Editorial Liability Reform Is A Smart Move For Massachusetts

When the Mass. Medical Society (MMS) offered its strong support of legislation to curb the cost of medical liability insurance, some of its members were cheering louder than others — especially those who find $100,000 or more disappearing from their bank account annually.

That’s a good chunk of change — and would have been almost ridiculous a decade ago. But that’s what physicians in certain fields, such as radiology and obstetrics, are being saddled with. And that’s why Massachusetts is facing a looming crisis as doctors seek regions that are more financially friendly.

Several stories in The Healthcare News this month touch on the liability issue, beginning with the official MMS response to legislation designed to ease their burden (see page 7). And statistics show that the medical community has good reason to keep a close watch on the situation.

The MMS releases an annual study called the Physician Practice Environment Index, which has shown a deterioration in doctors’ workplace satisfaction for 10 years running — with low reimbursements coupled with skyrocketing insurance costs a major factor.

No wonder, then, that just 35{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of medical residents and 50{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of fellows currently preparing for their careers in Massachusetts say they do not intend to practice medicine in the Bay State once they graduate. The grass — at least from a fiscal standpoint — definitely seems greener in Connecticut, New York, and even other regions of the country.

Yet, there are still plenty of advantages to practicing in Massachusetts. The health care workforce is world-class, and not only based on reputation. An MMS survey shows that 88{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of patients expressed satisfaction with the care they received in the past year, even as 18{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} said they had some problems getting access to care.

That latter number is one that the Commonwealth must turn around, and that won’t happen if physicians are fleeing the state or reducing their range of services to avoid unreasonable liability costs. And 49{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of doctors surveyed by the MMS are making just those kinds of cuts in service for exactly that reason.

The bill now being advanced by the Legislature’s Joint Committee on Insurance aims to make some common-sense changes to current liability law, including making defendants liable only in proportion to their degree of fault in a case. At the moment, all defendants are equally responsible to satisfy a judgment, no matter who is principally responsible. This is but one measure included in the bill, yet it alone would help bring down insurance costs.

And the bill doesn’t let physicians off the hook by any means. In fact, one provision aims to enhance patient safety by requiring insurers to report data on claims and payouts due to medical negligence to a state database of medical errors in an effort to develop stronger patient-safety initiatives — again, with the significant secondary benefit of reducing insurance premiums.

An exodus of physicians from Massachusetts is not a matter to be taken lightly. The MMS’ annual Physician Workforce Study (see story on page 20) highlights several specialties facing severe shortages, but suggests that all types of physicians are in demand. And unfilled positions mean less access for the patients who need their services.

The liability issue is one that the Mass. Medical Society has harped on for quite some time, and lawmakers are beginning to listen — and possibly do something about it. The steps called for in the proposed legislation are not extreme by any means, protecting both the safety of patients and the continued viability of doctors to practice medicine in a state known for its high quality of care.

That’s not a reputation that will remain intact, however, unless more physicians consider the Bay State a smart place to set up shop. We think lawmakers need to do their part to make that happen, and this bill is a good start. –