Senator Frist, the Tennessee heart and lung surgeon heard over and over that physicians are leaving the state and physicians in training do not want to come to Ohio during a meeting with doctors chosen through the Academy of Medicine of Cleveland/Northern Ohio Medical Association and other health care entities in Northeastern Ohio.
Senator Frist, a physician, blamed trial attorneys for the litigation lottery mentality that has developed in Ohio and indicated that this mentality is destructively changing the practice of medicine. Senator Frist indicated that the Bush administration would like to help advance legislation dealing with medical liability costs that thus far has been blocked. Senator Frist said President Bush was committed to applying nationally the kinds of malpractice liability measures enacted in California. He voiced support for caps on non-economic damages such as pain and suffering; limits on contingency fees for attorneys representing injured people; and caps on punitive damages. All three of these issues were addressed in legislation the 124th Ohio General Assembly recently adopted in Senate Bill 281. Constitutionality of the provisions has yet to be tested.
Many of the physicians in attendance at the roundtable voiced their concerns about the medical liability crisis and how it has affected their practice as well as their personal lives. Lack of emergency room coverage in certain specialties, cutting back on services and outright quitting the practice of medicine were all issues brought up at the roundtable discussion. There was also debate about the inability of physicians to practice in volunteer settings after retirement – at a time when there is such a great need for physicians to volunteer at free clinics and other setting to assist with the uninsured care.
Additional comments were made regarding the “brain drain” that is occurring in Ohio because residents are not choosing this state to practice after their training due to the medical liability crisis. The AMC/NOMA has conducted surveys that have clearly showed that even medical students in our area do not plan to go into certain specialties or practice in the state of Ohio due to the medical liability crisis.
An AMC/NOMA board member provided Senator Frist with a copy of a letter to the editor sent to the area newspaper. The letter read in part “trial lawyers will tell you that the system works since 90% of judgments are in favor of the doctor. That is true, but at a terrible cost to our system of health care. In areas where malpractice insurance is at crisis levels physicians are quitting and leaving patients with limited or no medical coverage.” The doctor that authored the letter also indicated that in his case his malpractice insurance premium has doubled in each of the last 3 years and now represents more than half of all his practice expenses. Senator Frist said he currently maintains a liability insurance policy for use on occasions in which he provides services in clinics. He declined to say how much it costs, but acknowledged it is less expensive than when he was an active surgeon.
There was a request that Senator Frist seek legislation at the federal level to pass the costs of liability insurance onto patients and payors through some type of administrative fee structure. Physicians are precluded from doing this under plans such as Medicare and it may be something that should be evaluated and explored at the federal level.
There were also concerns raised that with reduced reimbursements and additional costs for medical liability coverage that physicians would also have to carry the burden of introducing electronic medical records into their practice. Senator Frist indicated that the federal government wants to be sure that there is interoperability of these type of systems and set some standards so that EMR will work if implemented. Senator Frist suggested working through Senator Voinovich on this issue.