Editorial Reforming Medical Liability Needs To Be A Legislative Priority

More than 1,000 physicians, nurses, and patients, gathered in one place, can make a strong statement.

And that statement only gets louder with the support of Gov. Mitt Romney, who backed the position of the recent Rally for Reform in Boston, which was assembled to promote medical liability reform.

Speaking to those gathered at the Grand Staircase at the State House, the governor declared, “We need reform now!” He added that if the state does not solve the liability crisis promptly, “we will be jeopardizing the ability of our citizens to get health care in one of the great health care states in the nation.”

Those are strong words, and doctors hope they give needed momentum to the fight against soaring liability premiums, which threaten to drive physicians away from Massachusetts and make it more difficult for patients to access prompt, quality care.

“We must work together as individuals, patients, physicians, and a community to preserve all patients’ access to quality medical care. We must let our legislators know that the time for reform is now, before we lose more physicians,” said Dr. James Wang, a Westfield obstetrician/gynecologist who stopped delivering babies on April 1 because of liability premiums.

Others associated with Wang feel the sting of that decision. “I felt a sudden personal and professional sadness and loss,” said Mary Ellen Pender, a nurse and a patient of Wang. “I have strong feelings of loss for so many women and families who will no longer be cared for by this excellent obstetrician.”

Elizabeth Flaherty, also a nurse and patient of Wang, added, “this is not just an issue for me or my friends. This is an issue affecting every woman in Massachusetts. It goes directly to the ability of women of every socioeconomic background to have access to care, and to have that access protected when choosing to have a family.”

Although the problem is particularly acute in the ob/gyn field, it’s far from limited to that practice. Liability premiums have forced trauma centers and hospital departments to close in many regions, leaving patients with longer waiting times for orthopedic, radiological, and neurosurgical services. Recruitment of physicians to Massachusetts has also been hampered, exacerbating the access problem for patients.

According to a recent Mass. Medical Society (MMS) poll, 75{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of the state’s residents say not reforming the current system will risk the loss of hundreds of doctors from the health care system in Massachusetts; 83{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} agree that unlimited awards in malpractice lawsuits could result in higher medical costs for everyone; and 80{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} view the malpractice-induced flight of medical specialists as a serious problem facing a health care system widely recognized as one of the best in the world.

Another MMS poll showed that 98{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of physicians believe the medical liability crisis is a serious problem. In addition, 84{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} said they practice more defensive medicine; 53{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} said the problem impacts their willingness to disclose medical errors to patients; 46{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} said it significantly impacts their willingness to disclose medical errors to colleagues; 52{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} are considering retiring early; 50{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} are considering switching to a non-clinical position in medicine; and 43{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} are considering moving to another state.

Those are harsh numbers, but legislation endorsed by the MMS, Mass. Hospital Assoc., and other groups is intended to reverse the tide. The bill includes the elimination of the waiver on the cap of non-economic damages. State law now caps non-economic damages at $500,000, but allows the cap to be waived in individual cases.

The bill also provides for the elimination of joint and several liability, providing for judgments based on one’s share of responsibility; structured settlements after $50,000, allowing judgments to be paid over time; and other changes.

Dr. Charles A. Welch, MMS president, told the rally participants that “what brought us here this morning is our commitment to excellence in health care and our duty to protect our patients’ access to care. We worry that more and more of them will not be able to get the care they need. This event is about our patients — the care they need, and the care they deserve.”

The issue is indeed about patients. The numbers don’t lie — physicians have indeed shut down practices or moved to other states because of extravagant liability costs, and more threaten to do so all the time.

A change is due. Health professionals understand that, and so does Gov. Romney. And so do we.