Medicine, law join forces to face crisis

Data, not just anecdotes, are needed to find the causes of the crisis.
By WILLIAM K. ALCORN
VINDICATOR HEALTH WRITER
ROOTSTOWN -- Medicine and law are joining to find solutions to Ohio's medical malpractice insurance crisis.
The Northeastern Ohio Universities College of Medicine in Rootstown and the University of Akron School of Law will study the medical malpractice insurance problem over the next several months and develop solutions.
Atty. Maria Schimer, NEOUCOM's general counsel and director of the Institute for Community-Based Medicine and Law, said the solutions will be based on facts, not anecdotes.
The study is being done under the auspices of the institute, which was created by the schools to bring together physicians, lawyers and others.
The institute is expected to release its initial findings at a symposium in April 2005.
We are currently dealing with a great deal of anecdotal information," said Schimer.
More hard information is needed to help identify the root causes of the medical malpractice insurance crisis so they can be dealt with, she said.
In addition to gathering information about court cases, the institute also will look at trends behind the cases with the goal of improving medical care, she said.
"The current situation is resulting in problems for both physicians and patients," she said.
The issue
Schimer said skyrocketing malpractice insurance premiums and frozen reimbursement levels are forcing physicians to make some real, simple economic decisions.
"They can't afford to take care of patients any longer under these circumstances. Because of this, patients are not receiving the kind of care that they used to. It's simply not available ... it's simply not accessible," she said.
Schimer said the institute's first priority will be to determine the number of malpractice claims filed, and their outcomes, in NEOUCOM's 17-county service area, including Mahoning, Trumbull and Columbiana, and the major metropolitan areas of Cuyahoga, Lucas, Hamilton and Franklin counties.
The search of court records will be done by several students who have graduated from AU's School of Law but who haven't taken the bar exam, she said.
Also, the institute is looking for people in the insurance industry to add to the knowledge base. It plans to tap the Ohio Department of Insurance, which itself is looking into the matter, for data on settlements, defense costs, information from insurance companies, and which medical specialties are hit hardest, Schimer said.
The institute also will look at trends behind the cases to identify the medical procedures and mistakes giving rise to lawsuits, with the goal of improving medical care. That is one of the reasons the institute will look at the medical specialties, she said.
Gathering information
The April 2005 symposium will invite about 75 participants -- trial lawyers, both for the plaintiff and defense, physicians, insurers and people from the consumer advocacy community. It will be a day-and-a-half format to discuss quality assurance and improvement in the medical and legal professions.
The bottom-line goal is using hard data to examine some real solutions to suggest to legislators and the public, she said.
There may be multiple answers, she said. Perhaps one of the alternative ways to look at high-risk specialties, such as obstetrics-gynecology, is to take care of children without establishing fault, she said.
"One of the things we're really looking at is solutions that have really worked on other states and why," Schimer said.
The institute is supported by a grant from the University of Akron, and it also is looking for support from the Bar, medical associations and private foundations, Schimer said.
Motivation
Creation of the institute was triggered by a couple of things.
First, Dr. Lois M. Nora, NEOUCOM's president and dean, is a physician and a lawyer and has a keen interest in both areas.
"Her goal is to have the best community-based medical school in the country. She challenged all of us to improve in our areas," Schimer said.
Second, NEOUCOM is community-based.
"We don't live in a university hospital. We work with hospitals already in the community and private physicians. We're not talking about stem cell research. What we're looking at is the community-based physician and hospital," Schimer said.
"All of us are patients. We all want good, competent practitioners available, and we need to make sure we're not driving them out. If we have bad practitioners, weed them out. We need to address the needs of people who experience negative outcomes without having the whole system crash," she said.
Schimer also is an associate professor of community health sciences and director of the Office of Geriatrics/Gerontology at NEOUCOM.
She received the honor of Permanent Master Teacher, is the founding chairman of the Consortium of Ohio Geriatric Academic Programs and a member of the Bioethics Network of Ohio.
alcorn@vindy.com