Texas MedMal in the News

Well, what to believe. A couple of days ago an analysis of Texas Medmal verdicts was released, finding basically that Texas had no crisis of skyrocketing Medmal verdicts. That this goes against the conventional wisdom in my field is a given. Symtym has quotes from several of the Usual Suspects. Reflecting my skepticism with an eloquence I lack, Ted Frank at PointofLaw has questions for the authors, and points out some fairly basic flaws in the paper.

Then, comes this news:

TMA Action

Citing the 2003 liability reforms and passage of Proposition 12, two more professional liability insurers announced last month they plan to cut their rates.

Physicians who hold policies written by The Doctors Co. should see an average 14-percent drop in premiums. The company has asked the Texas Department of Insurance (TDI) to approve its plan to give rate reductions of up to 30 percent to most of its 1,100 customers in Texas. The change would be for new policyholders effective April 1 and for renewing policyholders effective June 1.

American Physicians Insurance Exchange said it will cut rates for about 2,200 Texas physicians by an average of 5 percent.

The cuts are the latest reductions announced by insurers in the wake of the 2003 reforms. The Texas Medical Liability Trust (TMLT) has reduced its rates by 17 percent. TMLT President Tom Cotten called the reduction “indicative of the triumph of medical liability reform in Texas.”

OK, I’ll give you that 5-15% cuts aren’t terribly dramatic, and the days of $2000 coverage are gone forever. However, I know which of these I believe. If insurers are voluntarily lowering rates after a historic run-up, that tells me that medmal reform works to lower rates.

The real solution to this situation is for people to realize no-one is perfect and that accidents happen. I’m for actual victims of real malpractice being appropriately compensated. I’m against the current adversarial/lottery system, and I’m against medmal being used as disability insurance by patients with bad outcomes.


Comments

  1. Counselor Curious:

    Firstly, my premiums are more then a few thousand bucks as are the premiums of many of my colleagues. If you had taken the time to read my post, you would have gleaned that information correctly. And how much money I make has nothing to do with whether legally extorting physicians in a broken liability system is right or wrong.

    The reason why Texan physicians enjoy rate cuts immediately has to do with Prop 12 which ammended the constitution of Texas making it constitutional to implement caps thus avoiding the lengthy court battle that ensued over CA’s MICRA legislation instituted by your brethren who were desparate to protect their 40% contingency fees.

    I am not ignorant of the economics of the plaintiff’s side. I know what it costs to obtain experts, do research and try the case. That IS the problem and that is what needs to be fixed. Caps will simply stop the hemorrhage until the actual problem is addressed. That problem is you and your colleagues siphoning off gobs of money out of the healthcare system and creating an environment of fear and paranoia that has led to billions in defensive medicine costs. The trial bar needs to be extricated from healthcare.

    If you are so concerned about the young and the elderly, start taking their cases based on merit. Physicians do this everyday. We take any case regardless of ability to pay and then risk unlimited liability at the hands of an injury attorney.

    Do I have disdain for people like you? Absolutely. Do I think I am immune from injury/catastrophe? Of course not. But keep this mind, odds are much more likely that you or your family will need me then I will need you.

    Our professions will never see eye to eye in this lifetime. But at the very least JD, you and your injury colleagues need to accept part of the blame for creating this mess. Physicians play a role. Some of us are bad and we need to be better policed. The fact of the matter is that health care has never been so advanced and efficient. Kings come to America to get their healthcare. Have malpractice premiums skyrocketed because we are all such bad doctors? Or did the tort system invade healthcare 40 years ago?

    When you can admit your culpability on this matter, we might be able to move forward. But all I hear from you guys is about how terrible docs are killing 100000 people a year…………..hogwash. Take a little personal and professional responsibility for what you have done. It will be good for your soul. You have one of those, right?

  2. Curious JD says:

    So let me get this straight. You can talk about greed all you want as long as it’s lawyers you’re talking about, and you never mention the actual victim? But referring to how much you make has no relevance? Quite the double standard you have there. You don’t want a civil discussion. You’ve been whipped into an anti-lawyer frenzy by the AMA and you want to hate lawyers. You have forgotten all about the people they represent because that would require you to see what these proposals do to them.

    You enjoy those “cuts” in Texas. You must be a master bargainer if a 100% rate increase followed by a 15% cut represents a good deal to you.

    How do caps stop the costs? In states with caps, do they not still hire experts? Do those experts charge less? You evidently are ignorant of the economics if you think that’s the case. You’re a scientist – are you really taking this cap stuff on faith? Do you practice medicine with this much trust in what you’re told? When you submit your bills to the insurer for reimbursement and they tell you that they’re not paying them – do you just believe them and say OK, I must have overbilled?

    As for taking meritorious cases pro bono, lawyers do that all the time. My state ATLA handles cases pro bono for servicemen overseas. But do you take cases that require you to go broke? Would you handle a patient knowing you would be required to spend $100,000 and hundreds of hours of time and that you had a 75% chance of never getting anything for them? Of course not.

    Do you want me to admit that lawyers sometimes file BS cases? I’ve got not problem doing that. But just as I don’t believe that bad doctors are an epidemic I don’t believe that there is an epidemic of BS suits being filed in the malpractice arena. If you were going to file a frivolous suit, why do it in the arena where cases are the most expensive and you lose at trial 75% of the time? If I were going to file BS cases, they’d be car wrecks. Much cheaper.

    And your argument that billions are siphoned off health care again illustrates your ignorance. The bulk of many awards goes to pay medical bills. Have you ever heard of the right of subrogation? That’s where your health insurance company can recover whatever it paid out if you recover against a 3rd party. That doesn’t take the money out of the system, it merely puts it on the responsible party.

    If you don’t like contingency fees, tell me how people are supposed to pay for an attorney to battle an insurer? If you leave work today and get hit by a Wal-Mart truck and are disabled, how would your family handle your case? Who would you hire? Will you be able to pay hourly rates of $100+, and experts, and make your mortgage, and your medical bills, and your usual daily expenses? And you’re a doctor!

    We can have a very civil discussion on a lot of issues in this debate. But the president’s proposal of caps and insurers being allowed to pay judgments over time is nothing but an insurer profit protection bill. Period.

    Caps fall disporportionately hard on the weakest members of society – those without economic damages. You want to talk screening panels – great. You want to talk expert pools – great. You want to talk venue issues – great. But that’s not what’s on the table right now.

    Again, who do you think is going to represent you if someone else puts you in a bad spot – be it a car wreck, medical malpractice, product liability case, or whatever? Do you think the party at fault just writes big checks to cover hundreds of thousands in medical bills and lost wages just because you ask?

    Do you think that those lawyers who work for insurers at $150+ an hour, or who represent Fortune 500 companies are interested in representing you against their corporate clients?

  3. Curious JD says:

    Scot,

    This is an interesting article on the economics of practicing medicine:

    http://www.newyorker.com/fact/content/articles/050404fa_fact

    Some interesting quotes:

    “A well-run office can get the insurer?s rejection rate down from thirty per cent to, say, fifteen per cent. That?s how a doctor makes money, she told me. It?s a war with insurance, every step of the way.”

    Why do you trust them so implicitly on your premiums when we all know that’s the case? I’ve worked for insurance defense firms – 1/2 the battle was wording your timesheet correctly so it didn’t get kicked back by the third party bill reviewer.

    If you would focus 1/2 the hatred you have toward lawyers into the bigger problems of healthcare, much more would be solved. But no one marches on their state capitol about reimbursement rates, do they?

    Another interesting quote from a doctor who opts out of insurance payments:

    “Why not? the surgeon was asking. ?For doctors to think we have to be altruistic is sticking our heads in the sand,? he told me. Everyone is squeezing us in order to make money, he said?everyone from the supply companies that we pay to the insurers who are supposed to pay us. ?The C.E.O. of Aetna?s compensation is now ten million dollars,? he pointed out. ?These are for-profit companies. Insurance companies make money by withholding reimbursements to physicians or by not approving payment for a service we?ve provided.? To him, the question is why we deal with them at all.”

  4. Regarding the argument that it is senseless for a plaintiff’s attorney to take on an obviously meritless case, yes, if a trial was the desired outcome but it is not. The broken system can only be described as legalized exTORTion. The goal of filing excessive cases (remember 70% of all cases are dropped, dismissed or found for plaintiff) is settlement.

    A physician never wins a lawsuit. Once a claim has been filed there is only the option of damage control. It is always cheaper and easier to settle meritless cases then it is to go to trial and win.

    Are you saying that someone who recovers fully in one year has greater pain and suffering than someone who loses a son? It doesn’t seem very democratic to me that one person’s injury is worth millions while the same injury in another is worth nothing. However, I love your idea of a set fee schedule for pain and suffering.

    MICRA was declared constitutional in 1988.

    Children and non-working spouses are assigned a “salary” on which to determine economic damages.

  5. Did some homework. According to a July 28, 2003 General Accounting Office report regarding med/mal insurers.

    “profits are not increasing, indicating that insurers are not charging and profiting from excessively high premium rates”.

  6. Curious JD says:

    Beth,

    Have you ever negotiated with an insurer? If you’re a physician, I know you have. Do you really think they just roll over and pay meritless claims? If you do, I’d like the name of the insurer you’re dealing with.

    If it’s so damaging for a physician to have a case filed, why are there so many physicians with multiple payouts out there who are still practicing? Less than 5% of the physicians are responsible for more than 50% of the payouts in each state, and many have multiple claims.

    I think you misunderstood my point with regard to damages. The tort system only provides for recovery when another party is at fault (yes, I know you dispute that). If you want to advocate a no-fault style system, go for it. European countries have fee schedules for damages, but their residents also don’t have vast amounts of medical bills to repay because of universal health care. You really can’t have one without the other.

    I think you need to check your facts on that MICRA salary. I’ve never heard or seen that, but I could be wrong. If it exists, do they attribute the average physician salary of $150K a year to the child?

    As for the GAO, the only report I could find was the August 8, 2003 one, which found, among other things:

    “In the five states with reported problems, however, GAO also determined that many of the reported provider actions were not substantiated or did not affect access to health care on a widespread basis. For example, although some physicians reported reducing certain services they consider to be high risk in terms of potential litigation, such as spinal surgeries and mammograms, GAO did not find access to these services widely affected, based on a review of Medicare data and contacts with providers that have reportedly been affected. ”

    and

    Limited available data indicate that growth in malpractice premiums and claims payments has been slower in states that enacted tort reform laws that include certain caps on noneconomic damages. For example, between 2001 and 2002, average premiums for three physician specialties–general surgery, internal medicine, and obstetrics/gynecology–grew by about 10 percent in states with caps on noneconomic damages of $250,000, compared to about 29 percent in states with limited reforms. GAO could not determine the extent to which differences in premiums and claims payments across states were caused by tort reform laws or other factors that influence such differences.

    http://www.gao.gov/docdblite/details.php?rptno=GAO-03-836

  7. Anonymous says:

    So what you are saying is the amount of money I make yearly should correlate with how high or low my malpractice premiums go? You’re starting to sound like one of those liberal socialist democrats determined to distribute wealth equally at any cost. That cost will be a loss of innovation, decreased risk taking and a disincentive for the best and brightest to go into the field.

    And for the record, I am not an AMA member nor do I hate all lawyers, just injury lawyers. My father is a lawyer as is my best friend. They despise injury lawyers too. I have developed this seething hatred and generalized ignorance all by my lonesome self. And the scary thing is, Curious, I may be just one bitter, angry, disgruntled yet well qualified surgeon, but I am the tip of the iceberg and am fairly representative of my entire profession. Remember that the next time you are staring up at one of our faces when it is your turn.

    Just watch some daytime television and leaf through the yellow pages. Or drive by some billboards located outside of hospitals like I do every day to see how shameless your profession has become.

    I agree with you wholeheartedly about the reimbursement side of the issue and thank you for the article which I read written by Atul Gawande. He also wrote a book called “Complications” which I would recommend reading. The other half of my anger and bitterness is no doubt directed at that obscene industry, but that is a completely separate issue from the broken liability system. It is also crucial that health insurance providers and their evil ways not be mixed in with the insurance companies that sell malpractice insurance to physicians. Many in your profession often combine the 2 to spin the debate favorably in your direction deliberately confusing the stakeholders(ie the patients).

    In fact my practice is in the process of dropping all insurance products and going fee for service. It may be the final straw for my career in this state hastened of course by my malpractice premiums, but the thought of doing another appendix at 3am in a snow storm on Xmas Eve for 400 bucks physically sickens me.

    You asked for an alternative to contingency fees? Loser Pays.

    Also, get rid of laypeople on juries easily swayed by the level of disability over the merits of a complicated case that many physicians cannot even understand. Lay jurists are not my peers. They are a jury of the least educated most readily available and most easily swayed. Get a panel of experts to evaluate the standard of care. Eliminate hired guns. If I am not mistaken, we are the only civilized nation in which juries try civil cases.

    You also made a comment to Beth regarding 5% docs responsible for 55% of the claims. The problem is it’s a DIFFERENT 5% every year. You do not take into account that high risk guys like NSurgeons and OBs are sued with much greater frequency based on the cases they handle. Frankly, I don’t know a Nsurgeon who isn’t sued yearly. Wanna get rid of all of them? Your arguement suggests we do that.

    Yes let’s get rid of the few bad apples that truly commit malpractice regularly. But if we plan to do that, please provide us an avenue in which to do that so that when we call somebody out for being a bad doctor, one of your colleagues does not step in to sue the hospital for millions for ruining that bad doctors career. The tort system essentially scares us out of turning on our own bad apples.

  8. Forgot to post my name.

  9. Curious JD says:

    Acutally, Scot, you completely misunderstood what I was saying with your first comment. I really don’t know where you got that. If I misspoke, I apologize, because I did not intend that at all.

    You can hate injury lawyers all you want. To do so you have to either 1) believe you will never be injured in any way at the hands of another or 2) be so wealthy you can afford to fund a case against someone paying hourly rates. If you’re the first, I congratulate you on your imperviousness to harm. If you’re the second, you’re one of a tiny percentage of people in this country, and I congratulate you on that as well.

    I notice you generalize all lawyers who represent injured parties by those you see on billboards? Is that fair? Should I judge all physicians by those who operate drunk? Or those who write fake prescriptions? Or those who perform 200 eye surgeries a day and advertise on the radio? C’mon, doc, you’re better than that.

    I’m not combining the 2 to spin anything. I’m merely pointing out that you seem to believe wholeheartedly everything that industry tells you on one hand, especially the fact that they pay frivolous claims, but you ought to know better from seeing how hard they make you work for reimbursement.

    As for the necessity of expert juries, why exactly is that a problem when juries already find for physicians 75% of the time? What percentage do you want? 100%? Should we have juries only made up of contractors for construction defect cases? Brokers for securities violations? How about engineers for design defects? Just lawyers for legal malpractice? Do you really think that what you do is beyond the realm of everyday understanding?

    You definitely misunderstood what I said to Beth. The bulk of those docs have had multiple payouts over multiple years. And, you’re mistaking payouts for claims. Give me the percentage of neurosurgeons who have been sued. I hear anecdotes, which as a scientist you know are not reliable, but I never hear statistics.

    Finally, as to loser pays. The only thing loser pays does is make it so only rich people can file suit. If that’s your goal, that’s great, but come out and say it. Don’t be ashamed, it’s the president’s goal too. Now, some states have the screening panel where if they give the thumbs down and you still proceed, you pay the costs. And frankly, many lawyers who do a lot of med mal (I’m not one) tell me they appreciate the idea of the screening panel. It’s a cheaper way to assess a case.

  10. 50% of all defense costs go to defending innocent doctors. With 75% of all cases found for the defendent, there are too many merit less lawsuits being filed.

    Loser pays would require a plaintiff to realistically examine the merits of the case. It would make whole, an innocent doctor defamed. It is completely fair. I’m not sure why health care must pay for the excesses of the legal system.

    Truly injured patients would recieve compenstaion much more quickly.

    The only winner in the status quo are trial attorneys.

    Loser pays would end the problem. However, it isn’t even an issue because the trial bar is too rich and powerful.

    How sad for America that we can’t stand up to those bully’s.

  11. Curious JD says:

    Beth,

    Surely you’re not arguing that the insurance industry and the other Fortune 500 companies lined up behind all kinds of tort reform are not wealthy enough or have the access to power that the trial bar does? Be serious. Do you know who is in the White House? Who controls Congress? C’mon.

    I’ll have to ask for the citation on that 50% statistic. Does it include typical insurer overhead – buildings, exec salaries, etc? And it’s not 75% of all cases filed – it’s 75% of all cases tried to a jury. What makes you think that the merits of the case aren’t realistically examined anyway? Again, if you’re going to file a frivolous case in the hopes of a quick settlement, why file a med mal case, the most expensive in terms of out of pocket costs? Plus if you’re working on a contingency fee, you’re fronting all those costs and your time is worthless if you lose. And perhaps you can tell me how caps would weed out frivolous cases? The cases most likely to be affected by caps are the ones most likely to be legitimate.

    The impact of litigation on healthcare spending is at most 2%. And quite a bit of that would still exist unless you eliminate all lawsuits against physicians. Because that percentage includes insurance premiums, the cost of adjusting claims, salaries, etc. Are you advocating complete immunity for physicians? If you put 1/2 the energy you put into hating lawyers into the much bigger problems with healthcare you’d probably achieve something of note other than squeezing the weakest members of society who have already been injured.

    Like I said, if loser pays is the way you want to go, you will eliminate access to the courts for the poor and middle class. Why do you think lawyers would suffer under loser pays? Or that injured patients would get paid any quicker? Like I’ve said before, a talented trial lawyer will always have work. Do you think insurers will roll over even easier given that typically they are in a far better financial position than the injured party?

    You say the only winners with the status quo are trial attorneys? How about the injured party who was offered nothing from the other side’s insurer despite their negligence, but now is no longer facing bankruptcy and can afford to fund their future care? Did they not gain something? Did you forget about them?

    How do you as an individual win under loser pays? Maybe you’re like Scot, impervious to harm or wealthy enough to pay hourly fees, experts, etc. plus all your regular bills if you are injured by the negligence of another. Who do you think will represent you? Those lawyers in the skyscrapers with hundreds of corporate clients? You think they want to alienate their clients for the sake of one case?

  12. Curious:

    You know damn well that the trial bar has used the trillions in contingency fees it has collected in assorted class actions to purchase politicians on both sides of the aisle, but most notably the Democratic party. Tort reform votes are party line votes. ATLA owns the Democratic party, plain and simple. ATLA easily rivals the power of the insurance industry. In addition, you also own the judiciary at most local, state and federal levels. Our judiciary consists of former trial lawyers in black robes that generally declare tort reform unconstitutional at the drop of a hat every time it passes somewhere.

    Regarding the cost of liability being 2% of the cost of healthcare, that’s a line right out of The Breck Hair Girl’s(aka John Edwards) campaign playbook. The 2 are unrelated. An indisputable fact is that liability premiums are exorbitant. If physicians cannot afford to pay those premiums and are forced to retire early, curtail high risk procedures like childbirth or not go into the field altogether thus leaving Americans at the hands of foreign trained doctors, there will be no one(of quality) to deliver the care regardless of how high health care insurance premiums are for the average American. No doctors, no health care.

    If a straight loser pays system excludes those not as filthy rich and physically invincible as you think I am, then have a panel of experts(doc, lawyer, lay person) screen the case. If it is deemed to not have merit, you can proceed BUT pay if you lose the case. If it is deemed to have merit and you still lose, then you are not required to pay defense costs. What would be the problem with that?

    Regarding juries, yes I think what I do is way beyond the realm of the average person. That doesn’t mean I am better or smarter. It just means what I do carries complexities dealing with the human body that not even my own colleagues can understand. We are the only civilized nation that uses juries in civili cases. That needs to end. Juries are swayed by emotion and need to be removed from the equation. Studies have shown verdicts are dependent on the level of disability a plaintiff has, not the merits of his case. So anotherwords, wheel a bad baby in front of a jury and you get a 50 million dollar verdict. Just ask the Brack Girl how that works. Of course channeling their voices through you always helps too.

    Incidentally, Missouri Governor signed a hard cap of 350k on pain and suffering today. Let’s see what happens there in the next several years now that the cap has been significantly lowered and loopholes have been closed.

  13. Curious JD says:

    Scot,

    Do you really think that the trial bar, even with contingency fees (which for some reason you seem to hate), can match the financial clout of business? Even with AIG restating it’s earnings, it’s market value is 80 BILLION. That’s one insurer. Not to mention the other business interests lined up behind tort reform. You have divorced yourself from reality if you think the trial bar can match up with that.

    You’re also pretty ignorant if you think the judiciary is former ATLA members. Most lawyers who want to be elected judges don’t want to align themselves too strongly with any group, because they want contributions from all. And given that better than half the voters in this country vote Republican, alienating them doesn’t make much sense. Here’s where you go astray, when you think you know as much about law as medicine. I’d venture to say you’ve never read one opinion of one case holding caps unconstitutional. It’s like me diagnosing malpractice from a newspaper article.

    I’d also bet that you didn’t know that the right to trial by jury was one of the reasons we fought the Revolutionary War. Or preserved in the Constitution?

    Liability premiums are exorbitant? How much do you make and what percentage of your income goes to liability premiums? The average surgeon makes $250,000 a year, the average physician $150,000. If you’re going to cry about your expenses, tell us about your income. The exodus of physicians was debunked long ago, so give that up.

    I’m not opposed to the screening panel. But that’s not being proposed on a national level. Caps and periodic payments are the only things being proposed.

    At the end of the day your next to last paragraph illustrates your goal. You believe you are above all the rest of us. I ask you again, would you like to have just lawyers for legal malpractice, contractors for construction defect cases? If your new house was built poorly, would you like to have just contractors on your jury?

    What jury studies are those you speak of? Have a link? I bet you don’t. Of course awards are going to be higher for worse injuries. Do you think a broken arm sustained in a car wreck that heals in 3 months has the same value as lifetime paralysis?

    You want to throw out juries? Move overseas. The Founders of this country recognized the right to a jury trial was worth fighting for and worth protecting. If you want a government by the wealthy, for the wealthy, and in service of the wealthy, move overseas. There you can find the expert juries you want, maybe even cheaper insurance. And, oh yeah, nationalized health care. Funny how those seem to go hand in hand.

    We will see in Missouri. Hope your memory isn’t as short the next time we have an economic downturn and the AMA declares a crisis. They go hand in hand.

    And I don’t know if you are rich and physically invincible. Your hatred of lawyers who represent people who are neither indicates you are. You must assume that there is no possibility that you nor anyone in your family will ever need our services.

  14. Curious JD says:

    By the way, Scot, did you know there is only one practicing lawyer on the Forbes 400 Richest in the US? Lots of guys with law degrees, but they’re all businessmen of one sort or another, not practicing lawyers.

    The guy? Joe Jamail, who won the $9 billion verdict against Texaco on behalf of Pennzoil based on their interference with Pennzoil’s contract to buy Getty Oil. It settled for $3 billion I believe, and he had it on a contingency fee. Guess that was just another example of a runaway jury, huh? Not smart enough to decipher what was going on in the world of high finance?

    Yeah, the poor business community is helpless against the plaintiff’s bar.

  15. Curious JD says:

    By the way, thought you might enjoy this:

    http://www.legalunderground.com/2004/03/bush_banishes_l.html

    Also, in a more serious vein, here’s an article from Medical Economics which is a very fair look at the whole issue:

    http://www.memag.com/memag/article/articleDetail.jsp?id=141338

  16. Curious JD asked Scot:
    How much do you make and what percentage of your income goes to liability premiums? The average surgeon makes $250,000 a year, the average physician $150,000. If you’re going to cry about your expenses, tell us about your income.

    I don’t know how much money Scot makes, nor do I think it’s any of Curious JD’s business (unless he wants to play some twisted version of “you show me yours and I’ll show you mine” – but in PA, the “average” general surgeon pays between $75,000 and $125,000 per year for malpractice insurance….and since PA physicians are among the lowest reimbursed physicians in the nation,I suspect that JD’s “average” salary of $250,000 might even be a little low….

    Does that put things into slightly better perspective?

    Also – EVERY neurosurgeon in South Florida has been sued at least five times. If the number of lawsuits filed against a doctor is an indication of his or her competence, one might suggest that every neurosurgeon in South Florida should have his or her license revoked…..

    Oh….and one more thing. It may be possible to force the uninformed to confuse the health insurance industry (which is EXTREMELY and obscenely profitable) with the professional liability insurance industry….but WE know it’s a bogus comparison. Medical liability insurers pay out an average of $1.37 for each premium dollar they collect. They’re LOSING money on medical liability insurance. They’re NOT making obscene profits because they’re not making ANY profit. And Blue Cross doesn’t SELL medical liability insurance. (They’re too smart for that….)

  17. I’M “curious” about something – who’s paying Curious JD’s quarter hour charges while he (or she)is “defending the honor” of America’s trial liars(I mean LAWYERS…..!)in the middle of the work day?

  18. If a man is being held up at gunpoint, does it matter how much he makes?

  19. Apparently Curious is curiously class envious. Does it really matter what I make? Is it OK to legally extort me because I make an above average salary. And Donna is on the mark. Your ridiculous salary numbers don’t apply to me in the least bit. But Donna’s malpractice premium figures do.

  20. Curious JD says:

    Class envious? Hardly. Interesting how you all clam up about your income, but you don’t hesitate to prattle on endlessly about your expenses. And you’re always focusing on how much lawyers make in the cases that they do win, and are all itching to cap a lifetime of pain and suffering damages at what most of you make in under 2 years. So talking about everyone else’s money and your expenses are the first things you want to do, but you’re so quiet when it comes to your own. Don’t be such hypocrites.

    My ridiculous salary numbers come from the Dept. of Labor. Those crazy SOBs may be full of it, though.

    By the way Donna, I’d love to see the link that shows that EVERY neurosurgeon in South Florida has been sued. The facts about Florida are that there has been no substantial increase in claims since 1990. There were 2,776 that year. There were 2,063 in ’03. In 1990, there were some 32,000 physicians in Florida. Today? 48,000. What a horrible, horrible environment. Since 1990, there were 831 million dollar plus payouts in Florida. Only 63 were jury verdicts. The source – Florida Dept. of Health records. They’ve been collecting this sort of info since 1975.

    Donna, you’re $1.37 per $1.00 collected premium is for one year. That’s it. One year. What about all the other years? It’s like saying that home insurance is not profitable after only looking at the year the hurricane hit. Did you know that St. Paul had $1 billion in med mal reserves in 1989 that it released as profits over the next decade? $1 billion. My source – the Wall Street Journal. Insurance is about covering risk. Sometimes that risk comes due. I didn’t realize that we needed a constitutional guarantee to make sure insurers were always profitable.

    Beth, I think you’re getting a little out there with your comparison. Considering that you guys are ashamed to even say what percentage of your income your insurance cost represents (My guess – under 5%) – you’re obviously not too threatened.

    You really should read the Medical Economics article I put up there. I think you’ll find it enlightening. And Medical Economics is hardly an ATLA publication.

    You might also read KevinMD’s blog. There’s an article there about how Medicare is looking to cut reimbursement rates. While you guys have been working so hard in a misguided attempt to stick it to lawyers, in the hope that your rates maybe, might, possibly go down, your real source of reimbursement is being quietly gutted. A priority check may be in order.

    Once again, the facts trump the anecdotes.

  21. Curious JD says:

    And Donna, it’s “He”, I bill in 1/10 of an hour increments, I never am too busy to help others like yourself, and it’s not lawyers I’m defending. It’s you, but you just don’t know it. Unless, of course, like Scot, you are a wealthy superhero.

  22. For those keeping score at home, that was CuriousJD’s 30th post in this thread.

  23. Curious JD says:

    Glad to see you’re still reading.

    #31.

  24. “Once again, the facts trump the anecdotes,” says Curious JD….

    NOW I understand the rules of this game. If HE or another lawyer (or a law professor) says it, it’s a fact. If anyone who disgrees with him or the ATLA playbook he recites so well says it, it’s an anecdote.

    See, that’s how they win in court…..

    Oh, and just for the record – the AMA has been aware of the Medicare reductions and negotiating with the legislature all along, as well as leading the fight each year since the Clinton “Balanced Budget Bill” was passed to correct the flawed formula which mandates the physician reimbursement reductions. So far, every year since this flawed piece of legislation was passed, the AMA has been able to persuade the legislature to “fix” the flaw – and work is already being done to persuade them once again. Sadly, we have thus far been unable to persuade the legislature to repeal the portion of the legislation which contained the flawed formula – but we’re working on it….

    And the $1.37 payout per premium dollar was for the past TWO years…in earlier years since I learned about this issue in 2001, if memory serves, it was slightly higher, possibly in the neighborhood of $1.48 per premium dollar…I’d spend a couple of hours looking for it, but I don’t bill in 1/10th of an hour increments…..

  25. Curious, its nice to see your seething hatred for doctors equals mine for those in your slimy profession. The reimbursement side of the equation is not being left out. That is a separate battle. It is being fought. The answer is simple, but physicians have been scared into participating in these plans that siphon hundreds of millions into CEO pockets……kind of like what you do on the other end of the equation.

    What I make is none of your business regardless of the number but it is shamefully low for what I do. I am double boarded and do about 400 in-patient surgeries per year and as I have said before I have never paid a malpractice verdict or settlement to anyone. Think my malpractice premium is 5% of what I make? Good try. This year, the premium is 85% of my pretax salary. In 2006, it is projected to be 125%. Am I being taxed sufficiently enough for you or does your disdain for my profession require me to suffer more?

    As you and your parasitic colleagues pretend to care about the little guy, you are the ones gutting the future of medicine as you stuff your pockets. But I realize those TV commercials in between “Days of Our Lives” and “The View” soliciting the sick, the dying, and those who fell off a toilet seat in a supermarket are expensive so keep up the good work Robin Hood. Too bad you can’t bill for the time you spend here.

    Apparently you too are a superhero Curious and think that you or your family will not need my services. Good luck with that.

    Everyone takes a turn. No one is immune.

  26. I stand corrected. My malpractice premium this year is 60% of my 2005 pretax salary. Projected 2006 malpractice premium will be 90%. My apologies. I feel so much wealthier now.

  27. Release from the Politically Active Physicians Association, April 1, 2005: (abridged)

    “Physicians at Crozier Chester Medical Center and Lancaster General Hospital have confirmed five deaths, some teenagers, from head trauma after being transported from Chester County. I confirmed the death of a 17 year old who was 2 hours from time of automobile accident in Chester County to Crozier Chester Medical Center in Delaware County with the Medical Examiner. When head trauma occurs, time is of the essence (usually less than one hour) for neurosurgical intervention to save the life of the patient. These Chester County residents were deprived of this highly imperative emergency lifesaving medical care. The following facts reveal why this is happening.

    “In 1999, there were 6 full time neurosurgeons covering the five hospitals serving 450,000 residents of Chester County. Today there are no full time neurosurgeons left. The situation in the rest of Pennsylvania is almost equally grim. For example, in 1996, there were 214 practicing neurosurgeons in the state. From 1985 to 1996, the neurosurgeon growth rate in Pennsylvania was 4.5 percent a year. The standard recommended ratio between neurosurgeons and population is one neurosurgeon for every 65,000 people.

    “Pennsylvania, with a population of approximately 12 million, should have at least 185 neurosurgeons. Today there are only 152 with some surveys showing only 141 who are mainly clustered in the cities. (Source Pennsylvania Neurosurgical Society, The Chester County Medical Society and American Association on Neurological Surgeons and the Congress of Neurological Surgeons). That is a loss of 63 or perhaps 73 neurosurgeons in just 9 years.

    “The situation is seriously exacerbated by data from the American Association of Medical Colleges who report in a 2004 study that the percentage of Pennsylvania-trained neurosurgical residents who plan to stay and practice in the state is “zero”. The established neurosurgeons are leaving and/or retiring and there are no neurosurgeons coming behind them.

    “Dr. Sam Lyness was the last full time neurosurgeon in Chester County. He left Brandywine Hospital when his medical malpractice insurance premium hit $283,000. He is now practicing in Texas.

    “The Medical Board statistics reflect between May of 2002 and November of 2004, 5,600 doctors in Pennsylvania were sued, many of them neurosurgeons.”

    Yes, I know, DOCTORS and their evil minions released this information, so it’s probably only an “anecdote.” Sadly, though, these anecdotes appear to have killed people….NOT due to medical malpractice, but LEGAL malpractice….

  28. http://www.hcla.org
    IN THE NEWS:
    PATIENTS WHO CAN?T GET THE CARE THEY NEED
    BECAUSE OF THE LIABILITY CRISIS

    More and more Americans aren’t getting the care they need when they need it because our
    legal system has turned into a lawsuit lottery where a few win and the rest of us lose. The
    ?disappearing doctor? phenomenon is getting progressively and rapidly worse. It is an
    increasingly serious threat to everyone?s ability to get the care they need.

    These are just a few of the reports on the hurting patients and the lawsuit filled, but health care starved communities which are feeling first hand the need for common sense federal
    medical liability reforms.

    Real Stories of Patients Hurt by the Liability Crisis

    Leanne Dyess: Husband Brain Damaged After Six Hour Delay in Emergency Care

    Leanne Dyess? husband Tony crashed his car and suffered severe head injuries, but the closest hospital did not have a specialist who could put a shunt into Tony?s head.

    Mr. Dyess was airlifted to a medical center ? six hours later. ?I learned there were no specialists on staff that night?because rising medical liability costs had forced physicians in that community to abandon their practices,? said Mrs. Dyess. Her husband is now permanently brain damaged. ?I had heard about some of the frivolous [lawsuits] and of course the awards that climbed into the hundreds of millions of dollars,? Dyess said. ?And like most Americans, I shook my head and said, ?Someone hit the lottery.? But I never asked, ?At what cost???(Gannett News Service,
    February 12, 2003)

    Nancy Allen: Waiting Six Months To Have Lumps Removed from Uterus

    The loss of OB-GYNs to high malpractice costs in Las Vegas is affecting pregnant and non-pregnant patients alike. As pregnant women take up dwindling patient slots,non-pregnant patients are finding it more and more difficult to get an appointment.

    Nancy Allen waited six months to have suspicious lumps removed from her uterus and ovaries. She would have waited longer, but went to her doctor?s office and refused to leave until her hysterectomy was scheduled. ?All that time it was going through my mind and my husband?s that I might have cancer. We were so upset. I had these three tumors and we didn?t know what they were.?(The Las Vegas Review-Journal,November 5, 2002)

    Jim Lawson: Dies in Distant Emergency Room One Day After Nearby Trauma Center Closes

    The shock from Jim Lawson?s July 4 death in a Nevada auto accident was felt well beyond his family and friends. The two-car crash on a busy street leading to the Las Vegas airport came just one day after the nearest trauma clinic, at the University Medical Center, closed down. The 58 orthopedic surgeons who rotate through the
    hospital had insisted on relief from the soaring cost of medical malpractice insurance.

    No one can be sure his death, confirmed at an emergency room an hour away, could have been avoided?. but it brought new attention to a national problem?(Houston Chronicle, July 20, 2002)

    Ambur Peterson: Forced to Travel 100+ Miles Out of State to Deliver Her Baby Ambur Peterson?s obstetrician in Cleveland, Mississippi stopped practicing three weeks before her due date, and she had to drive out of state, over a hundred miles, to Memphis, Tennessee, to get the care she needed.?(U.S. Department of Health and Human
    Services, July 24. 2002)

    Thelma Anne Wandling: Losing Vital Specialists

    ?In the last few months we have lost three surgeons, a neurologist, a urologist, a
    gastroenterologist and an OB-GYN. Fortunately, we still have our primary care physician. In attempting to schedule an appointment with a new doctor, I learned that they were at this time scheduling for September 2003.?-Thelma Ann Wandling, Charleston, WV, Letter to the Editor regarding the state losing doctors because of the
    medical malpractice crisis. (Charleston Gazette, October 26, 2002 )

    Marine Hawkins: Doctor Stops Delivering Babies Two Weeks Before Due Date

    Marine Hawkins, 20, of Boyle, Mississippi, was shocked to hear from her obstetrician that he was closing his practice ? just two weeks before her due date of July 21. The nearest doctor is 30 minutes away. She doesn?t have a car, and will
    have to rely on relatives to get there. ?This is isn?t what I needed now,? she said.
    (Houston Chronicle, July 20, 2002)

    Richard Ide: Traveling Days For Neurological Tests
    Richard Ide sometimes spends an entire day traveling to his doctor because high insurance premiums have decreased the number of neurosurgeons practicing in Northeastern Pennsylvania. ?Sometimes, it?s a three-day trip just to get a test taken,? said the 71-year old Ide, who suffers from two herniated disks. (The Wilkes-Barre Times Leader, October 23, 2002)

    Laurie Peel, Marisa Eshleman and Paula Walsh: Forced to Look for New OB/GYNs

    Dr. Stanley Prince?s patients felt helpless when the Ephrata, Pennsylvania OB-GYN decided to close his practice because of the cost of his medical malpractice insurance.

    ?I think it is a shame I had to lose a good doctor because of insurance costs,? said Marisa Eshleman, who learned that she had to find a new doctor less than a month before her due date. Paula Walsh, whose twin sons were delivered by Dr. Prince said, ?I am very devastated. Throughout the entire pregnancy, I felt like I was his only patient. I could call him day or night and he fit me in. He took care of me like
    you wouldn?t believe. He is just an incredible guy.?(Lancaster New Era, January 15, 2003)

    Laurie Peel was happy to find Dr. John Schmitt after moving to Raleigh. She was 11 weeks pregnant and experiencing complications. She had been told over and over again by each OB-GYN office that she contacted that they were full and not taking new patients. Dr. Schmitt took her in. ?In short, my relationship with Dr. Schmitt
    was everything one could hope for in a doctor,? Mrs. Peel said. ?It?s also a relationship both he and all of his patients would very much like to continue. But we can?t because of the crippling cost of medical liability insurance. What he must pay to protect himself from the remote possibility of lawsuits (or at least legitimate ones)has prevented Dr. Schmitt from continuing the outstanding practice he had made his
    life?s work.?(Congressional Testimony of Ms. Laurie Peel, Raleigh, NC, Before the Committee on Senate Judiciary, February 11, 2003)

    Helen Boone: Uncertain Her Oncologist Can See Her Through Cancer Treatment ?I don?t understand how this can happen?, said William Boone, whose wife, Helen, recently underwent cancer removal surgery. She started chemotherapy, not knowing if her surgeon would be able to see her completely through the process. ?Are we supposed to go to the lawyers for surgery?? Boone asked. (The Florida Times Union, June 30, 2002)

    Elizabeth Gromny: OB/GYN Can?t Deliver Her Baby
    Elizabeth Gromny went through years of infertility treatments and conceived her first
    child after six years. When she called to make her first appointment with her obstetrician, she found that the doctor had just capped the number of deliveries she could perform. Gromny found this to be the case throughout Las Vegas because of malpractice costs. (Time, September 16, 2002)

    Jim Chaffin?s Pregnant Patient: Can?t Find a Surgeon to Do Gallbladder Surgery

    ?Jim Chaffin, a local obstetrician, has a pregnant patient who needs gallbladder surgery, and he cannot find a surgeon to handle it.? (The Florida Times-Union, June 30, 2002)

    Unnamed Aneurysm Patient: Can?t Get Emergency Room Treatment

    Doctors in Florida are taking on less Emergency Room shifts partly due to skyrocketing medical malpractice insurance. ERs are left without specialists and must transfer patients to larger medical centers. In one case, a man with an aneurysm had to be transferred more than 30 miles from West Boca Medical Center to Memorial because no neurosurgeon was on call and no closer ER would take him. ?The guy was in bad shape already, so the transfer couldn?t help,? said Dr. Donald Krieff, a neurosurgeon. ?If [an ER] can?t find a specialist to do what needs to be done, they?re kind of in trouble.? Details about the outcome of the case were not available. (South
    Florida Sun-Sentinel, February 5, 2003)

    Colon Cancer Patient: Unable to Find Skilled Surgeon

    ?In March, doctors at Nellis Air Force Base in Las Vegas sent a 34-year-old woman with colon cancer to Joseph Thornton, a highly experienced colon and rectal surgeon in the area. Because of the war in Afghanistan, most of Nellis’ specialized surgeons are now deployed, and the remaining military doctors said they couldn?t remove the cancer unless they cut out the woman?s entire colon, leaving her with a colostomy
    bag to drag around and empty the rest of her life. They hoped that Thorton?s expertise might offer a better outcome. Just one problem, Thorton, at the age of 56, retired on March 31 because his malpractice insurance company was closing, and he couldn?t afford what the insurers were charging. He paid $35,000 last year for
    malpractice insurance, but the going rate in Nevada now is 100,000 or more for a surgeon. The woman showed up in Thorton?s office just before his retirement, but she needed chemotherapy and radiation first, and the surgery couldn?t be performed before Thorton?s policy expired. ?It broke my heart,? he said. ?I felt like I was
    planning my own funeral.? (National Journal, May 18, 2002)

    Shelby Wilbourn?s Patient: Lifesaving Emergency OB Care May Be Endangered

    ?OB-GYN, Shelby Wilbourn wonders who will deliver the 500 babies born each week in Las Vegas and if there will be any OBs to take emergency calls like the one he recently answered. The patient was 34 weeks pregnant, in premature labor and
    hemorrhaging, and her baby?s heartbeat was frighteningly low. Wilbourn arrived in minutes, and both mother and children made it successfully through childbirth. If this were next year,? he contends, ?that baby would have died.? (U.S. News and World Report, July 1, 2002)

    Cindy Davis Hirsch: Waiting Months for a Mammogram
    A shortage of doctors and technologists fueled in part by doctors afraid of lawsuits, is forcing patients to wait months for routine mammograms. Cindy Davis Hirsch, 55, of Mount Laurel, NJ was shocked when she learned she had to wait 6 months for a mammogram. ?I have been going once a year forever,? said Hirsch. ?I have really good insurance. It never entered my mind it would affect me to this extent.? (The Florida Times-Union, February 15, 2003)

    Unnamed Mother: Gives Birth En Route to Distant Hospital

    Dr. Lloyd Van Winkle?s office in South Texas got a visit from a pregnant woman who showed up less than 10 minutes from delivery. Her family doctor stopped delivering babies because of malpractice worries and she was trying to drive 80 miles
    to her San Antonio doctor and hospital. ?She made it as far as Castroville and decided she wasn?t going to make it any further,? Van Winkle said. (Fort Worth Star- Telegram, January 26, 2003)

    Ruth Parker: Waiting Six Months for a Routine OB Appointment

    ?I had to wait six months for a routine OB appointment,? said Ruth Parker of Salt Lake City. An informal survey of several obstetricians? offices found waits as long as eight months for women who are not currently pregnant. (Deseret News, May 24, 2002)

    The Bottom Line: Solving the Crisis & Safeguarding The Care Patients Need

    All across America people are being denied access to care because our broken lawsuit system is driving doctors out of business. This is clearly a national problem that needs a national solution
    .

    We know medical liability reform works because several states across the country have adopted them and we?ve seen the results. For example, California suffered from a health care crisis in the 1970s similar to the one the nation faces today. The reforms it passed in 1975 have stabilized the insurance market and maintained access to quality care in that state for nearly 30 years.

    HCLA?s reforms would guarantee full and unlimited recovery of a patient’s economic damages: medical expenses, lost wages, rehabilitation costs, future earning potential, lost use of property, costs of repair or replacement, etc. They would reasonably limit NON-economic damages to a quarter of a million dollars. . . fair and equitable compensation to patients that doesn’t bankrupt the healthcare system. It?s time for Congress to enact common sense liability reforms
    that safeguard patients? access to care.

    (“Anecdotes” take on a little more meaning when they have actual NAMES, hmmmmm?)

  29. Oh but those are just silly anectdotes Donna. Couldn’t you please provide me with a link to a fancy study commissioned by lawyers or one of those consumer groups headed by Ralph, Joan or Joanne Doroshow to make your claims more credible?

    Are you proud of what you have done Curious? Shame on you. Stop denying you are part of the problem or that a problem even exists and do something constructive for a change.

  30. “one of those consumer groups headed by Ralph, Joan or Joanne Doroshow to make your claims more credible?”

    Do you mean one of those “consumer” groups which receive funding from the American Trial Lawyers’ Association and private law firms, which then use those groups to mine potential liability suits, and put a more palatable and sympathetic face on their efforts to protect their bottom lines?

  31. Curious JD, oh I wish it were only 5%. It is the single largest expense in our office.

    What does money buy in politics? Lawyers and lobbyists are the single largest donor to Democrats. The Democrats have sold out to a small and very rich (think multi- millionaire John Edwards) special interest group. If the lawyers weren’t so adept at spin, more people would realize that they unintentionally support a small minority gaining riches at the expense of the majority.

    No other group donates toward a single goal of stymieing reform like lawyers who benefit from the status quo. It is silly to think the fisheries have the same goals as steel manufactures.

    Lawyers have a single laser-like intensity or are you really interested in strawberry farming in South Dakota? Lumping all “business” interests in order to falsely portary lawyers as the underdogs is laughable.

  32. Still waiting for an answer about REAL insurance reform.

    Still waiting to hear how to correct the disgusting 70% error rate.

  33. Curious JD says:

    Still all the crying about your expenses, but no word on how much you make. What’s the matter, are you guys ashamed? Afraid the public might not take your cries of poverty so seriously? Did you know that the average physician makes 150% of what the average attorney makes. Wouldn’t want that little nugget getting out to the public, would you?

    How about I post all the incidents of children harmed by malpractice? How about ones in California, where their lifetime of pain and suffering was valued at less than what a physician makes in 2 years? Will that matter to you? We can play that game all day, and I promise you will come out looking worse.

    Donna, those are nice stories of high insurance premiums, but they have nothing to do with caps. For every story you can post about a doctor who claims he’s quitting because of premiums, it turns out that claims in his state haven’t risen significantly nor have payouts. The area where I grew up, very rural and remote, not a lot of wealth, has always had trouble keeping physicians. Yet if they were to leave these days, we’d be hearing about how the premiums made them leave. I noticed you cited a couple of Las Vegas stories there. I guess you didn’t know that after the Nevada legislature passed caps, premiums didn’t go down at all. In fact, the head of the physicians task force pushing caps said that even if it were $5, premiums wouldn’t go down.

    I also noted you cited Pennsylvania. I guess the state’s largest insurer going under due to financial mismanagement had nothing to do with their problem? What, you didn’t know about that? The politically active physicians’ association didn’t tell you? How surprising. I guess they didn’t tell you that despite claims that 1700 doctors left PA in ’03, that actually 800 new doctors came to PA. And that according to the National Practitioners Data Bank, there was a 13% decrease in med mal claims between 1995 & 2002? That the number of awards per 100 doctors declined? How about that the total payouts only increased by 1% a year between 1999-2003, according to the PA Dept. of Insurance?

    I don’t hate physicians, I like them. I just detest their willingness to throw away the rights of people who have already been hurt away on the outside chance their insurance rates might increase a little slower.

    As for the issue of lawyers v. tort reformers, if you truly believe that the tort reformers aren’t better funded, then you have obviously tossed all common sense out the window. Go look at the companies who fund groups like Common Good and ATRA. Look at the client lists of the firms who employ the lawyers who run those sites. Hell, AIG is in the news a lot these days and their now deposed chairman Greenberg was one of the most agressive tort reformers around, showering millions on these groups. And that’s just one company.

    Sorry my Medical Economics article wasn’t neutral enough for you. I hadn’t realized they’d become a front for ATLA and Ralph Nader. Same with the Florida Dept. of Health, the National Practitioners Data Bank, and the PA Dept. of Insurance. Not to mention the insurers themselves. Look at the lengths you guys have to go to to deny the truth. How sad for you.

    You know what’s really the most sad about all this? How willing you are to suspend your normal high standards for filtering information in order to achieve a goal. You’re normally some of the most skeptical people in the world, but you’ve thrown all that out the window.

    Oh well, I guess everyone has to have faith in something. I just never figured it would be an insurer and a lobbying organization. Oh well, I guess I’ll give up. There’s no changing someone’s mind when the argument is based on faith. As I’ve said before, Jesus would be lucky to have such adherents to his message as you guys do to what the AMA et al put out.

  34. Curious JD says: “Donna, those are nice stories of high insurance premiums, but they have nothing to do with caps. For every story you can post about a doctor who claims he’s quitting because of premiums, it turns out that claims in his state haven’t risen significantly nor have payouts.”

    Curious, I don’t think the stories I posted are “NICE” at all. I think they’re tragic – and a sad commentary on the state of health care. (And that you think they’re “nice” is frankly frightening…) Furthermore, nothing PERSONAL, Curious, but I question the truthfulness of studies about liability reform done by law professors, all of which were released within days of each other, the choreography of which would be the envy of Bob Fosse or Tommy Tune. What, we’re supposed to take the word of only the MOST RECENT studies, the ones offered up by people who have a clear bias? How about all of the previous studies which showed a CLEAR correlation between payouts and premiums? And the simple FACT that states with effective caps (and no, I don’t mean sliding scales with exceptions and loopholes you could drive a Bradley through) have lower premiums. That’s why so many of Pennsylvania’s doctors, whom I know personally, have moved to Wisconsin and Colorado -SOLELY because of the malpractice situation. One orthopedic surgeon specializing in shoulder repair (the only one in northeast PA) moved to Wisconsin where he’s paying one quarter the premiums for twice the coverage. Oh – and it’s with the same company.

    JD says: “The area where I grew up, very rural and remote, not a lot of wealth, has always had trouble keeping physicians. Yet if they were to leave these days, we’d be hearing about how the premiums made them leave.”

    If an area has always had trouble retaining physicians, it will be among those HARDEST hit by high liability premiums. Doctors in rural areas are already victims of low reimbursement and long work hours…and since, in areas like that, Medicaid tends to be one of the largest payors, there’s very little “profit margin” to fall back on when liability premiums go up 30-50% each year. I know the last orthopedic surgeon in a western PA county, who relocated last year and who has yet to be replaced, because no one is foolish enough to come there. The hospital’s CEO is expressing concern that without orthopedic surgery to generate income, the hospital itself may not be able to remain solvent. I know ob/gyns in suburban Philadelphia who have been trying to recruit a new physician to replace one who got sick of the premiums and moved to Maine FOR TWO YEARS, without a “bite” from a young doctor. Recruiting physicians in rural areas has been exacerbated by the medical liability crisis. No one from any medical lobbying group has claimed that the medical liability crisis is the ONLY cause of physician shortages in rural Pennsylvania. It is, however, the major cause that physicians who DO leave can’t be replaced.

    JD says: I noticed you cited a couple of Las Vegas stories there. I guess you didn’t know that after the Nevada legislature passed caps, premiums didn’t go down at all. In fact, the head of the physicians task force pushing caps said that even if it were $5, premiums wouldn’t go down.”

    Don’t know where you got that one, JD – did you write it yourself or is it in the ATLA playbook? Premiums are just beginning to go down in Nevada…they’re still dealing with constitutional challenges, you know….in Texas, where the voters passed a constitutional amendment, thereby circumventing the possibility of having their cap tied up for years in court, premiums are falling all over the state…

    JD Says: “I also noted you cited Pennsylvania. I guess the state’s largest insurer going under due to financial mismanagement had nothing to do with their problem? What, you didn’t know about that? The politically active physicians’ association didn’t tell you? How surprising.”

    Since you have no idea what I do know or don’t know, stuff the sarcasm in your briefcase, Counselor. I can quote you chapter and verse of every malpractice carrier failure in PA and just how many doctors were disaffected by each of them, as well as how many cases our state insurance guarantee association is still handling AND how much PA doctors have to kick in PERSONALLY if an award exceeds their limit. The medical society in PA has always considered the failures of PIC, PIE and PHICO as part of the reason we have a problem. Of course, a large part of the reason PIC, PIE and PHICO went belly-up was the explosion in payouts, for which they had inadequate reserves. Stupid on their part, but still only a PART of the problem.

    JD says: “I guess they didn’t tell you that despite claims that 1700 doctors left PA in ’03, that actually 800 new doctors came to PA.”

    You need to fact-check your sources, JD. You’re quoting an article from the Allentown Morning Call, written by a reporter with a clear bias (whose bias bought him a job at a small-town newspaper somewhere in Virginia not long after his claims were debunked to the satisfaction of the newspaper’s editorial board). The 800 “new doctors” the reporter referenced were interns and residents who were training in PA hospitals – not experienced doctors and certaining not actively practicing and taking care of Pennsylvania residents. Recent figures released by the service which matches residents to training programs showed that only 17% of the 1,100 residents completing training in PA stayed in Pennsylvania in 2003 – that’s 287 residents, if anyone’s counting – compared to the 50% of new physicians who’ve traditionally stayed in Pennsylvania to practice.

    JD says: “And that according to the National Practitioners Data Bank, there was a 13% decrease in med mal claims between 1995 & 2002?”

    Like I said before – fact-check, Counselor. You really will make yourself look foolish if you just keep quoting the talking points on the ATLA website. Here are the actual payouts for the past 10 years:
    _ 1991, $182.5 million
    _ 1992, $216.7 million
    _ 1993, $208.4 million
    _ 1994, $228 million
    _ 1995, $233.3 million
    _ 1996, $309.5 million
    _ 1997, $320.3 million
    _ 1998, $279.2 million
    _ 1999, $356.4 million
    _ 2000, $350.8 million
    _ 2001, $423.7 million
    _ 2002, $398.9 million
    _ 2003, $394.5 million
    _ 2004, $448 million
    Source: U.S. Health Resources and Services Administration
    Let’s see – you say there was a 13% decrease between 1995 and 2002? Payouts in 1995 were $233.3 million. Payouts in 2002 were $398.9 milion. Granted, I suck at math, but even I know that $398 million is MORE than $233 million….and if you’re referring NOT to the payouts but the number of cases filed, well, obviously, that’s totally irrelevant to the amount of money paid out by PA’s insurance carriers…and we all know that premiums are based on future risk…

    JD says: “That the number of awards per 100 doctors declined?”

    Well, if that’s true, and I don’t feel like looking it up, then the DOLLAR AMOUNT of awards skyrocketed – thus MAKING my point…..

    JD says: “How about that the total payouts only increased by 1% a year between 1999-2003, according to the PA Dept. of Insurance?”

    Based on your own alleged quote from the PA Dept. of Insurance, a 1% increase each year from 1999 to 2003 would have put payouts in 2003 at about $370 million, assuming that a 1% increase is $3.5 million per year, using the $356.4 million payout in 1999 as a starting point. The actual figure, however, was $394.5 million. You’ve really got to stop drinking kool aid and DO THE MATH.

    As to California – check public records for the case of the Olson family, which was awarded $42 million in economic damages for their son, whom the jury decided was injured at birth. They also received about $8 million in non-economic damages, which the judge promptly reduced to California’s limit of $250,000 FOR THE PAIN AND SUFFERING ALONE. The ECONOMIC DAMAGES award for the child’s medical care and other needs was carefully calculated to take care of him for the rest of his life, increasing incrementally for every ensuing year. As his life span was projected to the age of 60 and above, the annual payments would have been in the $900,000 range. The family opted, instead, for a lump sum payout, the amount of which was NOT publicly dislosed, although the annual payments would have continued until their son died. Perhaps their lawyer, who walked away with several million dollars himself, advised them that they’d make out better NOT assuming their son would live to a ripe old age – I don’t know. Years later, they joined Ralph Nader’s traveling victim show to condemn California’s law, which “only” paid them $250,000 for their son’s lifelong disability, and actually told reporters how unfair it was that their son’s life was only worth about $17,000 a year….A newspaper in Tennessee published the records of the actual award and they haven’t been heard from since…I’m sorry for their tragedy – but not sympathetic to their demands for more money when a jury awarded them $42 million in economic damages. So don’t try to sell the “is a life ONLY worth $250,000″ argument on this corner, because no one’s buying it….

    You gave your personal stake in this away when you pointed out that the “average” physician makes 150% of what the “average” lawyer makes. I’m curious to know why you’re so desperate to have Scot tell you how much money he makes….

    America’s doctors, if anything, are more skeptical than ever – their recent experiences with politicians, the trial bar, and the political process have forced them to be….so don’t delude yourself that ANYONE is “duping” the doctors of America into shilling for big business or big insurance. Scientific method has revealed both the diagnosis and the cure – surgically remove most of the lawyers and the patient will get better….

  35. Oh yes Curious, please do wheel out the damaged children. Put them in their wheelchairs and wheel them right in front of that jury. Channel their voices like The Smiling One did and then blame their Obstetricians right out of business for something that was completely out of their hands. You threaten us with that bullcrap as if your colleagues don’t already do that on a regular basis. Everytime you guys want to stop common sense legislation, you roll out the injured in front of the legislators regardless of the mechanism of their injury. Give us a break Curious. Get some new tactics, will you.

  36. Class Envious JD, how much do you make? What percentage of your salary is malpractice.

    And why is it OK for physicians but not lawyers to have to pay for bad outcomes? Loser pays will work. If you are concerned about closing the courts to the downtrodden, then lets have the losing lawyer, not the plaintiff, pay. You’re smart enough to figure out which cases have merit, so you should have no problem with that right?

  37. My brother in law, a general practice lawyer, recently complained that HIS malpractice insurance had gone up to $1,300 a year! Of course, he’s not required to purchase $1 million of malpractice insurance to have a law license in PA like physicians are…

  38. Denial? Who’s the group denying that a crisis exists? Who’s the group denying that the tort system is not causing premiums of tort insurance to rise? Who’s the group denying that the single largest donor to the Democratic party has absolutely nothing to do with their voting the ATLA party line?

    Please explain how capping non-economic damages would deny anyone their rights. How exactly is the door shut? The only group completely denied any rights are those victims of Judicial Malpractice.

    Isn’t that hypocritical that the Judiciary has completely removed any accountability for their actions to prevent being the victims of meritless suits? Isn’t it hypocritical to block frivolous lawsuits while denying their very existence?

    When the ATLA kicks the door of the courthouse in for those victims you will have the right to get on your high horse.

  39. Come on Curious JD, do you really expect us to believe that lawyers only do what they do out of the goodness of their hearts? I am not a lawyer (or a doctor) but I worked for a law firm for jsut over a year before leaving law altogether in disgust at the fact that all anyone cared about was making money. The lawyers were constantly expected to bring in more work and make more money. Those who did were praised and those who didn’t were reprimanded. They didn’t take on cases based on merit, only profit was considered.

    Yes, I know, mine is only an ‘anecdote’ but I know others in my situation and also know that doctors are not the only ones who dislike injury lawyers.

  40. I’d like to join in…I wholeheartedly agree with Sonia’s and Scot’s recent comments…and by the way I am a lawyer…and have been one for a long time…but not a PI or medmal lawyer. As they say…some of my best friends are medmal and PI lawyers…and yes they are very selective(and most will so acknowledge) in the cases they choose to go forward with….likeihood of success and MONEY being the main criteria…they line up the alleged victims, assess which ones will return the most, and toss the others aside. And you can sure bet that hardly anyone(or at least very few) going into law decides to do it because they want to save and protect the injured (as some of those obnoxious Yellow Pages ads and TV commercials suggest) …they do it because of the potential monetary rewards…and unfortunately all too often many decide to go to law school because they don’t know what else to do with their lives. How often I have heard I guess I’ll go to law school…and then suddenly they see the potential golden goose…the insurance companies and those “rich” doctors. Medmal/PI here I come! How come only in America is there a real medmal issue…its because of an unduly litigious sociiety encouraged by medmal, PI, and class action lawyers….the ones who benefit most. If there was no insurance you’d find an exodus from medmal and PI…and if there was no deep pocket corporations/businesses you can be certain that class actions and other lawsuits would drop significantly. Why?? Because no golden goose at the other end. And if lawyers in the medmal/PI field were so inclined they would and could come up with an alternate to contingency fees…it’s relatively simple…create a fund initially funded at least in part by recoveries from the lawsuits and insurance payouts and by medmal/PI lawyers (sort of like drs who have to pay significant amounts into funds in their states when they annually renew their license to help pay for awards) and have the funds administered by a select group of lawyers who would mete out funds to support potentially worthy cases…be creative JD as you are in your remarks. And one more thing, have juries comprised of specialized/trained persons, not lay people who just see $$$ signs and are easily swayed. Countries outside the US do not have the medmal issues that we face in the US…they also have expert juries for lawsuits. Nor are those countries litigious as we are in the US. First words out of someone’s mouth in the US is “I’ll get my lawyer and sue you” (for what they do not know but sue they can…just go to the Yellow Pages and pick a lawyer from one of the many many far to many ads). I suggest that JD stop writing briefs with extensive citations in support of his/her entrenched position…the sooner the medmal/PI lawyers recognize they are a major part of the problem and work toward addressing and resolving the issues the better off we all will be as a society. I have always wondered where were all those “bad doctors” years ago…those who went into the field of medicine were always the most dedicated and brightest . Has that changed to cause all this litigation and medmal settlements. No, I do not think so…what has happened is that the legal profession, much to my dismay, has been very creative in finding new and different ways to recover $$$$$ for themselves and their clients…sort of the flavor of the day. We are the greatest country in the world…and our medical system is second to none…our legal system is in
    need of an overhaul and we can take some lessons
    from others. Enough for now.

    thedon

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