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Malpractice insurance rates put the squeeze on Pa. doctors

February 18, 2002

Malpractice insurance rates put the squeeze on Pa. doctors



By STACEY DANZUSO
chbbureau@innernet.net


Dr. Deborah Geer, a general surgeon on staff at Surgical Associates of Waynesboro, Pa., has felt the pinch of rising medical malpractice premiums.

In the last two years, the annual premium for the three-surgeon practice has risen a whopping 93 percent to $126,000, she said.

That has prompted Geer, who has a master's degree in theology, and the other physicians in the group to seriously consider leaving private practice for missionary work.

"This is really difficult because reimbursements continue to decrease from insurance companies and malpractice is going up," she said.

Already busy, Geer said there is no way to increase patient volume enough to make up the difference.

"It essentially comes out of our paychecks," she said.

Doctors in Pennsylvania can't practice without medical malpractice insurance, however, so they are faced with paying the premiums, limiting their liability by cutting back on any high-risk medicine or leaving the state.

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The issue


Medical malpractice insurance rates have steadily increased over the last decade, but in the past two years insurance carriers have raised their rates to the point where it was hard for local physicians to swallow, said Chuck Moran, spokesman for the Pennsylvania Medical Society.

In 2001, major carriers in Pennsylvania increased their rates anywhere from 21 to 90 percent. For 2002, the insurance companies again hit doctors with an average 40 percent to 50 percent rate hike, Moran said.

He said the primary reason for the increases is the million-dollar awards juries in eastern Pennsylvania are handing out.

Jury awards in Philadelphia County, which averaged just under $1 million between 1994 and 2001, are higher than the rest of the state.

Excluding Philadelphia, Pennsylvania's median verdict for medical malpractice cases during the same time period was $410,000, according to figures from the Pennsylvania Medical Society.

Pennsylvania was second in the nation, behind New York, in the amount of medical malpractice payments physicians made in 2000, according to the society. Awards and settlements totaled $372 million.

With the allure of such large awards, some trial lawyers attempt to venue shop, or bring their cases to a county they believe will hand out the largest sum, Moran said.

The rising rates have had different impacts on physicians and health care in Franklin County.

Summit Health, which operates hospitals in Chambersburg and Waynesboro and several health centers across the county, had to close its maternity clinic for low-income women at the end of December.

The Healthy Beginnings Plus Maternity Clinic served 200 Medicaid patients annually for 15 years, but faced with a tight budget between lowered reimbursements from insurance companies and higher malpractice premiums for the doctors on staff, Summit Health shut down the facility, said Norman Epstein, president of Summit Health.

Summit Health continues to pay liability insurance for several other obstetricians and physicians on staff.

"We can only do that for so long. Sooner or later it's going to break the bank," Epstein said.

For Fiscal 2002, Summit Health will pay more than $1.5 million in premiums for medical professional liability, double what it paid in 1999, according to Fred Stenger, chairman of Summit Health's Finance Committee.

Options


At least two family practices in Greencastle, Pa., have stopped delivering babies because it added $30,000 to their insurance bills, Epstein said.

Geer can't limit her liability as a general surgeon, so she said she and her partners have considered performing surgeries at a Hagerstown-area facility.

She found they would have to do 60 percent of their surgeries there to qualify for malpractice coverage in Maryland.

Turning to missionary work grows more and more appealing to Geer, who has been in private practice for 12 years and an Army doctor for nine years.

"The situation is overwhelming. You try and figure out how you can keep going or if it is worth it," she said.

Epstein said several surgeons have admitted to him they are considering moving their practices to other states. Others have already gone.

"You can go 20 miles and lower your rate 80 percent," Stenger said.

Dr. Sohael Raschid, who owns Women's Health Professionals with offices in Chambersburg, Shippensburg, Pa., and Mercersburg, Pa., chooses to stay in Franklin County, for now.

Raschid said his practice is now the only privately owned obstetrics-gynecology practice in the county, and doctors shoulder their own medical malpractice premiums.

"If premiums stay the same for the next several years I would consider that livable, not enjoyable," he said.

Raschid and his family have lived in Chambersburg for 12 years, however, and he said he has no intention of moving his son, a high school senior, and daughter, a junior high school student.

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