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Groups blame malpractice crisis on medical errors - Consumer Advocacy Organizations

WASHINGTON -- If physicians really want to lower their malpractice premiums, they should weed out bad doctors who are responsible for medical errors, representatives of a coalition of consumer advocacy organizations said at a press briefing.

The groups--which also include Public Citizen and the Consumer Federation of America--are challenging organized medicine's long-time claim that increased litigation and super-sized legal judgments are to blame for skyrocketing malpractice insurance costs.

The American Medical Association "is investing its resources in a firestorm" to prove that the insurance crisis is hurting patients, said Arthur Levin, a member of the Institute of Medicine (IOM) committee that in 1999 reported that up to 98,000 people die in hospitals annually because of preventable medical errors.

"Nothing is farther from the truth. It's injuries that are hurting patients," he said.

In focusing on the malpractice "crisis," organized medicine is ignoring the IOM's call to reduce medical errors, said Mr. Levin, who is also director of the Center for Medical Consumers.

As an example, the AMA has successfully prevented patients--and physicians--from learning the identities of physicians in the National Practitioner Data Bank who have had malpractice payouts against them. Nor can patients learn which physicians have either lost their hospital admitting privileges or had restrictions placed on their privileges.

This secrecy deprives patients of valuable information when choosing a physician, said Dr. Sidney Wolfe, director of Public Citizen's Health Research Group.

Although data on individual physicians are not available, overall statistics from the data bank show that in the past 12 years, just 5.1% of U.S. physicians accounted for 54.2% of malpractice payouts, Dr. Wolfe said.

"In other words, most repeat offenders are still practicing, usually without ever having had any disciplinary actions taken against them," he commented.

Only 7.6% of physicians who have had two or more malpractice payouts have been disciplined in the last 12 years, according to the data bank.

Further, state medical boards have done a poor job in enforcing medical practice laws and adequately disciplining physicians, Dr. Wolfe said. Physicians should be looking inward--and pressuring state medical boards to do a better job.

The rise in malpractice premiums also can be attributed to normal economic cycles, according to a Public Citizen report released at the briefing.

When the economy is robust and investment yields are high, insurance companies are able to keep premiums at modest levels. But when the economy falters and investment returns drop, insurers raise premiums to make up for lost revenues, J. Robert Hunter, director of insurance for the Consumer Federation of America, told reporters.

Medical organizations also have exaggerated the growth in new malpractice insurance claims, the Public Citizen report said. Citing data from the National Association of Insurance Commissioners, the report indicates that the number of new malpractice claims actually declined by 4% between 1995 and 2000. Compared with 1995, when 90,212 claims were filed, only 86,480 claims were filed in 2000.

Although medical costs have increased by 113% since1987, the amount spent on malpractice insurance has increased by only 52% over that time, the Public Citizen report said.

Physicians' groups disagree with those arguments. "It's self-serving [for these groups] to say that doctors are at the heart of the problem," said Dr. Thomas Purdon, immediate past president of the Association of Obstetricians and Gynecologists. The escalation in premiums is due to the outrageous rise in jury awards--not just in cases of medical malpractice, but in all aspects of commerce, he told this newspaper.

Medical liability reform has topped the AMA's lobbying agenda for some time. This year, the organization continues to push for legislation to limit the number of years that a plaintiff can file a suit, and to cap noneconomic or "pain and suffering" damages. A recent plan from the White House to reform medical liability proposes a $250,000 cap to these types of damages.

"Caps do work," Dr. Donald Palmisano, president-elect of the AMA, told this newspaper. An actuarial analysis by the Medical Society of New Jersey concluded that a $250,000 cap on noneconomic damages would produce immediate savings to physicians by lowering their premiums. States that have capped awards within these limits have stable insurance markets, Dr. Palmisano said, citing the report.

Others don't agree. Capping damages would only hurt those patients who have suffered from a medical injury Public Citizen President Joan Claybrook said.

RELATED ARTICLE: More Physicians Quit Practice in Response to High Premiums

Evidence is mounting across the country that physicians arc walking off. the job because of rising malpractice insurance premiums.

Blue Cross and Blue Shield drew this conclusion when it surveyed 42 of its companies and found that 56% of plans in states with a malpractice crisis report that physicians are refusing some high-risk procedures, are leaving practice, or are retiring.

More than twice as many plans in crisis states report that physicians are reducing emergency department calls or are refusing to see patients, compared with plans in states that don't have a malpractice crisis. Nearly a third of plans in crisis states say that physicians are moving their practices out of state.

The insurer based its definition of a crisis state on an American Medical Association survey conducted in 2002, which identified 12 states with a medical malpractice crisis and 30 others with a growing malpractice problem.

States in crisis include: Florida, Georgia, Mississippi, Nevada, New Jersey, New York, Ohio, Oregon, Pennsylvania, Texas, Washington, and West Virginia.

© 2003 International Medical News Group
© 2003 Gale Group