December 2004 Bulletin

One giant step toward medical liability reform

The possibility of federal tort reform looks brighter

By Stuart L. Weinstein, MD

Election night, November 2, 2004, heralded the beginning of Phase II of our medical liability reform campaign. The re-election of George W. Bush as president and the Congressional victories by supporters of medical liability reform increased the chances of obtaining a federal solution in the next election cycle. As we look back to see what the AAOS medical liability reform campaign has accomplished since its inception in March 2003, we can be justifiably proud of our efforts.

This campaign was launched in response to a high-priority member need and was a total organizational effort. The effort mobilized volunteers and staff from every aspect of the AAOS organization. Our main goal remains achieving federal medical liability reform, with a secondary goal of achieving meaningful and constitutionally sustainable liability reform on the state level.

The AAOS Board of Directors authorized the expenditure of $1 million from Association reserves and began to enlist your help for our state and federal campaigns. We used every communication vehicle of the AAOS to keep you informed each step of the way on an ongoing basis. It was not easy for us to solicit funds from you early on because we weren’t able to share with you some of the strategic tactics necessary to accomplish our mission. I realize that this may have been one reason why so many AAOS fellows didn’t contribute initially. As you read on, I think it will become apparent why this was necessary during Phase I of our federal campaign and why, during the upcoming Phase II, your support across the board will be necessary.

State reform efforts

On the state level, we developed a public education campaign called “Protect Access to Care and Treatment” (PACT) to facilitate grassroots advocacy on liability reform.

We created a print and electronic advocacy “toolkit” for use by individual orthopaedic surgeons and state societies. These tools enable members to take the liability reform message to their patients, their communities and their state legislatures. Many items contained in the toolkit can be downloaded from the campaign’s interactive Web site, which can be found at

We also allocated grant support for state orthopaedic societies in states on the “tipping point” of enacting possible tort reform to help them in their efforts. I am proud to tell you that we were able to award grants to all of the state orthopaedic societies that applied for them to help them in their fight for state medical liability reform. Four of these states achieved success and two more came very close. Several others have a significant chance to achieve success in the next election cycle.

The AAOS Board also has allocated resources to help state orthopaedic societies in tipping-point states fight the battle in the next legislative round.

Strategies for federal reform

We knew that the federal campaign would be long and expensive and that we could not do it alone. The AAOS initiated the formation of a national coalition, Doctors for Medical Liability Reform (DMLR). We successfully recruited 11 other specialty societies to join our effort. DMLR, representing more than 230,000 physicians, is the largest medical organization fighting the liability battle on the federal scene.

The most difficult aspect of this campaign was our inability to share the tactics to be employed with you when we requested additional financial support. The campaign depended on complete restriction of information until it actually launched. Our goal was to have an impact on this year’s Senate races.

As you know, the only reason we have not been able to achieve federal liability reform is the inability to get a medical liability bill through the Senate. We already had the support of the President, who stated that he would sign a bill modeled after the California MICRA legislation. The House had passed such a measure twice—in 2003 and in 2004—but four attempts to pass various modifications of medical liability reform failed to get the necessary 60 votes in the Senate. Votes were generally, but not completely, along party lines; most Republicans supported the measure and most Democrats opposed it.

Our DMLR strategy was therefore to educate and inform the public, business leaders and legislatures about the disastrous effects of the medical liability crisis on the nation’s health care and economy (see February 2004, June 2004 and October 2004 issues of the Bulletin) in our targeted states. This campaign was supplemented by independent hard-dollar campaigns by the political action committees (PACs) of the various DMLR member associations.

This campaign resulted in even greater awareness among the American public as to the ramifications of this crisis on their access to health care. It forced every candidate for national office to take a stand on the issue of medical liability reform. As you know, it was also a factor in the Presidential campaign.

Expectations exceeded

The election results far exceeded our expectations. We had hoped to influence a few select Senate races, but in the end we were able to contribute to the successful election of five new YES votes on liability reform (Florida, Louisiana, North and South Carolina, and South Dakota). Candidates favoring medical liability reform won six out of eight open seats. Senate winners in Oklahoma, Georgia, Florida, North and South Carolina and Louisiana all signed the DMLR pledge. In addition, two incumbents who support medial liability reform (Arkansas and Kentucky) were re-elected.

One of the biggest victories for orthopaedic surgery was the election of Tom Price, MD, to the House of Representatives; he is the first orthopaedic surgeon elected to Congress.

In summary, Phase I of the AAOS medical liability reform campaign was very successful. We achieved significant victories on the state front and increased the likelihood of attaining success on the federal level in the next election cycle. With a President who places a high priority on passing medical liability reform, a similarly disposed House of Representatives and a more favorable balance in the U.S. Senate, we must redouble our efforts in the next election cycle. The American public is fully aware of the increasing threat that this crisis has on their access to health care.

Support of every member needed

The medical liability crisis is the No. 1 issue affecting our members’ ability to practice, yet only 8.5 percent of members contributed to Phase I of the campaign. Despite this fact, hard work and an effective campaign strategy enabled us to achieve significant success. We have set the stage for accomplishing our ultimate goal!

We took one giant step toward achieving medial liability reform this election cycle. As we move into Phase II of this campaign, the window of opportunity will be narrow and the stakes high for our patients and for our profession. We will need each and every member of the orthopaedic community to answer the call to action.

Stuart L. Weinstein, MD, is the AAOS first vice president, chairman of the AAOS Medical Liability Reform Oversight Committee and chairman of Doctors for Medical Liability Reform.

Dr. Weinstein elected DMLR chairman

At a strategy session on Nov. 19, 2004, the 11 medical specialty societies that comprise Doctors for Medical Liability Reform (DMLR) elected Stuart L. Weinstein, MD, AAOS first vice president, chairman. Dr. Weinstein previously served as DMLR vice-chair and replaces neurosurgeon Stewart Dunsker, MD.

Election victories in November present the physician community with the opportunity to enact meaningful medical liability reform. Be part of the campaign. Send your personal or corporate check payable to American Association of Orthopaedic Surgeons to AAOS Medical Liability Reform Campaign, 6300 N. River Road, Rosemont, IL 60018-9527.

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