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Coverage squeezed for elder-care physicians: Tort crisis hits nursing homes

Physicians are calling for tort reform for nursing facilities. Changes in elder abuse laws are also urged.

By Tanya Albert, amednews staff. March 8, 2004.

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Physicians with nursing home patients are now facing medical liability insurance premium hikes that are forcing some of them to re-evaluate whether they can continue the practice.

It is well-known that rising premiums have pushed some physicians out of high-risk specialties such as obstetrics and neurosurgery. Now physicians specializing in elder care are spotting similar disturbing trends.

Among the most troubling findings in a recent survey: 21.5% of physicians who work in nursing homes said they had problems obtaining or renewing their medical liability insurance in the past year.

Of those physicians, 34.2% said insurers refused to cover them because they work in nursing homes, according to an American Medical Directors Assn. survey of 325 physicians completed in December 2003.

More than 12% of those physicians said that insurance carriers had pulled out of the nursing home market in their areas.

"We're very concerned about who is going to care for the elderly, especially as the aging population explodes," said Meg LaPorte AMDA's acting director of government affairs.

While nursing home patients are still able to get care, physicians may be responsible for a larger number of patients and patients may no longer have their first choice of a doctor.

Family physicians and internists who used to follow their patients into nursing homes are no longer doing that, said AMDA President James Lett II, MD, who works in California nursing homes. Even some who have dedicated their careers to the elderly have had to give up the nursing home portion of their practices or resign their medical director roles.