Few states get high marks in report on liability environment

The American College of Emergency Physicians looked at damage caps, reform efforts and liability premium increases.

By Amy Lynn Sorrel, AMNews staff. Feb. 6, 2006.

States that received failing grades for their medical liability environment have one thing in common: No effective cap on noneconomic damages in medical liability cases.

Eleven states and the District of Columbia received F grades in the "National Report Card on the State of Emergency Medicine" released by the American College of Emergency Physicians in January. ACEP gave D's to 30 other states in the "medical liability environment" category, assessing the level of caps, reform initiatives and the increase in insurance premiums.

"We believe the most important reform is caps," said ACEP Immediate Past President Robert Suter, DO.

Medical liability has a significant effect on whether emergency physicians can afford to practice and whether the specialists they depend on for follow-up care can afford to stay in business, said Dr. Suter, a Houston emergency physician. That's why the medical liability category counted for a hefty 25% of a state's overall grade and why caps on noneconomic damages weighed so heavily, he said. Only one state on the failing list, Maryland, has a cap on noneconomic damages. But at $650,000, it is still "largely ineffective," said Michael Preston, the Maryland State Medical Society's executive director.

The grade also took into account pretrial screening, expert-witness rules, joint liability reform and the increase in medical liability insurance rates for physicians and specialists from 2001 to 2004. Only a few of the failing states succeeded in some of these areas.