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Sunday, July 06, 2003Republicans made it clear that they intended to use the vote against Democrats. "Women are having trouble finding obstetricians to be able to deliver their babies," said Senator John Ensign, Republican of Nevada, the chief sponsor of the measure. "In states like Nevada, doctors are leaving in droves, and that kind of scenario is repeating itself over and over around the country," Mr. Ensign said. "As voters become aware of it, I think you're going to see the change of minds of senators who may now be against it. We bring it up for a vote now, and it may cost them in the next election." And it should. It's no coincidence that there's not one Democrat behind the bill. They recognize the hand that feeds them. Speaking of which, that same hand is busy feeding others to fight their battle: ...Both sides are lobbying hard. The medical association is starting an advertising campaign focused on senators opposed to the bill, and USAction, a consumer advocacy group backed by the trial lawyers, is spending more than $500,000 on a two-week advertising campaign featuring victims of medical malpractice. Notice that the AMA isn't hiding behind another group, but is making its own commercials. The trial lawyers, however, are hiding behind a "consumer advocacy group." An advocacy group that supports out of control asbestos litigation, and which describes those with whom it disagrees as "right-wing forces". (That echo of "vast right wing conspiracy" is no coincidence. Many of the group's executives have ties to the Democratic Party.) The Trial Lawyer Association, er, I mean, USAction, plans to hit back with stories of gross neglect and injury: "This Congress has a very bad track record of supporting powerful special interests at the expense of average Americans," said Jeff Blum, USAction's executive director. "We want to make sure that real stories of real people are in the debate on medical malpractice." Forget for a moment that USAction itself is supporting one of the most powerful special interests in Congress, and just consider "the real stories of real people." One could argue that more real people are suffering real harm from the current medical malpractice crisis than would be harmed by tort reform. Look what's happening in my town: Consider Dr. Robert Norman, a geriatrician in Cuyahoga Falls who specializes in treating people with Alzheimer's disease. His malpractice insurer raised his annual premium from $5,700 to $34,000 last year and warned him that it could jump to $100,000 this year if he continued treating patients in nursing homes. But when it came time to renew his policy in May, every insurer gave him an unexpected ultimatum: Either sign a paper agreeing to stop seeing nursing home patients or lose his malpractice coverage altogether. He had 150 nursing home patients who had to find another doctor. Then there's the high-risk woman who couldn't find a doctor to treat her: Before seeing him, she went to six other doctors seeking help for uncontrollable uterine bleeding. ``She was not a thin woman,'' Davis says. ``She was told right to her face, `If you were a thin woman, I'd operate on you.' '' Davis agreed to take over her care and tried hormonal treatments, which eventually stopped the bleeding without surgery. None of the other doctors she had seen offered any help, even nonsurgical options. ``That's what's bothering me,'' Davis says. ``People are starting to be stereotyped and doctors are saying, `I'm not going to treat this kind of patient because she's too high-risk.' '' There's more than just prejudice against the obese at work here. The hormone therapy in a morbidly obese woman is also riskier. Dr. Davis took a chance that his colleagues didn't want to take: Just having one jury verdict, one settlement or one unresolved lawsuit, he says, could make an Ohio doctor uninsurable. Davis says doctors have to make a decision: ``Should I risk my care of my 5,000 other patients for one patient?'' And, of course, there's the problem of finding and keeping an obstetrician: Regardless of the cause of high cost of malpractice insurance, patients such as 24-year-old Carrie Mace, of Cuyahoga Falls, are getting an unwelcome lesson in the economics of medicine. Mace was five months' pregnant when her family doctor, Ross R. Black, decided he couldn't afford to deliver babies anymore. The Cuyahoga Falls physician was notified at the beginning of the year that his annual premium would jump from $45,000 to $75,000 if he continued to practice obstetrics. So he dropped that part of his practice in February, and his annual premium fell to about $17,000. And then there's the factor that often doesn't get noticed in the current debate. The effective of plummeting safety ratings of malpractice insurance companies on a doctor's ability to practice medicine: Adding to the problem is the fact that several major insurers still offering malpractice insurance have had their financial stability ratings downgraded below an A- in recent months. Most major hospitals require doctors to be insured by a company with a rating of A- or better to stay on staff. Phyllis Klein, a 73-year-old Akron resident, was caught in this insurance pitfall when she was hospitalized for intestinal problems. When she arrived at the emergency room, she found out her physician, Dr. Steven L. Cochran, was no longer allowed to take care of her at Akron General Medical Center. ``It's kind of hard when the doctor who walks in to discuss your case is a stranger,'' Klein says. ``It was kind of a shock to find that I would be dealing with doctors with whom I have no familiarity at all. Not that they weren't absolutely wonderful and certainly professional. But they still weren't my doctor.'' Cochran is looking for another, higher-rated insurer that will offer him a policy so he can get his hospital privileges back. ``We receive daily phone calls from the patients: `Why aren't you here? Why aren't you seeing me? I want my doctor,' '' he says. ``It's been very stressful to a lot of the patients, particularly the geriatric patients. ``This (the malpractice crisis) has probably changed the nature of our practice more than anything that has happened in the last 10 to 20 years.'' Yes, indeed, it has. And what happens when there are no more insurance companies with safety ratings of A- or higher in a state? (And believe me, they're dropping like flies.) Will hospitals be left without doctors? Probably not, since a hospital can't function without doctors. But before hospitals change their rules, there will be a lot more doctors - including those who depend on their hospital practices for their livelihood such as surgeons and cardiologists - who will be forced out of practice. And then who will care for their patients? posted by Sydney on 7/06/2003 08:04:00 AM 0 comments 0 Comments: |
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