Physicians decry rising cost of insurance

Medical malpractice fees
have doctors calling
for legislative reforms

By linda denicola
Staff Writer

Medical malpractice fees
have doctors calling
for legislative reforms
By linda denicola
Staff Writer

JERRY WOLKOWITZ Joan Raspantini of Howell holds a banner with a question many women in New Jersey may be asking in the future.JERRY WOLKOWITZ Joan Raspantini of Howell holds a banner with a question many women in New Jersey may be asking in the future.

Physicians are angry about the rising cost of malpractice insurance and they are not going to take it any longer. At least that was the sentiment expressed by speakers at a Nov. 6 rally held to educate the public and healthcare professionals about the issue.

Attended by about 200 people, many wearing white coats or scrubs, the rally, held in the main lobby of CentraState Medical Center, Freehold Township, was the fifth and final rally statewide called to address the issue.

Frustrated by liability premium increases of up to 200 percent, hundreds of healthcare providers have attended the rallies. Last week, doctors from Monmouth, Ocean and Middlesex counties listened to physicians who are leading the movement and the local legislators who support their cause speak on the need for tort reform; all of them emphasizing the impact rising malpractice insurance has on their patients.

In addition to the rallies, one of the sponsors, New Jersey Citizens United for Healthcare Access (NJCUHA), is planning to lead a protest in which all physicians will be asked to close their offices for three days in December, said a member of the citizens group.

Dr. Stephen Tarnoff, Freehold Township, talks about the rising cost of medical malpractice insurance during a Nov. 6 rally.Dr. Stephen Tarnoff, Freehold Township, talks about the rising cost of medical malpractice insurance during a Nov. 6 rally.

According to information posted on the American Medical Association (AMA) Internet Web site, the AMA has identified 12 crises states and New Jersey is among them. The others are Florida, Georgia, Mississippi, Nevada, New York, Pennsyl-vania, Ohio, Oregon, Texas, Washington and West Virginia.

The AMA supports the Health Act, federal legislation HR 4600 and S 2793, based on a California law known as MICRA. According to the AMA, MICRA has proven fair to patients and effective at maintaining stability in the California medical liability insurance market. MICRA reforms include a $250,000 cap on non-economic damages, something that participants cheered for when it was brought up at the CentraState rally.

According to the AMA article, California is not suffering from the current medical liability insurance crises that is hitting states without reforms.

In September, the U.S. House of Representatives passed a measure to cap the pain-and-suffering damages that juries may award in medical malpractice suits at $250,000. Three bills in Trenton also contain tort reform elements; S-1902, sponsored by Sen. Joseph Kyrillos (R-13) and S-1850/A-2762, sponsored by Sen. Martha Bark (R-8) and two Republican Assembly members from the same district.

Physicians stress that one of the most troubling aspects of the current medical liability litigation system is the effect on patients. Unbridled lawsuits, they claim, have turned some regions in the country into risky areas to practice medicine. Because of large jury awards and the burgeoning costs of defending themselves against lawsuits (including frivolous claims) medical liability insurance premiums are skyrocketing.

Dr. Ben Weinstein, senior vice president and medical director of CentraState Medical Center, said doctors aren’t upset because the rising cost of malpractice insurance limits their ability to buy a new car, rather, it means firing staff and seeing patients every six minutes instead of every 15 minutes.

"Doctors are forced to say, ‘How many patients can I see today to make my bills?’ " Weinstein said.

Assemblyman Herbert Conaway Jr. (D-7), who is a doctor, said, "There is a healthcare crisis coming very rapidly. Doctors are leaving the profession in droves. The legal community is saying (to physicians) ‘We have nothing to do with it. It’s your fight.’ We have obstetricians who can’t afford medical malpractice insurance. We have to protect women’s health."

In addition to Conaway, two other legislators lent their support to the movement. Assemblyman Samuel Thompson (R-13) explained that the crisis is approaching very rapidly. Many physicians get their new insurance bills in December.

Those are "bills they can’t afford," Thompson said.

Monmouth County Assemblywoman Clare Farragher (R-12) said legislators across the country are looking at the limits in California. Exorbitant malpractice rates have ruined a whole sector of the medical community.

"That’s got to stop," Farragher said.

Escalating insurance premiums are affecting obstetricians especially hard. According to Dr. Howard A. Grabelle, an Ob/Gyn practicing in North Brunswick, obstetricians are hit hard because they have two patients at once, the mother and the baby.

"We pay the same malpractice rates as high-risk surgeons, but we don’t earn the same money," the doctor said.

Grabelle, who is also a professor at the Robert Wood Johnson Medical School and a member of NJCUHA, said he has seen 10 of his colleagues leave New Jersey since Jan. 1.

"They couldn’t afford to stay in business," he said, adding that because of high insurance premiums and health insurance reimbursements that were below the cost of the service, they couldn’t pay their bills.

Grabelle said his insurance more than doubled, going from $40,000 to $81,000 annually.

"My insurance company is pulling out of the state. The doctors they kept were the ones who had the least liability," he said.

In addition to his own malpractice insurance going up, the part-time physician who shares Grabelle’s office also has seen her insurance increase, from $26,000 to $41,000.

"We’re paying $120,000 for insurance. That’s $10,000 a month. It means we have to do five deliveries every month before we can make our insurance premiums. That’s on top of all of the other office expenses," he said.

Dr. Norman Back, chairman of CentraState’s Ob/Gyn Department, urged attendees to get angry and speak to their legislators. He also expressed concern about another problem — students who might have, but are not, going into obstetrics.

Dr. Robert Rigolosi, president of The Medical Society of New Jersey, another sponsor of the rally, added his voice to the number of physicians who blame the tort system, that "gives away millions of dollars and wreaks havoc on the healthcare system."

"The trial lawyers say there is no crisis. Of course not. When you collect golden eggs, why would you want to kill the goose?" Rigolosi said.

He spoke about a Camden colleague who recently closed his office and is now practicing in Delaware.

"He followed others. Others will follow him," Rigolosi said.

A fact sheet drawn up by the Medical Society of New Jersey lists three factors that have come together to create the crisis: the normal underwriting cycle, the turndown in the economy and the sudden escalation on damage awards won by trial lawyers and their clients.

The doctors are calling for meaningful tort reform, which would include the $250,000 cap on non-economic damages; a fair statute of limitations; modification of the expert witness and certificate of merit systems so that only qualified physicians can state that a medical error has occurred.

In addition, they want quicker case resolution and less attorney costs as well as measures that would ensure that injured patients are able to be fully compensated for any medical expenses, including long-term care, loss of all income, and other harmful effects of medical or patient error.