Pain and Suffering in the state of Virginia

[SpeelmanC]

I will be at this meeting on Feb 4 to protest...this one makes my blood boil!!!!!!!!!!!!!!

Doctors to march on Capitol

In February, they will meet here to press for changes in Virginia's malpractice laws

BY BILL MCKELWAY

TIMES-DISPATCH STAFF WRITER

Friday, January 9, 2004


Virginia doctors are blaming huge increases in malpractice premiums and policy cancellations for a growing erosion of patient services and access to care.

In a rare public demonstration next month, hundreds of white-coated physicians will march on Richmond and argue for changes in the state's medical-malpractice laws, once regarded as among the country's most protective of doctors.

The Feb. 4 march is part of a massive lobbying and informational campaign that is building steam across the state; some Northern Virginia doctors early last year called publicly for work slowdowns and strikes. A handful of doctors are leaving or altering their practices.

The reform movement is part of a growing state-by-state trend in the wake of failed efforts at similar changes in Congress. The impact of the Virginia effort is less certain because of the state's 25-year history of tight controls on jury awards.




The malpractice-reform effort is draw- ing strong and building opposition from patient advocates and trial lawyers.

"These changes being proposed would give Virginia the strictest laws in the country," said Jack L. Harris, executive director of the Virginia Trial Lawyers Association.

Premium increases are reflective of a nationwide correction among insurers, he said, and conditions in Virginia have been complicated by many other factors: Medicaid shortfalls, the collapse last year of a major Richmond-based insurance pool, and regional disparities that influence rates in the state.

Nor is it clear that any Virginia insurer has promised long-term reductions in rates if the reform measure is passed.

But physicians reached this week said they are becoming desperate and predict a medical crisis if adjustments are not forthcoming.

"I don't think you would see this happening if it was something just affecting doctors' paychecks," said Lynchburg obstetrician Dr. Donald Shuwarger, whose four-doctor practice has seen its malpractice premiums double in one year to more than $230,000.

"But we're getting active about it because we see this issue as threatening patient access and patient safety. It's time to step up for the patient community."

Lynchburg and localities across the state are losing doctors close to retirement, high-risk specialists and doctors whose insurance has been lost or becomes too costly.

"There is fear. Doctors feel threatened and, in Virginia, which has always been on the forefront of change in this area, we need to do something to give us breathing room," said Lynchburg cardiologist Dr. Daniel Carey.

Carey said he hopes to shepherd as many as 200 doctors to Richmond from Lynchburg by the busload. Hundreds more are coming from other regions of the state. "I'm telling people that political activism has become a clinical skill necessary to give proper care to our patients," he said.

The Medical Society of Virginia is coordinating the lobbying effort and backing so-called tort-reform legislation that is being sponsored by state Sen. Stephen D. Newman, R-Lynchburg.

Newman's bill, which generally copies tort-reform measures in California, would limit noneconomic, pain and suffering awards in Virginia to $250,000. While overall awards in the state are now capped at $1.7 million, juries can push awards to that limit for pain and suffering even when an injured patient experiences minimal, direct economic loss.

Other aspects of the bill would limit where suits can be brought, require consideration of other sources of payments, redefine when a suit can be dropped, and put plaintiffs' lawyers' fees on a sliding scale.

Newman has described the bill as a measure that would reduce the risk to doctors from frivolous suits; it would also structure court awards so juries are less likely to award patients out of sympathy when a doctor's negligence is not clearly apparent or when economic damages cannot be clearly defined.

The changes are Draconian, said the trial lawyers' Harris.

"The medical profession is holding their injured patients hostage to gain new concessions from the legislature," he said.

Harris said the legislation would make Virginia the only state in the country where "caps exist within a cap."

The bill would also break agreements set in 1999 that established a 10-year window before major tort-reform efforts would be made to amend the state's malpractice laws, said Jeffrey Breit, a Virginia Beach trial attorney.

In a compromise that year, the legislature established a scale that increased overall award caps $50,000 a year, beginning at $1.5 million the first year.

Harris said the proposed law is an outrage to catastrophically injured patients whose economic loss is difficult to factor or inapplicable and who will not benefit from further medical care.

"What this would do is take a child blinded at birth by a doctor's negligence and limit his award to $250,000," Harris said. The bill would also affect nonworking people, especially retirees, he said.

But Dr. Mitchell Miller, president of the state's medical society and a family physician in Virginia Beach, said excluding catastrophically injured patients from the cap creates "the difficult question of what defines catastrophic injury."

Miller said his insurance has increased 400 percent in two years, despite 17 years without a suit, and he is seeing similar situations across Virginia. "Even having a suit filed against you and then dropped is causing premium increases," he said.

If national protests over tort reform are reflected in Richmond, legislators here will be deluged with testimonies not just from doctors but also from injured patients whose day in court brought them little compensation.

The legislation's prospects will likely hinge on the extent to which doctors can show that Virginia's laws and jury awards are affecting insurance rates here.

Virginia was among the first states to adopt limits on court awards in medical-malpractice cases. In 1976, during a similar insurance crisis, the legislature approved a $750,000 cap.

In 1983, the cap was raised to $1 million.

Four years later, also during an insurance-availability crisis, the state created a program for infants severely injured at birth by brain damage; it bars families from suing and promises eligible children lifelong medical care.

The birth-injury program, coupled with the cap, was supposed to make Virginia one of the safest states in the country to practice obstetrics. But that specialty is being hit the hardest.

More than $100 million short of the money it is required to have on hand, the birth-injury program is failing, and its loss could further insurance woes.

Shuwarger, the Lynchburg obstetrician, said premium increases have come to his practice even though it does not handle high-risk pregnancies and the firm has not been sued.

"They tell me we haven't done anything wrong; we're not being punished," he said. "But here is what the cost will be to insure us."


Contact Bill McKelway at (804) 649-6601 or bmckelway@timesdispatch.com


This story can be found at: http://www.timesdispatch.com/servlet/Sa ... 1773006830

[Denise_Nach]

They have been saying and doing the same things in Pennsylvania and other states. What the drs. forget to mention is that ALL insurance rates are going up! Our car insurance, home insurance, construction workers liability...you name it! It sounds like the drs. in Virginia will be threatening to leave the state in droves. What I wonder is though where are all these drs. going to practice? They say they are leaving Pennsylvania because they can't afford their malpractice rates, they say they're leaving Texas for the same reason and I'm sure it's happening in a lot more states. So if it's so high in all these states what's the big threat of leaving about? Hmmm thats just it--they just want to threaten the people so they can get the laws changed in their favor. I havent seen many drs. driving clunkers and living in broken down homes lately so I think they're managing to keep their heads above water. The public needs to be made aware of the drs. adgenda!