Doctors scramble to fill gaps as malpractice issues simmer

March 15, 2006|by TAMELA BAKER

ANNAPOLIS - Despite a special legislative session and the passage last year of legislation to establish a stop-gap fund to stem escalating malpractice premiums for the state's physicians, doctors say the state's malpractice climate has not changed.

And in Washington County, the hospital staff picks up the slack for doctors who no longer exercise their hospital privileges, according to Hagerstown surgeon Karl Riggle.

In testimony submitted to the House Judiciary Committee Tuesday, Riggle said more than 80 percent of the primary care physicians in Hagerstown no longer see patients in the hospital.

"Hospitalists," employed by the hospital in a program established last year to serve patients who do not have a primary care physician, are caring for most hospital patients, he said, but are not responsible for aftercare. Riggle said having hospitalists providing so much hospital care often is more costly because they practice more "defensive" medicine - subjecting patients to more, sometimes unnecessary, procedures to avoid potential liability.


The overall number of physicians practicing is not down since last year, Riggle told The Herald-Mail, but they're not coming to the hospital.

"We've had no success in drawing anyone" to replace surgeons the county has already lost, he said.

Riggle said seven surgeons cover a "draw area" of nearly 250,000 for Washington County Hospital.

Last year's bill, which eliminated a 2 percent tax exemption on coverage premiums for health-management organizations, was designed to subsidize malpractice insurance costs to prevent them from rising again after two years of double-digit rate hikes. But Riggle said not all insurance companies - and not all physicians - are getting the subsidies, so their rates are still rising. In any event, the subsidies are scheduled to decrease until 2009, when they will end.

Half the general surgeons in Washington County no longer see children, Riggle said.

Del. Christopher B. Shank, R-Washington, told the committee Tuesday that "every other evening, there is not a pediatric surgeon on call" at Washington County Hospital. As the parent of two small children, he said, "I find that deplorable."

Shank is sponsoring three medical malpractice reform bills this year; Del. John P. Donoghue, D-Washington, is sponsoring one. They include providing structured, periodic payments for malpractice awards, providing "Good Samaritan" immunity for physicians working in emergency situations and establishing special courts for malpractice cases.

Riggle, a founder of "Save Our Doctors, Protect Our Patients," said he was concentrating the bills to establish health-care courts.

He told The Herald-Mail that the public hasn't experienced problems yet because physicians still practicing at the hospital are doing their best to close the coverage gaps.

"But there's a breaking point," he said.

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