June 2003 Bulletin

Illinois physicians rally for tort reform

Orthopaedists push for legislation modeling California’s MICRA

Illinois physicians rally for tort reform at
Daley Plaza in downtown Chicago

By Sandra Lee Breisch

More than 4,000 physicians, other medical professionals and patients rallied at the Daley Plaza in Chicago on May 13 to support a proposed $250,000 federal cap on noneconomic damages such as pain and suffering that could be awarded in medical liability lawsuits. Leading the way was a contingent of orthopaedic surgeons.

Protesters arrived alone and in busloads, wearing white coats, scrubs and stethoscopes chanting, "Reform now," and carrying signs that read, "Support Medical Liability Reform," Preserve Access to Care" and "U.S. Senate Action NOW!"

"Our goal is to increase public awareness about the medical liability crisis that is leading to problems with access to care and patient safety," said Richard A. Geline, MD, an AAOS member and president of the Chicago Medical Society (CMS), which organized local efforts. The event was sponsored by the CMS and supported by the Illinois State Medical Society (ISMS), the American Medical Association (AMA), the Illinois Civil Justice League and other organizations.

In March, Illinois became one of the 18 full-blown crisis states, joining the ranks of other states such as Pennsylvania, West Virginia and Mississippi, where patient access to care is jeopardized because physicians are forced to move to less litigious states, curtail high-risk procedures, leave practice entirely, seek alternative employment or retire early.

"This rally is to call public attention to a serious, deep and profound problem with the professional liability situation in America," said Dr. Geline. "We need to work with legislators to influence their decisions on issues that affect doctors’ daily practice. The only way that we will bring resolution of this crisis is through legislation."

Dr. Geline also said, "I applaud the AAOS, AMA and other organizations for being at the forefront of tort reform issues and taking action."

Further, Dr. Geline declared, "The problem with escalating professional liability premiums is growing rapidly and having an impact on access to care and quality of care. Corrective measures are needed to bring major legislative changes modeled after the California style of tort reform called MICRA [Medical Injury Compensation Reform Act] that has been in place since the 1970s. We need to gain physician and public support to send a message to representatives in Washington that the physicians of the state of Illinois who are facing the rising costs of professional medical liability premiums have difficult choices: they can stop performing certain procedures, move their practices elsewhere to states that have enacted tort reform or retire early."

Richard A. Geline, MD AAOS member
and president of the Chicago Medical
Society, urged physicians at the Chicago
rally to push for congressional action.

AMA chair-elect, William G. Plested III, MD, a thoracic and cardiovascular surgeon, also touted the benefits of California’s MICRA legislation, saying, "The doctors of Illinois are saying, ‘Wake up Chicago, wake up Illinois, wake up America...your health care is in crisis!’"

According to projections from the state’s largest physician-owned liability insurance company, ISMIE Mutual Insurance Co., there has been an average 35 percent increase in premiums per policyholder this year, effective July 1. However, industry analysts predict that individuals in some specialties like neurosurgery, orthopaedic surgery and obstetrics may be hit even harder, with increases of up to 100 percent.

Among orthopaedic attendees was Wayne M. Goldstein, MD, immediate past president of the Illinois Association of Orthopaedic Surgeons and president and founder of the Illinois Bone and Joint Institute, Ltd., who was flanked by 35 orthopaedists. "We are really the local representatives of the AAOS. We want everybody to know about the need for some type of reform," said Dr. Goldstein. "We attended the rally to increase the visibility of the orthopaedic practice. The ability and safety to do complex and high-risk surgery is really being threatened.

"Another issue of contention," continued Dr. Goldstein, "is that senior orthopaedic surgeons who want to slow down [practicing] could potentially be knocked out of practice because they cannot generate enough income to cover their professional liability insurance and overhead. And young physicians starting out will have difficulty in specialties–like orthopaedics–that have high liability insurance premiums."

Dr. Goldstein also pointed out that doctors are increasingly reluctant to take emergency room call or trauma call because of the number of high-risk patients and limited nursing staff working with specialized orthopaedic equipment.

Orthopaedist Arnold J. Herbstman, MD, president of Sherman Hospital’s medical staff in Elgin, Ill., rented a bus to bring 50 medical professionals to the rally. He said, "This rally is not only for the doctors, but to improve patient’s access to health care and for small business owners. Reform legislation will save everyone’s health care premiums. But Illinois is definitely a crisis state and this is the time to do something to create public awareness of this situation."

Brian J. Bear, MD, who is in group practice at Rockford Orthopaedic Associates, said, "We’ve got two senior partners who’ve had an opportunity to slow down. But they can’t ever slow down. And all of us have to go [full patient] load– basically work harder or stop practicing medicine due to the decrease in reimbursement and the professional liability crisis."

Right now, the federal tort reform bill is stalled in the U.S. Senate, showing little, if any, momentum for passage in the current session of Congress. In March, a bill passed by the House of Representatives would put caps on noneconomic damages at $250,000.

Rally speaker James H. Skogsbergh, president and CEO of Advocate Health Care, said, "This issue has become increasingly more important to all of us…we can and should make an effort on a statewide level and much of the effort will have to come from Washington…. This is a situation going from bad to worse and impacting quality health care in this state. It will not be easy to balance the needs of patients whose access to care is being compromised. We have all seen and heard horror stories and risks we take every day. It’s a complicated issue…we need change."

ISMS president, William E. Kobler, MD, a primary care physician who practices at St. Anthony’s Hospital in Rockford, Ill., told the crowd, "It’s very important for physicians to contact their federal legislators, specifically, senators," he said. "The public’s access to care is at risk and we need to get the attention of physicians to get them more involved in trying to something about this problem."

The rally concluded with Dr. Geline at the podium, stressing, "When you leave here, please keep the momentum going. Send your message to your congressman, send it to Senator Durbin. Send it to Senator Peter Fitzgerald. Ask your colleagues to send messages. Ask your friends to send messages. And most importantly, ask your patients to send messages. Do it more than once; we must sustain the effort until our goal is achieved."

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