Pennsylvania malpractice crisis

by rcentor on December 27, 2002

It is getting ugly in Pennsylvania. Surgeons threaten walkout over insurance costs.

Claiming high premiums are forcing them out of business, at least 45 doctors in Scranton said they have stopped accepting new patients and won’t perform surgeries after January 1. The total includes 10 of the small city’s 18 general surgeons, 14 of its 15 orthopedists, and all 8 of its urologists.

“I don’t want to be irresponsible. I just want someone to put their feet in my shoes for a while,” said Scranton neurosurgeon Shripathi Holla. “We need more people to take care of these patients, and the insurance situation is driving us out of the market.”

Doctors have tried mass walkouts elsewhere in the nation.
In Las Vegas, 150 doctors at University Medical Center resigned in July to protest high insurance premiums, prompting the hospital to shut down its trauma center for 10 days.

The action prompted a special session of the Nevada Legislature, which enacted a law capping damages in trauma center malpractice cases at $50,000, except in cases of gross negligence. About half the doctors returned to work after the bill passed.

The American Medical Association, the country’s largest physicians group, said that while such mass demonstrations are rare, physician groups have also been forced to shut down in several other states because of high insurance costs.

In Scranton, some are calling the threatened walkout a protest. Others insist it is a simple business decision. Holla said his malpractice insurance costs $450 a day — a rate he says is strangling his practice and preventing his hospital from recruiting doctors.

Even physicians must make business decisions. One should not expect us to work in a situation which seems hostile. The current malpractice costs help define a hostile environment. This action is undesirable, but I do understand their problem. Please do not just think them greedy. It is much more complex than that.

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{ 3 comments }

Beth December 28, 2002 at 12:03 pm

What is getting very little to no media attention is the fact that this is the third year of double digit increases and two of the commonwealths biggest insurance providers, GE Medpro and the Joint Underwriters Association (PA’s insurer of last resort) have been approved for a 43% and 52% rate hike respectively for 2004. It is completely unstustainable in light of the 4.4% expected decrease in medicare reimbursements for 2003.

Many of Pennsylvania’s physicians have already left the state, limited their practices or retired early. Our local doctors are acutely aware of the long term effect this will have on health care in the state. It is impossible to recruit new physicians. Dr. Holla must cover the trauma service 24 days a month because he simply cannot find another neurosurgeon willing to take a sharp paycut to practice in Northeastern Pennsylvania.

What makes the situation appear even more bleak is that the trial lawyers have now challenged in court the sorry band-aid of tort reform passed last year. This will pretty much guarantee that insurance companies will continue to avoid the hostile environment in Pennsylvania.

CHenry December 28, 2002 at 10:43 pm

The situation in Pennsylvania is a potential disaster in the making. The abject failure of the state’s legislature to create a lasting and secure reform, given the more than ample warning they have had is a pitiful demonstration of just how badly the governmental processes of that state have been affected by the trial bar. To make matters worse, the December 20, 2002 letter sent to all Pennsylvania-licensed doctors by C. Michael Weaver, the Pennsylvania Secretary of the Commonwealth, implied that a doctor’s decision to suspend practice (forced on some practitioners unable to afford the available malpractice coverage) may be grounds for actions against the licensee for patient abandonment. Mr. Weaver’s letter is an embarassment to the Commonwealth and will only further the harm already caused by this situation the state government has failed to control. As far as I know, the decision to practice medicine is still one of free will, regulated, not impressed by the state. The right of a practitioner to discontinue practice for any reason cannot be usurped by
the Secretary of the Commonwealth, and I doubt by the state (unless we’ve gone and repealed the XIII Amendment or war has been declared and the doctor has been drafted). This is a time for intelligent, constructive, swift and lasting reform along the models that have proven to work in California and elsewhere, not for desperate lame-duck-appointee finger-pointing and threats. The potential need for an organized response to a public health threat in Pennsylvania shouldn’t be jeopardized by a malpractice crisis that is sending doctors out of state or into retirement.

db December 29, 2002 at 6:31 am

Beautifully stated! The Pennsylvania situation represents a MAJOR crisis in health care. The letter was insulting, inappropriate and demeaning.

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