News: Medical Malpractice Insurance and Physician Practices

Side Note: this article from The Hill reports on a bill currently in Congress, aimed at subsidizing malpractice insurance costs for physicians volunteering at community health centers.  Currently, the high liability insurance cost of volunteering makes it essentially impossible for most physicians to volunteer, though many would like to.  This bill would allow physicians to give back to their communities, and increase the health care coverage available to low-income citizens around the country.  While we at the Cunningham Group can express nothing but support for this bill, the underlying problem is the unreasonable cost of medical liability insurance.  This problem must be addressed head on, with reforms to the legal system like limits on non-economic damages, reduced statutes of limitations, or alternatives to the court system (currently catching on in New York).

by Julian Pecquet
The Hill

A bill that would have the federal government cover medical malpractice costs for physicians who volunteer at community health centers cleared the Energy and Commerce panel’s health subcommittee on Thursday.

The sponsors of the bipartisan Family Health Care Accessibility Act, Reps. Tim Murphy (R-Pa.) and Gene Green (D-Texas), say the bill would enable underserved communities to have access to care at minimal cost to the government. The bill extends to volunteers the medical liability protections currently offered by the Federal Tort Claims Act to physicians employed at community health centers.

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Side Note: this article from the Wall Street Journal details a new pilot program in New York aimed at stabilizing that state’s volatile malpractice climate.  The program is funded by a $3 million grant, a part of Obama’s health care reform package.  The central feature of the pilot program is mediation of malpractice cases by a judge, also called judge-directed negotiations.  This is a promising idea, as we noted in a previous post, and early results seem to show that the process is significantly cutting malpractice payouts where it is in use.  This is an encouraging trend, but broad reforms need to be passed in states around the country, so that premiums remain stable and Americans’ access to healthcare is not compromised.

by Suzanne Sataline
Wall Street Journal

To cut medical-malpractice costs, five New York City hospitals have agreed to a pilot program to divulge medical mistakes early, offer settlements quickly and use special state “health courts,” where judges will help negotiate agreements before cases go to trial.

The program, funded for three years with $3 million from the federal government, aims to cut the $1.4 billion spent annually in New York State on medical-malpractice premiums, hospital and state officials say. It is one of several programs being funded by the federal government to encourage hospitals to acknowledge and reduce medical errors.

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Side Note: The Wisconsin Supreme Court has found that the state must repay $200M that it took out of the state patient compensation fund for malpractice.  This is a victory for the Wisconsin Medical Association, and for health care consumers in Wisconsin.  A solvent patient compensation fund keeps medical malpractice insurance premiums stable, and in turn drives down the cost of health care in the state.

by Scott Bauer
Business Week

The Wisconsin Supreme Court ruled Tuesday that the state must repay a medical malpractice fund more than $200 million it took to balance the budget three years ago, potentially throwing the current budget into disarray.

In its 5-2 decision, the court agreed with the Wisconsin Medical Society that taking the money from the fund used to help pay malpractice claims was unconstitutional. It sent the case back to a lower court with directions that it order the state to pay back the money with interest and lost earnings.

The ruling did not say when the money would have to be paid back. That was left to the lower court to determine.

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Side Note: ISMIE is the largest malpractice insurer in Illinois, and the Cunningham Group is pleased to see that its rates have held steady.  However, we share Dr. Jensen’s apprehension, considering that the results of the Illinois Supreme Court ruling early this year have yet to be seen.  Physicians who want to be sure that malpractice insurance premiums remain steady in the future should support the efforts of Illinois medical professional organizations and politicians to restore tort reform to Illinois.

by Bruce Japsen
Chicago Breaking Business

For the fourth consecutive year, the state’s largest insurer of medical liability for doctors said it will not increase the base premium rates on policies.

ISMIE Mutual Insurance Co. credited its decision to a stable “lawsuit environment nurtured by Illinois’ 2005 medical litigation reform law, but cautioned that resulting market improvements could be at serious future jeopardy.”

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side note: this Wall Street Journal interview with a Case Western law professor addresses the trend toward electronic medical records and its effect on medical malpractice.  The professor sees several problems with EMR’s, noting that computers can cause errors with bugs or shutdowns and that entering data into computers impedes on physicians already squeezed schedule.  On the whole, however, she is optimistic about the shift to a digital record system and recommends EMR risk management techniques to minimize exposure to malpractice suits.  These include communicating about the system with patients and making sure to receive adequate training.  This is a good read for physicians who are thinking of moving to an EMR system in their office, or already have one.  As always, practicing sound risk management is a small investment that could save you from a big lawsuit in the future.

by Katherine Hobson
Wall Street Journal Blogs

How could the Health Blog resist a law journal article on two of our (and our readers’) favorite topics — medical liability and electronic medical records?

Sharona Hoffman, a professor of law and bioethics and co-director of the Law-Medicine Center at the Case Western Reserve University School of Law, recently published (with her co-author and husband Andy Podgurski), an  article on just that topic. “E-Health Hazards: Provider Liability and Electronic Record Systems,” which appears in the Berkeley Technology Law Journal, says that while “the potential benefits of computerization are considerable,” digitized medical systems also “may bring novel responsibilities, burdens and complexities for medical practices,” including a whole new rash of medical malpractice worries.

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Side Note: After three years without an increase, New York malpractice insurance rates have been increased an average of 5% this year.  Though this is a manageable increase, New York is still a hostile legal climate for doctors.  New York physicians should advocate for tort reform in their state, so that premiums do not increase more.

by New York State Insurance Department
readMedia

NEW YORK, NY (07/06/2010)(readMedia)– The average medical malpractice insurance rate increase for New York doctors this year is five percent, New York State Insurance Superintendent James J. Wrynn announced today. By law, Wrynn is charged with establishing the rates for medical malpractice insurance coverage. The increase, which took effect July 1, followed two years of rate freezes.

“I am pleased that we could keep the first medical malpractice rate increase in three years to an average of five percent,” Wrynn said. “This rate will help hold the line on costs for physicians while giving the insurance companies the resources to pay claims as they come due.”

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side note: This article from the Associated Press discusses the results of a new survey from the American Medical Association.  The survey showed that 90% of American physicians acknowledge that fear of malpractice lawsuits leads to unnecessary testing, building on earlier results we covered several weeks ago.  The survey’s result is convincing, as the large sample was randomly selected from a population that includes most American physicians and the response rate was around 50%, quite high for a survey of such a large population.  These new results strengthen the AMA’s call for tort reform.  Limits on noneconomic awards must be established to eliminate the economic waste being caused by defensive medicine.

by Lindsey Tanner
Associated Press

CHICAGO — Ninety percent of physicians surveyed said doctors overtest and overtreat to protect themselves from malpractice lawsuits.

That sentiment is more common among male doctors than female doctors, according to the survey published Monday in Archives of Internal Medicine. The findings echo a recent Associated Press story in which many emergency room doctors said lawsuit fears are the main reason for overtreating in the ER.

The Archives survey of 1,231 physicians nationwide included ER doctors and other specialists, surgeons and primary care doctors.

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Side Note: This article from the Associated Press describes one New York judge’s unique approach to the problems of the U.S. malpractice system.  Judge McKeon call his approach “judge-directed negotiations”, and focuses on humanizing malpractice cases and patiently working with all parties to reach a fair resolution.  The New York City court system has received a grant of $3m to test this approach on a larger scale.  We at the Cunningham group agree that special medical education for judges can only be beneficial, but it remains to be seen whether this type of approach can be a substitute for meaninful legislative reform to the system.

by RICARDO ALONSO-ZALDIVAR
Associated Press

WASHINGTON — Part listening, part cajoling, an innovative approach to resolving medical malpractice cases could become a model for courts around the country thanks to a pioneering judge who invested his own time in learning about medicine.

The Obama administration is spending $3 million to see if the methods developed by longtime New York judge Douglas McKeon can work on a broader scale, opening a way around the political stalemate over how to reform the medical liability system.

A senior appellate judge, McKeon named his approach “judge-directed negotiations.” But he also calls it “humanness.” Curiosity about medical matters led him to become a specialist in resolving wrenching cases that involve life-changing harm to patients.

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