Surgeons to protest insurance rates with slowdown

September 24, 2004|by ANDREW SCHOTZ

HAGERSTOWN - Facing double-digit rate increases for malpractice insurance, several Washington County physicians groups on Thursday said they will stop performing nonemergency surgery on Nov. 15.

Representing the Washington County Surgical Association, Dr. Karl Riggle said examples of elective, or nonemergency, surgery include hernias, gallbladders, breast biopsies and colonoscopies.

Emergency cases, such as trauma or ruptured aneurysms, will not be affected, he said.

On Sept. 14, the Maryland Insurance Administration approved a 33 percent rate increase for Medical Mutual Liability Insurance Society of Maryland, which insures most of the state's doctors.


Three months earlier, the administration approved a 60 percent rate increase for GE Medical Protective Co., which also insures doctors.

Washington County's general surgeons announced their decision leading up to Thursday's Washington County Hospital quarterly medical staff meeting at Fountain Head Country Club. During the meeting, other groups followed suit, Riggle said afterward.

A Herald-Mail reporter who went to the country club was asked to stay in another room during the meeting.

Starting Nov. 15, Washington County will have no neurosurgeons, anesthesiologists or plastic surgeons available for elective procedures, Riggle said.

Groups representing cardiologists, pulmonary medicine physicians and orthopedists, as well as a few primary care physicians, also vowed Thursday to stop performing elective procedures, but there will still be specialists left in those fields in the county, he said.

In addition, the county's only thoracic surgeon is leaving the business completely on Nov. 15, said Riggle, the administrative director of Washington County Hospital's trauma program.

Riggle said doctors are in the midst of an insurance crisis. Referring to malpractice lawsuit awards, he said, "We have this target on our backs. People are going after us."

James Hamill, the president and chief executive officer of Washington County Health System, the hospital's parent company, was out of town Thursday. He returned a reporter's phone call and left a message, but couldn't be reached later.

On Saturday, the Maryland Chapter of the American College of Surgeons expressed similar concern during a statewide meeting in Ellicott City, Md., but no one else suggested a work stoppage like Washington County's, said Dr. Scott E. Maizel, the chapter president.

"I hope the public takes away from this how desperate the (Washington County) surgeons feel," said Maizel, a surgeon in Baltimore.

By cutting down their work, the Washington County surgeons said in a statement, they can turn their quest "to make meaningful long-term changes" into a full-time pursuit.

The Washington County Medical Malpractice Crisis Task Force, which Riggle chairs, called for a special session of the Maryland General Assembly devoted to cutting premium rates and revamping the system.

It also recommended:

· Adopting a reform plan that exists in California

· Requiring that witnesses in malpractice cases be certified in their specialty.

· Granting "good Samaritan" immunity for physicians, unless there's gross negligence

· Considering binding arbitration through "health care courts"

· Rolling back insurance premium rates

Medical malpractice reform, an issue in the current presidential campaign, has been prominent in West Virginia and Pennsylvania. Doctors in both states planned either job walkoffs or slowdowns last year to protest sharply rising rates.

In Maryland, Gov. Robert Ehrlich, a Republican; House Speaker Michael Busch, a Democrat; and Senate President Thomas V. Mike Miller Jr., a Democrat, have said they support a special legislative session.

But plans for a session likely will be delayed not just "until the issues have been determined, but (until) the outcome of the issues have been determined," Ehrlich spokesman Henry Fawell said.

Ehrlich is limiting his public comments about medical malpractice while a state task force examines the situation, but he favors both reining in insurance costs and capping jury awards, Fawell said.

Miller said that establishing risk-loss funds to pay awards and "shore up the insurance companies" that haven't built up reserves should solve the problem.

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