PROFESSIONAL ISSUES

AMA studies liability surcharges

Tort reform is still its No. 1 legislative priority, but the Association is looking for nontraditional, non-legislative fixes for the tort crisis as well.

By Tanya Albert, AMNews staff. July 5, 2004.

Chicago -- Physicians gathered at the AMA Annual Meeting last month explored a variety of options for immediate relief for a profession besieged by increasingly unaffordable medical liability insurance premiums.

The hottest topic of discussion: liability surcharges. The idea is that physicians would tack a charge onto patients' bills to help offset their insurance payment. Low Medicare and even lower Medicaid reimbursement rates combined with managed care contracts that lock in fees have left them no way to recoup increased overhead, physicians said.

"People are trying to be creative so they can do what they were trained to do," said outgoing AMA President Donald J. Palmisano, MD.

Physicians have experienced double-digit increases in medical liability insurance rates in the past several years, with some high-risk specialists such as obstetricians, neurosurgeons and orthopedic surgeons facing increases of 100% or more. Doctors have pushed for what they see as the solution to the problem -- federal tort reform that would cap noneconomic damages awarded in medical malpractice lawsuits at $250,000. But senators who support the reform don't have enough votes to stop a filibuster. Attempts to pass legislation failed twice this year.

"Tort reform sounds great, but it's not going anywhere," said Washington, D.C., orthopedic surgeon Peter E. Lavine, MD. "It [a fee] gets patients' attention and plugs them into the issue. ... Patients may say, 'I don't want to pay this,' and get more involved in tort reform."

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