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Sunday, February 15, 2004Dr. Waleed Nemer had a choice -- either stop treating a patient he had been seeing for nearly two decades, or lose his malpractice insurance, and with it, his Akron practice and his livelihood. His elderly patient hadn't filed a lawsuit against Nemer. She hadn't complained about his care. The problem -- at least from the insurance company's point of view --was that she had moved to anursing home. ``The bottom line: The insurance company asked me to write a letter saying that I will never see another patient in a nursing home,'' Nemer said. ``Only under those circumstances, they will give me insurance.'' ....But Dr. Robert Norman had nothing to fall back on when his insurance company made the same demand. A Summit County geriatrician specializing in Alzheimer's care, Norman had built his career on caring for the elderly, especially those in nursing homes. In 2003, his malpractice premium jumped from $5,000 to $34,000. When he tried to renew his coverage for 2004, he ran into roadblocks from the insurer. Paperwork wasn't getting sent to him. Phone messages weren't being returned. Finally, someone at the insurance agency told him, ``Well, there's a problem.'' ``I said, `A problem?' Well, the problem was, they didn't want to cover me if I stayed in nursing homes,'' Norman said. .....Dr. Atul Goswami has cared for more than 300 patients in a dozen nursing homes over the last 15 years. But he, too, couldn't find insurance until he agreed to leave the nursing home patients behind. ``It was really scary for me when this all happened,'' said Goswami, who now focuses solely on his office practice in Akron. ``I wrote letters to all the families telling them that I would not be able to provide care for their loved ones. I got lots of calls and letters. The families cried. They'd say, `We don't want to lose you.' Many families said they would bring Mom to my office if I would continue to take care of them. I had to say, `No, I can't do that. The insurance company says I can't.' Dr. Norman is angry at the insurance company and thinks the state should do more to regulate them. I can't blame him. They certainly didn't behave honorably toward him - giving him the run around, and only announcing their decision at the last minute. I suspect he has the same insurance company I have, and there have been rumors that they're looking to get out of Ohio completely. They tried to make my policy null and void last week by claiming they didn't get my premium check six months ago. I had to threaten to report them to the Ohio Department of Insurance to get them to correct their accounting error and reinstitute my policy. They are not consumer friendly. But, the state does regulate them. The problem is, they're in financial trouble and are looking for anyway to reduce their costs. I suspect the rumors are true and they'll soon be exiting the market completely. And if the state restricts them too severely, even more companies will leave the market: One of the more controversial proposals for dealing with the malpractice crisis is Senate Bill 112. This legislation, which has some bipartisan support, would place limits on how insurance companies set rates and require longer contracts for doctors. State Sen. Eric Fingerhut, a Cleveland Democrat now running for the U.S. Senate, proposed the legislation as an amendment to last year's tort-reform bill, but it was tabled. State Rep. Scott Oelslager, a Canton Republican, has voiced support of the proposal. The bill would require that medical malpractice policies last five years, while also restricting a company's ability to cancel policies and, for the most part, limiting the amount of premium increases to no more than 5 percent a year. Ohio Insurance Director Ann Womer Benjamin has called the measure extreme. ``Were Ohio to take extreme action as suggested, companies would leave the Ohio market entirely or their financial situation would plummet... '' she said. ``Forcing medical malpractice companies into insolvency is not in the best interests of Ohio consumers.'' But, we do need at least a modest level of insurance regulation: Maglione said the Ohio State Medical Association likes the idea behind the bill but favors a simpler solution. In Ohio, insurers now can implement new rates while their rationale is reviewed by the Department of Insurance. A better way, Maglione said, would be to review the insurers' rationale for the rate increases before they take effect. And they should have to give doctors ample notice before terminating their policies. UPDATE: A reader emails: What is going to happen to the nursing home patients without doctors? You know. They will be dumped on the local emergency rooms when they become acutely ill, on doctors who know very little about their histories and who will be compelled to sort out their problems or have the on-call internists do the same once they are admitted. If they are discharged (and that invites another issue as to where, since you know how problematic post-discharge planning for nursing home patients can be) there remains the question as to who will provide followup, since the very mechanism of outpatient followup and management is being thwarted here. And thus begins the cycle again. Yes. It does nothing to improve care and everything to undermine it. And then there's this take on the nursing home problem from another reader: Families are automatically suing doctors when their parents die in a nursing home. They want to add to their inheritance at no risk to themselves. Lawyers are finding these families by reviewing obituary pages. Then they pressure the families to sue. The insurance companies can’t be blamed for reacting to this scam. I am very happy to see all of these malpractice insurance companies cancel policies and place limitations on doctors. This will create a national crisis that will force politicians to bring some sanity back to our destructive tort system. I don't know if lawyers scan the obituaries for possible clients, but it wouldn't suprise me. But what worries me is that these nursing home doctors are just the beginning. First they came for the nursing home doctors, then they came for me..... How long will it be before no one in Ohio can find malpractice insurance coverage? posted by Sydney on 2/15/2004 08:56:00 AM 0 comments 0 Comments: |
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