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Pennsivania Hospitals Brace for Doctor Walkout
Spartanburg Herald-Journal ^ | January 01, 2003 | DAVID B. CARUSO

Posted on 01/01/2003 6:47:09 AM PST by Captain Shady

By DAVID B. CARUSO
Associated Press Writer Hospitals in eastern Pennsylvania braced for a potential New Year's Day walkout by scores of surgeons who say they can no longer afford to buy malpractice insurance policies.

But with Tuesday's midnight deadline looming, there were signs that Gov.-elect Ed Rendell might have averted a large-scale work stoppage with a proposed aid package that would reduce doctors' insurance payments by $220 million in 2003.

Several large surgical practices in northeast Pennsylvania backed off Tuesday from a threat to stop performing operations Wednesday if something wasn't done about their insurance costs.

Scranton's biggest hospital, Community Medical Center, notified state officials Tuesday that its neurosurgeons agreed to keep working, avoiding the closing of northeast Pennsylvania's only trauma center.

"It feels like a huge weight has been lifted off our shoulders," said hospital spokeswoman Jane Gaul.

It was unclear whether doctor shutdowns would be avoided altogether.

At least 21 hospitals in southeastern Pennsylvania expected to experience some service shortages on Wednesday, according to the Delaware Valley Healthcare Council, a lobbying group that represents hospitals.

Most of the doctors threatening to stop work were surgeons, but some doctors in specialties where lawsuits are more common, like obstetrics, had also said they might curtail their practices.

Gov. Mark Schweiker said he didn't expect a crisis, but warned that there might be "pockets" around the state where patients would have trouble finding specialists.

Weeks ago, hundreds of doctors had been poised to stop working on New Year's Day to protest high premiums.

The Pennsylvania Medical Society said that in early December, at least 1,100 doctors were still looking for affordable insurance for the new year. Hundreds have since bought policies, but the society predicted there would still be many who would stop practicing on Jan. 1.

Those who have agreed to keep working are banking that Rendell - a Democrat who doesn't take office for another three weeks - can persuade the Republican-controlled Legislature to accept his plan.

Debate over the proposal isn't likely until midwinter.

"Our hope is that Rendell will be true to his word, and put through the reforms he has proposed," said neurosurgeon Steven Barrer of Abington Memorial Hospital in suburban Philadelphia.

Pennsylvania law requires surgeons to buy $1 million in medical liability insurance, plus pay into a state fund that helps pay court judgments that exceed the limits on their private policies.

For some doctors, the combined premiums can cost as much as $150,000 a year. Other doctors unable to obtain private coverage because of their claims history have been forced to turn to a state insurance plan that can cost as much as $300,000 a year.

Rendell's proposal would slash doctor payments to the state medical liability fund, and instead have health insurance companies pay for the fund through a one-time "assessment." Insurers haven't said whether they will fight the plan.

Surgeons in some specialties could save $30,000 to $50,000 a year under Rendell's plan.

Meanwhile, West Virginia officials doubted they could prevent a similar walkout by two dozen surgeons from four hospitals in the state's northern Panhandle.

Insurance and Retirement Services Director Tom Susman said Tuesday that the doctors seemed reluctant to wait a week for legislative proposals being drafted to address the costs of malpractice insurance.

In the event of a walkout, the hospitals planned to divert patients to Ohio and Pennsylvania, or south to Morgantown, W.Va.


TOPICS: Business/Economy; Culture/Society; Front Page News; Government; News/Current Events; US: Pennsylvania; US: West Virginia
KEYWORDS: govrendell; medicalcare; pennsylvania
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To: Captain Shady
The only way to force tort reform is for a massive nationwide strike of physicians to simply refuse treatment until something is done about lawyers using doctors as their golden geese. Americans need medical care a lot more than we need rich lawyers.

The doctors are going to have to get downright mean about this or the politicians will keep slithering around like the snakes they are. To those who say people would die under that scenario, I say they will die anyway as doctor shortages worsen because of the problem.

The future of modern medicine is on the line. The docs are going to have to offer a simple choice to the people of this country - Modern health care or no modern health care. I'll bet the millions of legal junkies in this country wouldn't let the tort problem threaten the loss of their supply of mood-elevating drugs. Prescription-waving Americans will storm the state legislatures for tort reform before their pills run out.

61 posted on 01/01/2003 2:21:40 PM PST by NoControllingLegalAuthority
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To: Captain Shady
Rendell's proposal would slash doctor payments to the state medical liability fund, and instead have health insurance companies pay for the fund through a one-time "assessment." Insurers haven't said whether they will fight the plan.

It won't work .. not till you do something about all the bad lawsuits being filed

62 posted on 01/01/2003 2:26:09 PM PST by Mo1
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To: Young Rhino
The trial lawyers are responsible for this mess, but Rendell doesn't have the spine to push tort reform.

Yep .. the trial lawyers will just keep getting richer and WE are the ones that end up paying

63 posted on 01/01/2003 2:27:16 PM PST by Mo1
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Comment #64 Removed by Moderator

To: quebecois
Still true--doc doesn't have to agree to take medicare patients and can opt out.
65 posted on 01/01/2003 3:15:26 PM PST by Founding Father
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To: Lawdoc
"Good on You!" Doc
66 posted on 01/01/2003 3:38:55 PM PST by Doc On The Bay
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To: snopercod
Impressive guy...wonder if he's still alive and if so, what he thinks of the situation in '03?
67 posted on 01/01/2003 3:51:16 PM PST by Abundy
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To: Founding Father
You missed the point. Even if you decline to accept medicare patients, you cannot be on a hospital staff unless you prove that you carry insurance. All hospitals accept medicare, and these hopsitals won't let you on the medical staff unless you are insured, regardless of whether you, as a doc, treat medicare patients. No hospital staff membership means no admissions...which means no business.
68 posted on 01/01/2003 4:02:07 PM PST by quebecois
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To: WFTR
If they find this evidence, the defendant pays. If they don't, then they must decide whether there is a preponderance of evidence that the suit never had any merit. If they find that the suit never had any merit, then the plaintiff should pay.

Since the plaintiff frequently will have little assets, with his lawyer operating on a contingency-fee basis, one modification of this is that the plaintiff AND his lawyer are jointly liable in the countersuit. This would make lawyers VERY skittish about engaging in meritless lawsuits

69 posted on 01/01/2003 5:52:56 PM PST by SauronOfMordor
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To: SauronOfMordor
That's a very good thought.
70 posted on 01/01/2003 7:10:27 PM PST by WFTR
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To: Mini-14
Is the point here that there are bad docs? True. That even good ones occassionally make bad mistakes. True also. This does not mean that suing reduces either problem or helps anyone except the lawyers and a very few litigious patients. You know, when doctors make bad mistakes, there is usually no way for the patient to know -- especially because the malpractice industry gives docs a tremendous incentive to cover up their mistakes.

Although off the subject, if your eyes are perfectly good but your vision is out of focus, I recommend the conservative treatment of eyeglasses rather than surgery. Common sense is that surgery is a last resort treatment.

71 posted on 01/01/2003 7:15:42 PM PST by Steve Eisenberg
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To: Mo1
Rendell's proposal would slash doctor payments to the state medical liability fund, and instead have health insurance companies pay for the fund through a one-time "assessment." Insurers haven't said whether they will fight the plan.

It won't work .. not till you do something about all the bad lawsuits being filed

What Fast Eddie is really doing is increasing taxes on insurers, the result being an indirect tax increase, in the form of higher premiums, for every insured person in the state. A few of the poorest who now can barely afford health coverage will drop their insurance.

Is Mol right that "It won't work"? Well, it won't work for me, but it will work acceptably for the doctors and just fine for the lawyers.

72 posted on 01/01/2003 7:40:45 PM PST by Steve Eisenberg
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To: Steve Eisenberg; All
Greetings from a call-room in Florida where I am a physician. The malpractice crisis is deep and widening. The problem is this -- as I have read through this thread there has been little discussion of what medical malpractice REALLY is. Many have said doctors make errors. Many have said that there are bad doctors, but this does not equal medmal.

In order to be civilly guilty of medical malpractice, the perponderance of the evidence must show that the physician committed the act of NEGLIGENCE, which is to say HE VIOLATED AN ACCEPTED STANDARD OF CARE. An error is NOT a necessarily a violation of the standard of care. Have I made an error in my practice? Sure, medicine is still an art, and that means that things do not always happen as you would hope or necessarily expect.

Like many have suggested, tort reform is an excellent point to begin solve this problem in the free market. Many physicians are being forced to go without insurance, and that is a horrible position for us to be in. We all went in medicine to deal with sick patients and help to remedy their situation, and to touch a life. Nonetheless, on a routine basis, people come to us without insurance, and ROUTINELY receive the best medical care in the world, and then tell us they will not pay us a thing -- it is their right to be treated. But if there is even the least unexpected turn in their care, then we get sued for real damage, punitives, etc.

Finally, the big scare in private practice is currently that the government will nationalize health care. Then you will see the exodus of many fine physicians from our healthcare, and we will have lost the best health care industry in the world.

73 posted on 01/01/2003 7:53:47 PM PST by gas_dr
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To: cynaman
I guess it was the fact that contingency fees are considered grossly unethical and illegal in most democratic governments that you dislike. Spoken like a true lawyer.
74 posted on 01/01/2003 8:05:58 PM PST by friendly
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To: Steve Eisenberg
Is Mol right that "It won't work"? Well, it won't work for me, but it will work acceptably for the doctors and just fine for the lawyers

Nope .. it won't work for the doctors either, because there are still too many stupid lawsuits out there. The doctors will still pay higher premiums and we will pay even higher premiums

What will happen is neither the doctors nor the patients will be able to afford the insurance anymore .. because the lawyers will end up with all out money

To solve this problem .. they somehow need to figure out which are the legit lawsuits (and there are legit ones) and somehow throw out the bad ones ...

75 posted on 01/01/2003 8:15:46 PM PST by Mo1
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To: gas_dr
In order to be civilly guilty of medical malpractice, the perponderance of the evidence must show that the physician committed the act of NEGLIGENCE, which is to say HE VIOLATED AN ACCEPTED STANDARD OF CARE.

If I understand this correctly, gas_dr considers doctors who violate an accepted standard of care to be properly considered guilty. If so, the doctors responsible for most of the great medical advances in history stand guilty of malpractice.

To take a specific example, let's say a patient comes in with massive injuries to a leg so that the standard of care says to amputate. But the doctor has a hunch, may be from a few words the patient said before going unconcious, that the patient would rather risk his life if there is a chance to save the leg. In this case, even without any written directive from patient or family, I would want my doctor to be able to ignore the standard of care if he saw fit.

The problem is not that malpractice awards are too high or too frequent, but that the whole idea of medical malpractice is based on a unrealistic idea of medical perfection, and on the idea that medical care is properly static, when it should always be in the process of rapid improvement.

76 posted on 01/01/2003 8:18:58 PM PST by Steve Eisenberg
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To: Steve Eisenberg
...doctors who violate an accepted standard of care (are) guilty. If so, the doctors responsible for most of the great medical advances in history stand guilty of malpractice... The problem is not that malpractice awards are too high or too frequent, but that the whole idea of medical malpractice is based on a unrealistic idea of medical perfection, and on the idea that medical care is properly static, when it should always be in the process of rapid improvement.

Outstanding observation that belies the sordid and corrupt lawyer industry.

Medical malpractice industry suits and payouts generally bear no relationship to competence. Thus doctors who agree see the most high risk (sickest) patients are the most likely to be sued. Very sick patients are more likely to have adverse outcomes.

77 posted on 01/01/2003 8:25:01 PM PST by friendly
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To: Steve Eisenberg
Is the point here that there are bad docs? True. That even good ones occassionally make bad mistakes. True also. This does not mean that suing reduces either problem or helps anyone except the lawyers and a very few litigious patients.
  1. Lawsuits are the only method by which patients can get compensation to pay for future medical expenses.  In addition, some patients who are so severely injured that that simply can't work at jobs that require ANY reading.  I am friends with several of these patients.  These patients need and deserve to be compensated for their loss of earnings.

    Doctors aren't known for offering to pay compensation out of the goodness of their heart.

  2. Lawsuits serve as an incentive for doctors to not perform unnecessary lasik procedures on high risk patients.

You know, when doctors make bad mistakes, there is usually no way for the patient to know -- especially because the malpractice industry gives docs a tremendous incentive to cover up their mistakes.

Yep.  It took me a couple of years to figure out that my refractive surgeon had mis-aimed the laser at both of my eyes.

Although off the subject, if your eyes are perfectly good but your vision is out of focus, I recommend the conservative treatment of eyeglasses rather than surgery. Common sense is that surgery is a last resort treatment.

Agreed.  I learned that lesson the hard way.  I am now back to glasses and contacts after having a cornea transplant.

78 posted on 01/01/2003 10:32:34 PM PST by Mini-14
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To: gas_dr
I once talked to an anesthesiologist in Florida who had to give up his practice after a lasik surgeon damaged the vision in both of his eyes. The lasik surgeon mis-aimed the laser (decentered ablations), and mis-aimed the microkeratome which caused decentered flaps.

The anesthesiologist continued working for some time while he was visually incapacitated.

79 posted on 01/01/2003 10:37:00 PM PST by Mini-14
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