June 2002 Bulletin

South Texas physicians protest skyrocketing insurance premiums

By Sandra Lee Breisch

Hundreds of doctors and other medical professionals in South Texas protested rising costs of professional liability insurance premiums by staging a "Day of Awareness" on April 8 to draw public and political attention to the crisis. Physicians rallied at local courthouse steps or closed their offices at lunchtime or for the entire day; however, hospitals and emergency rooms were fully staffed and no emergency patients were denied care.

"Physicians wanted to make the public aware of the true health care crisis due to the rising costs of professional medical liability premiums, the increase in and frequency of frivolous lawsuits that have been non-meritorious or lawsuits that have had very large jury awards," explains Tom B. Hancher, MD, immediate past president of the Texas Medical Association. "This situation leads to diminished access to care. Physicians are withdrawing from emergency room coverage. Physicians are also leaving the region to practice in other parts of the states where premiums are lower or moving to other states. It’s a huge recruitment problem because these [geographic] areas cannot attract primary care physicians or specialists in the Valley. Instead, physicians are moving to Louisiana and California where the premiums are lower. We’re also seeing early retirements from physicians in surgical specialties."

Dr. Hancher says the situation is most severe in South Texas and along the Texas-Mexico border, where the state’s highest professional liability medical insurance premiums and least available liability coverage are centered. "But we’re seeing symptoms of this crisis in every corner of the state," he says.

Orthopaedic surgeons are among those having difficulty getting professional liability coverage, points out Andrew P. Kant, MD, president, Texas Orthopaedic Association, who practices in Houston. "Three years ago, we had 20 professional liability insurance carriers in this state," he explains. "Today, we have only six [insurance carriers] who are writing coverage and two of those might not be financially secure. One of the problems with being insured with a professional liability insurance carrier who is not financially secure is that if they fail and you get sued, you have no coverage. So, if you cannot find affordable and secure insurance, you cannot continue to practice. This limits patients’ access to care."

Albert E. Sanders, MD, who is in group practice in San Antonio, Texas, and a member of the Professional Liability Committee, joined fellow orthopaedists at the Bexar County Courthouse steps on April 8 to draw media attention. "The number one problem in Texas is the cost of frivolous lawsuits that costs $30,000-$55,000 to defend–even if there is not a valid claim. Unless we change the liability situation in Texas–especially in certain parts of the state–it is going to limit patient access to appropriate care," he says. "We need to get legislation enacted similar to that in California to put caps on pain and suffering and to work diligently for Supreme Court Justices to be fair."

In some specialties, Dr. Hancher notes that over a three-year period, professional medical liability premiums have increased more than 170 percent. "The premium increases have most dramatically impacted the surgical specialties. What is also happening is that the availability of some of our specialties in the Valley has become impaired," he says.

According to Jon Opelt of Citizens Against Lawsuit Abuse, which helped organize and publicize the protest, trauma and emergency care doctors came to the anti-lawsuit abuse organization, expressed their frustration and discussed what could be done. "This was a plea for survival for doctors and patients," he explains. "Over the past year and a half, many Texas doctors–especially in the South–have seen their liability premiums increase 100 percent or more; in Corpus Christi, 63 percent of all practicing physicians have had a claim filed against them. That speaks to the volume of suits being filed. Statewide, 86 percent of these cases are non-meritorious and when they are successful, the awards are huge–and they encourage more professional liability suits."

Stresses Dr. Hancher, "The bottom line is to help mobilize the public’s support for a change in our tort system that would lead to relief of these problems. We anticipate that in the next legislative session there are going to be some important reforms introduced. With the public being made aware of what the problems are, we hope they will be receptive to supporting these reforms. Unfortunately, the next session isn’t until year 2003."

"Frivolous and junk lawsuits are crippling the health care system," says Opelt. "Judges have dictated the quality of health care in some communities by failing to enforce laws, failing to dismiss groundless suits and failing to follow the law requiring plaintiff’s lawyers to forfeit bonds when they do not provide timely and adequate expert witness reports."

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