Valley faces loss of doctors, panel says

Some doctors are retiring early; others are leaving the area, a physician said.
By PETER H. MILLIKEN
VINDICATOR STAFF WRITER
YOUNGSTOWN -- Increasing malpractice insurance premiums are having a major impact on the health-care system, according to the top medical official of a large local health system.
"The current malpractice crisis -- and it really is a crisis -- may be one of the defining issues in the future of heath care," said Dr. Clifford Waldman, chief medical officer at Humility of Mary Health Partners.
Dr. Waldman was one of five panelists in a discussion of the costs of medical malpractice insurance at Monday's Universal Cafe forum at First Unitarian Church.
Some physicians are leaving the Mahoning Valley for other places where premiums are lower; others are retiring early; and still others are going to work for hospitals or other employers who pay the premiums for them, he said. Because of the crisis, at least 25 local physicians have either left or significantly altered their practices in the past two or three years, h e said.
Other states
Physicians who consider leaving the area are "looking to other states where tort reform has managed to keep down the cost of health-care malpractice insurance," he explained.
The high cost of malpractice insurance causes college students to choose careers other than medicine, causes medical students to avoid high-risk specialties, such as obstetrics, and makes it harder to recruit physicians to the Mahoning Valley, he added.
Dr. Marc S. Saunders, a general surgeon and president of the Mahoning County Medical Society, said a survey of malpractice suits filed in the Mahoning County Courthouse since Jan. 1, 2000, found an average of more than five doctors sued in each case. The survey also found 65 percent of doctors sued in 126 cases filed in 2000 are still defending against those suits 4 1/2 years later.
Atty. Martin White of Warren, the only lawyer on the panel, said lawyers competent in the malpractice field don't use a "shotgun approach" of suing every physician named in a patient's chart.
His contention
Doctors defending against non-meritorious claims can be dismissed from cases, he said, adding that most of the doctors who are still engaged in such cases after 4 1/2 years remain as defendants because there's some evidence of their negligence.
Tort reform advocates seek to cap damage awards in medical malpractice cases because they say such caps will curb frivolous lawsuits, he noted. However, he said, "Frivolous lawsuits don't result in any damages" being awarded. "Capping the damages on severely injured children or quadriplegics has nothing to do with frivolous lawsuits," he added.
There's no evidence that malpractice awards are increasing, White said, adding that studies have shown that such payouts have actually declined in New Jersey and Missouri.
Studies show the cost of medical malpractice is less than 1 percent of total health-care costs, White said. "I think it's outrageous that the insurance industry is doubling, and tripling and quadrupling and canceling the medical malpractice coverage for physicians who have done nothing wrong," he said. The insurance industry was not represented on the panel.
"There has to be a way in which this industry can separate the good and bad doctors," White said of the insurance industry, adding that malpractice insurance plans should have deductibles, such as those that apply in other types of insurance, to reduce premiums.
Affecting access to care
"We really are losing a lot of doctors in town ... We can't afford to lose any more," Dr. Saunders said, adding that access to care is being reduced. He cited the case of a Boardman vascular surgeon who paid $150,000 a year in malpractice insurance premiums here, but is now paying only $15,000 a year in Wisconsin.
In the 21st Century, there'll be a maldistribution of physicians based on malpractice premiums, Dr. Waldman said. "We're really looking at a major crisis if we don't do something to reduce the costs," he concluded.