Posted on 01/03/2003 5:57:11 AM PST by NautiNurse
Hospital survey says Manatee not alone in liability issue
The medical liability insurance crisis is disrupting Floridians' access to health care statewide, a Florida Hospital Association report issued Thursday shows.
From the Panhandle to Miami, skyrocketing medical liability premiums are forcing doctors and hospitals to eliminate or cut back services, the report says.
Seven hospitals, from Doctors Hospital in Sarasota to Parkway Regional Medical Center in North Miami Beach to South Bay Hospital in Sun City Center, have closed their obstetric units. Four other hospitals have reduced or limited obstetric care.
Tallahassee Community Hospital has closed its mammography unit and four other hospitals have reduced mammography services.
Orlando Regional Healthcare System reported wait times for mammograms increased from 20 days to 150 days in 2002.
The Bert Fish Medical Center in New Smyrna Beach reported cutbacks have forced its medical staff to transfer 100 to 200 patients a year to other medical facilities to receive care.
The second half of the report concerns the impact of the medical liability crisis on specialists who are on-call for emergency room duty.
Sarasota Memorial Hospital, a publicly owned medical facility with a national reputation for research and innovative treatment, reported on-call speciality coverage has been eliminated in neurology services and reduced or limited in gastroenterology, neurosurgery, hand surgery and psychology services.
But the lack of on-call specialists for emergency room duty does not translate to limited access of care at Sarasota Memorial, said Dr. Bill Colgate, the hospital's vice president for medical affairs and an emergency room doctor.
"We have the same access to specialists as we had before," Colgate said. "We just have to route the request through the patient's primary care physician."
At the most, Colgate said, the lack of on-call specialists could mean a delay but not a lack of treatment.
The 230-member Florida Hospital Association gathered the information from surveys returned by individual hospitals.
"This is just a snapshot of what's happening, but it clearly shows that the medical liability crisis is forcing hospitals across the state to stop offering or to curtail health care services that Floridians need," said Wayne NeSmith, president of the Florida Hospital Association.
Neither Manatee Memorial Hospital nor Blake Medical Center, the two acute care medical facilities in Manatee County, are listed on the report.
Local impact
Although neither Manatee Memorial Hospital nor Blake Medical Center had to eliminate or cut back services, according to hospital officials, access to health care has been curtailed locally in other areas.
Currently, only one of Manatee County's five kidney specialists, Dr. Stephen L. Berkes, has medical liability coverage to serve more than 300 patients on dialysis.
Like many other kidney specialists across the state, Berkes and his fellow nephrologists lost their coverage when Farmers Insurance Group recently pulled out of Florida.
Dr. Thomas N. Braxtan, the new chief of staff at Manatee Memorial, and his partner, Guruswamy Ramamurthy, hope to receive word today that they have been insured through GE Medical Protective.
The news pleased Rep. Bill Galvano of Bradenton, the newly elected Republican representative for District 68, who made a call to a local insurance agent to help Braxtan get insurance.
"Dr. Braxtan is a reputable physician," Galvano said. "It makes you stop and say, 'Hey, what's going on here?' when someone like him, a hospital chief of staff, can't get insurance."
Manatee County's two other nephrologists, Dr. Celestino Palomino and Dr. A. Daniel Celaya, have submitted requests for leaves of absence from Manatee Memorial, Blake and the four dialysis centers serving Manatee County until their insurance problems are resolved.
A spokeswoman for Palomino and Celaya said they have placed applications with several companies and hope to receive word soon that they will be covered.
Until then, Palomino said Berkes will be hard-pressed to care for more than 50 patients a day.
"Three of us can handle the load," Palomino said, "but it will be very hard for just one nephrologist to keep up."
Several other physicians, such as Dr. Denise Baker, have had to limit their practices because of skyrocketing liability insurance premiums.
When Baker's carrier pulled out of Florida this summer, she said she had no recourse but to stop delivering babies, which meant 97 pregnant patients had to find new doctors to deliver their babies.
When faced with the cancellation of malpractice insurance last summer, Bradenton surgeon John V. Dunne said he was forced to limit his practice because he could not afford the high premiums charged by his new carrier.
Board-certified in chest surgery, general surgery and vascular surgery, Dunne, 66, said his premium would have been $103,000 to continue his surgical practice. Even though his practice is now limited to the treatment of veins and cosmetic laser surgery, Dunne still has to pay $77,000 for medical liability coverage. And because he is with a new insurance company, he has to pay "tail coverage" or a lump sum that will build a reserve in case he gets sued during the first year.
At least six other Manatee physicians have opted for early retirement or decided to leave the state when faced when premium increases ranging from 50 to 350 percent.
One neurosurgeon is now paying $220,000 a year for medical liability insurance.
And as insurance premiums continue to rise, reimbursement rates for doctors and hospitals are declining.
Medicare reimbursement cuts of at least 4 percent are expected this month. The decreases come on top of a 5.4 percent rate decrease in 2002. By 2005, the Medicare cutbacks in reimbursement rates are slated to total 15 percent.
Private insurance companies are following suit, the Florida Hospital Association said.
Baker said her income in the past decade has been reduced by at least 66 percent.
The worsening crisis
As reimbursement rates fall, the cost of business goes up, propelled, the medical community says, by skyrocketing medical liability premiums.
If something isn't done, doctors say, they will be forced out of business, especially those in high-risk specialities such as neurosurgery, obstetrics, emergency care and orthopedics.
"The problem is very real," said Dr. Colgate from Sarasota Memorial. "We may soon be without neurosurgeons if they don't get their medical malpractice problem solved."
And the problem is not just in Florida, but nationwide.
Who is at fault depends upon whom one talks to.
The medical community blames frivolous lawsuits and multimillion dollar awards to settle medical negligence claims.
The answer, says the medical community, is tort reform or caps on judgments similar to those enacted in California.
Trial lawyers say large settlements are not to blame: Patients' right to sue must be protected.
"In Florida, medical malpractice premiums account for less than 1 percent of total health care costs," says a report from the Academy of Florida Trial Lawyers. "Medical costs rose 13 times faster than malpractice premiums from 1988-98. . . . This shows that medical malpractice insurance is truly an amazing value when one considers that medical malpractice is the eighth-leading cause of death in the United States and that medical errors cost the U.S. economy between $17 billion and $29 billion each year."
The trial lawyers lay the blame on the insurance industry. Sensing a lucrative market in the boom years of the past decade, numerous insurance companies jumped into medical malpractice insurance with no experience, the academy says. These companies kept rates artificially low while at the same time investing heavily in a booming stock market. When the market turned soured, those same companies ended up overexposed with no way to cover themselves except by raising premiums.
Fixing the problem, Galvano said, will require addressing problems in all three areas - health care, tort reform and insurance reform.
"When I was just starting out in law, a mediator told me that if at the end of the day, one party is still happy, you have not done a good job. We are going to have to see some commitments from all three entities to fix the problem," Galvano said.
I suppose the trial lawyers are revved up to pad their wallets with more lawsuits for "patient abandonment." I don't expect the trial lawyers will cough up stats for increases in their coffers for the past ten or twenty years.
Agreed!
addendum: after the word "Lawyers" add..... wives, children, (natural, adopted, step,illegitimate), mothers, fathers, grandmothers, grandfathers, legal aids, paralegals, legal secretaries, legal researchers, legal office custodians and others who benefit from the harassment and destruction of the medical profession by the legal profession.
I would love to know how often it is already happening.
Added note--the state rep identified in the article, lawyer Bill Galvano, and I had a chat just before the election in November. I made it clear to him that I did not vote for him in the primary. He replied (while wearing his pinstripe suit) that I must be in the health care profession. He caught up with me again later to tell me he was endorsed by various health care orgs in the state.
Looks like it's time for me to chat with him again.
Actually it's the lawyers who benefit from the harrasment initiated by the . wives, children, (natural, adopted, step,illegitimate), mothers, fathers, grandmothers, grandfathers, etc. These people initiate the actions, the lawyers just represent them. You don't think that the lawyers are representing themselves in the suits do you? Place the blame where it belongs. Not on lawyers in malpractice suits, not on guns in murders. The law is a weapon the same as a gun. It's the person using it (plaintiff) that is responsible for it's use. The lawyer is just a part of the weapon.
But, how frequent were the claims against him? My general business liability (equivalent of malpracitce) premium is dependant more on the frequency of claims than the amount of a claim. Same way with my auto insurance. Or so my agents say.
From another artice in the Bradenton Herald: In all of his years of practice, he has never been sued, Palomino said.
A check of Florida health statistics shows he has a clean record with no complaints or judgments of more than $5,000 against him.
Balderdash!!
Of course they are representing themselves. They don't give a damn about the plaintiffs, they care only about the case.
If you're stating your personal opinion indicate it as such. Since you haen't done this I assume that you are claiming a fact. Care to validate your fact?
I don't know about what goes on in your world, but in mine Guns don't place millions of dollars in ads looking for "Malpractice suits", nor do they actively look under every rock for someone who might murder another. You obviously have never been at the scene of many accidents or Hospital emergency rooms. If you had, you would have noticed the Lawyers scrambling to see who would be first to give the "Victim", "Perpetrator" their card first.
Nothing like seeing a Lawyer try to give someone who is obviously overwhelmed with grief, their card.My opinion >>>>>>>> Most Lawyers are the scum of the earth, even the crud I scrape off the bottom of my shoes has higher standing in my book.
I have been in several emergency rooms in Denver for hours at a time. Never once seen a lawyer present. Seen it on TV and movies a number of times though. They wouldn't misrepresent things, now would they? And as for accidents. I've rendered assistance at several bad ones (I'm about 100 yards from a really bad intersection). Never seen a lawyer present. In fact, after the paramedics and cops arrived they have asked me to move away if I Witnessed it and wait to give a statement or just leave if I didn't witness it. Even reporters are kept at bay. Anyone other than emergency personell trying to scramble over one another to get to the victims would be arrested here, lawyer or not. But, again, I've seen it in the movies and on TV. They wouldn't just make that up, now would they?
So, that's my real life experiences with emergency rooms and accidents.
What, exactly, is yours?
Check out the yellow pages in your phone book. The attorney section will have the largest, loudest, and more ads than any other category. AUTO ACCIDENTS! PERSONAL INJURY!! WORKERS' COMPENSATION!!!
74 pages for attorneys in my phone book. Almost double that of physicians, restaurants, or automobiles (from auto air conditioning to salvage).
That's called the First Ammendment. I suppose you oppose this for attorneys? Who else would restrict from their rights? Any business (Doctor, Lawyer, or you and I) have the right to advertise for customers. Customers that are related to our specialty. Would you, for instance, only allow Doctors to advertise that they are a Doctor and not allow them to advertise to their respective specialties? My local phone book has 27 pages dedicated to physicians and 25 to attorneys. About the same number of full page and flashy ads as well. Who do you want to refuse advertising to and why?
The rest of us have to actually work for a living instead of living off other people's misery. In my opinion, Attorneys like having power, it's to compensate for areas of their life that they feel inadequate in. If society as we know it came to an end tomorrow and we had to go back to using our hands to make a living, most if not all Lawyers would die off.
Ironically, doesn't that sound just like a lawyer trying to practice medicine without a medical license? I think I smell a lawsuit...
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