No state immune to liability stress

Doctors in some states with liability reform give up high-risk procedures, and physicians elsewhere feel mounting pressure to keep reforms intact.

By Tanya Albert, AMNews staff. Aug. 23/30, 2004.

Someone assessing the practice particulars of Lynda Smirz, MD, might conclude that middle-of-the-night phone calls during a Midwestern snowstorm contributed to the Indiana obstetrician-gynecologist's decision to give up delivering babies.

But it was medical liability insurance rates that forced the doctor who delivered the nation's first surviving sextuplets in 1993 to give up a beloved part of her job this year.

Indiana is one of six states that physicians point to as having established tort reform, so it is surprising that insurance rates drove Dr. Smirz out of obstetrics. But Indiana physicians this year got socked with a 72.6% increase in the amount they have to pay into a patient compensation fund.

Doctors in Indiana and other states that the American Medical Association says are not showing signs of a medical liability insurance crisis know they have it better than colleagues in states without tort reform. Still, in some cases doctors are starting to see rates hit levels that are not financially feasible, given reimbursement rates from Medicare, Medicaid and private insurers.

In addition to Indiana, doctors in tort-reform friendly New Mexico and Louisiana say they are seeing some colleagues begin to retire early or give up high-risk parts of their practice.

In California, Wisconsin and Colorado -- the other states with effective tort reform -- doctors are fighting to ensure that reforms stay intact so doctors won't be forced to make practice choices based on insurance rates.