ones.

While our med mal cap is $1.7 million per claim, of the seven insurers still open to writing med mal, we are not aware of any who will write a policy for the capped amount. Instead physicians must purchase a minimum of $2 million per claim and $5.1 million aggregate.

Malpractice insurers in Virginia (Richmond no exception) have taken large rate increases in the last two years, averaging 51% in 2002 and 30% in 2003. The impact on physicians has been severe.

We find it incredible that Richmond -- an East Coast city of more than 1 million, can be legitimately compared with Midwestern and Western agricultural states.

We find it equally incredible that our rates would be considered among the lowest in the nation.

--Isaac L. Wornom III, MD, president

--Barklie Zimmerman, MD, president-elect, Richmond Academy of Medicine, Richmond, Va.

Sample logs not a hassle, rather they are a patient safety measure

Regarding "County exec: Insurer audits result in physicians not giving out samples" (Letters, Dec. 8):

While I can't comment about all requirements from a medical liability insurer during a medical office audit, I am surprised at the example described in the letter cited above.

While the individual physician at our medical center may dictate into the clinic chart note the information about samples given out, we also have always kept a written log for each physician. It includes a patient medical record number, the medication, the expiration date, and the lot number of the samples given.

That way, we can easily track the medication when the patient calls to tell us that "those little white pills really worked," but more importantly, we could rapidly track patients who received medication that is being recalled or has some sort of identified problem with a particular lot number.

It only takes a few seconds to record the information in a ledger as the samples are being given out.

To us, it isn't a "insurance paperwork requirement," but a patient safety measure.

--Joan B. Krajca-Radcliffe, MD, Morris, Minn.