Editorial The State’s System For Medical Liability Is In Need Of reform

For some time now, health care groups have been sounding the alarm about skyrocketing professional liability insurance costs and their impact on services to the public. The crisis that people have been predicting is, in fact, already here, and unless something is done to reverse current trends, a bad situation will only get much worse.


As our story on page 1 reveals, liability insurance costs are spiraling out of control in the Commonwealth. The physicians most impacted are ob/gyns, who, because of the high-risk nature of their work, have seen rates more than double over the past year, with some doctors receiving quotes for new premiums well in excess of $100,000.

This has forced nearly 20{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of the region’s 50 ob/gyns to either leave the state, retire early, or give up the practice of delivering babies and focus solely on the gynecological side of their practice, where the liability rates are much lower. And more physicians will surely do the same when their policies are up for renewal and they have to stare at the new estimates.

The crisis is already being felt in places like Ware. That area’s two ob/gyns have left the state, at least in part because of the rising cost of doing business, leaving women to travel to Springfield or other distant communities to deliver babies. Other area cities and towns have not felt the crunch to that extent, but if something doesn’t happen to stem this tide, the questions isn’t if they’ll see similar hardship, but when?

That’s why a bill now before the Legislature to cap non-economic damages in liability cases is so important. That measure would put a $500,000 cap on non-economic damages such as pain and suffering and would go a long way toward order in a liability system that currently has none.

Many people believe that the liability issue is about rich doctors who are suddenly faced with the prospect of being not-so-rich. That’s an over-simplistic reaction that is far from accurate, especially for people not long out of their residency. For these doctors, it’s not a matter of getting rich, it’s a matter of simply being able to pay the bills.

And when you consider that most ob/gyns would have to make 50 or more deliveries merely to pay for their liability insurance, one can’t blame them for seeking another line of work or another state in which to do business. People join the medical profession because they want to help people, but they are, after all, in business, and staying in obstetrics under these conditions simply doesn’t make good business sense.

The current situation impacts not only ob/gyns in the field, but those young people thinking about entering that rewarding, but also stressful, profession. Already, the numbers of residents in ob/gyn programs are down, and as the horror stories about six-figure insurance premiums mount, it will only become harder to draw individuals into the field.

But, as we said, the real issue here is not physicians or their ability to earn a decent wage. The issue is access to care, and without caps on damages, liability insurance rates will only continue to move skyward, taking more doctors to supposedly greener pastures along with them.

If that happens, as the physicians we spoke with said, women will have simply have fewer choices and, in the end, diminished quality of care.

Dr. Charles Welch, president of the 18,000-member Mass. Medical Society, says the professional liability system in Massachusetts is on the brink of collapse. He’s right. But it can be pulled back from the brink through legislation such as that proposed by the MMS.

It is our hope that the Legislature will understand that the bill is not being filed to help doctors with their bottom lines or to cheat women out of their rights if they or their babies are damaged. It’s being filed to help preserve a health care system that is said to be among the best.

It won’t have that distinction for long if the current climate is allowed to continue.