AAOS Bulletin - October, 2005

Medical liability reform: What’s it going to take?

Stuart L. Weinstein, MD

The results of last fall’s elections left all of us with renewed hopes of achieving meaningful federal medical liability reform. With the President’s first post-election trip to the “judicial hellhole” of the United States—Illinois’ St. Clair and Madison counties—and his highlighting of medical liability reform in the State of the Union Address, our hopes were elevated even further. We could see victory for patient access to care on the horizon.

Since then, however, we have seen victories in certain areas of liability reform but no movement on medical liability reform.

Although the House has once again passed liability reform just as it did twice in the last Congress, the Senate remains at impasse. Other issues, like the confirmation of Supreme Court nominees and hurricane relief efforts, have taken center stage and will occupy it for some time to come.

Successes so far

So what will it take to get meaningful federal medical liability reform? I will attempt to answer the question by first looking back at where we have been and where we want to go.

Just about 18 months ago, we began our efforts at the federal level and also attempted to help state orthopaedic associations achieve constitutionally sustainable liability reform at the state level. The total commitment by the American Association of Orthopaedic Surgeons (AAOS), both in manpower and in financial resources, was the model for other medical associations. We made significant contributions to successful state efforts, either with direct funding to state orthopaedic associations or through Doctors for Medical Liability Reform (DMLR), that resulted in successful reform efforts in Texas, Mississippi, Missouri, Georgia, South Carolina, Nevada and Wyoming. Currently we are supporting efforts in Maine and in Washington state, where voting on an important ballot initiative will soon take place.

With these successes at the state level, we can feel very proud of the progress we’ve made in a relatively short time. But a recent (July 2005) decision by the Wisconsin State Supreme Court overturning that state’s cap on noneconomic damages in medical liability cases demonstrates the fragility of state reform and highlights the needs for a federal solution.

The DMLR contributed more than $10 million to increase public awareness of the disastrous affects of the liability crisis on access to care. Our efforts contributed to victory in six of eight Senate races last election cycle and helped raise the medical liability reform issue to a major issue in the minds of the electorate. All candidates for public office had to declare their position on the issue.

Phase II underway

We began Phase II of our DMLR public awareness campaign in October of this year and plan to build momentum as we move toward the 2006 elections. We still need a few more votes in the Senate to achieve our goal. This will only occur if those sitting on the fence or those opposed to medical liability reform hear from their constituents.

Phase II will build on our previous activities and keep medical liability reform at the forefront of the national debate. It will position the DMLR as a top resource to the media, the Congress, the physician community and the public on medical liability issues. The fully integrated, targeted campaign is message-driven, and the message is: Pass medical liability reform.

It is not enough for a few doctors or medical organizations to lead the charge. The only way we will win is to get our patients mobilized. The DMLR campaign is geared to do just that by building a grassroots network of patients and physicians, mobilized to put politicians on notice. The message will be that access to care for Americans is in jeopardy until this issue is resolved—either fix it or we will elect representatives who will!

Financial support

The answer to the question—what’s it going to take?—is 100% participation by every member of the AAOS in Phase II of the campaign. In Phase I, only 8 percent of members contributed to the campaign; this level of support will not enable us to achieve our goal. The AAOS has pledged $1.7 million for the 2005-2006 election cycle.

Over the next few months, you may receive a telephone call on my behalf, asking you to contribute to the AAOS medical liability reform campaign. I hope that you will consider a contribution of $1,000 or whatever you can give to aid in our efforts to educate the public on the need to enact meaningful medical liability reform. We also will be contacting those of you who contributed to the Phase I campaign, asking you to again consider making a contribution to the Phase II effort. It is only through your generous contributions that we will have a chance of enacting state and federal medical liability reform.

We not only need every member to contribute financially, we also need every member to make their patients aware of the issue and give them the opportunity to be a part of our grassroots network. AAOS will help you get the message to your patients and give them the opportunity to participate. The Wisconsin example should give members in “safe states” pause. No state is safe until there is federal medical liability reform! We must achieve federal medical liability reform and we can only achieve it with member commitment. That’s what it is going to take.

Stuart L. Weinstein, MD

Chairman, Doctors for Medical Liability Reform

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