General Assembly should end medical malpractice inaction

The battle between Pennsylvania's doctors and lawyers over who is to blame for ever-higher medical malpractice insurance premiums continues to rage.

The latest skirmish involves a recent news story in the Allentown (Pa.) Morning Call that contends that doctors are not leaving the state or retiring in large numbers in reaction to high medical malpractice costs, as asserted by the state's doctors group. The Pennsylvania Medical Society wasted little time in firing off an e-mail statement in rebuttal, claiming certain relevant facts from the data were ignored or that statements in the newspaper article were taken out of context.

A follow-up article by the Associated Press noted that insurance payouts for medical malpractice claims against Pennsylvania doctors have fallen for the second year in a row. Payouts peaked at $424 million in 2001. In 2002, the figure dropped to $402 million and in 2003 fell to $394 million.

Appearing to contradict this data, the president of the Insurance Federation of Pennsylvania was quoted as saying, "The numbers raise more questions than they answer because the major medical malpractice insurers still doing business in Pennsylvania report an increase in amounts paid on claims from 2001 through 2003."

One interesting theory for the crisis, focusing more on the insurance industry than doctors or lawyers, suggests that claims and payouts soared during the 1990s, but that investment gains from the stock market boom masked those losses. Additionally, a very competitive insurance market drove premiums to doctors to artificially low levels. Now, those conditions have changed and following the bursting of the speculative stock market bubble of the late 1990s, insurance companies have had to jack up rates to regain lost money. These difficult conditions have driven some insurers out of business or out of the state - and the reduced competition has added upward pressure on premiums.

In the meantime, doctors and lawyers continue to battle it out, assigning blame for the crisis on the other side.

While many people in the state might be confused about the apparently conflicting stories, most people know, at least on an anecdotal level, that malpractice insurance premiums to doctors have skyrocketed - and that some doctors have stopped practicing or moved out of the state in response. Some doctors are still contemplating those moves or simply looking at an early retirement. Some group practices in this region have said they are having trouble attracting young doctors to join their practice, mostly because of the medical malpractice climate.

Young doctors are more inclined to set up shop in another state where the medical malpractice crisis has been eased by capping certain jury awards or other measures.

While the interpretation of the data by doctors and lawyers differs, most people accept that there is a problem with medical malpractice in Pennsylvania. Most people also recognize that the problem is not as simple as greedy lawyers or a few bad doctors. The problem involves the legal system, the medical community and the insurance industry. An effective solution will likewise involve changes to each area, including all or several of the following:

A cap on "pain and suffering" awards.

A limit on lawyers' fees for malpractice claims.

A review board to screen out frivolous lawsuits.

A more transparent system to allow patients to investigate a doctor's past malpractice and employment history.

More evidence that the state medical society is disciplining bad doctors, or limiting their practice to protect patients.

Review of insurance company profits and financial records to ensure rate increases are justified.

The causes of the medical malpractice crisis continue to be the subject of debate, but the fact that the costs of doing business as a doctor (especially those in the higher risk specialties of surgery and obstetrics/gynecology) in Pennsylvania have increased dramatically cannot be disputed.

Most people know that statistics and "facts" can be used or misused to prove anything. This debate has seen enough questionable facts tossed back and forth between doctors and lawyers.

Harrisburg lawmakers need to sort out the facts, follow the lead of most other states and move forward in bringing about reforms to ease the medical malpractice crisis in Pennsylvania.

- J.L.W.lll