Docs Malpractice Protests Off In Pa., On In W.Va.

By Michael Ha

NU Online News Service, Jan. 2, 2:47 p.m.ST?Action by Pennsylvania officials appears to haveaverted a threatened walkout by hospital doctors over medicalmalpractice insurance costs, but in West Virginia a doctors protestwas underway today.

Physicians had threatened to stop work at hospitals throughoutPennsylvania beginning New Year's Day to protest the cost ofcoverage.

On Dec. 30, however, Gov.-elect Ed Rendell and Gov. MarkSchweiker said that with their support remedial legislation wouldbe introduced to create a short-term fix.

The proposals would include two main points. One would eliminateor reduce payments for Medical Care Availability and Reduction ofError fund assessment. Mcare provides a catastrophic layer ofmalpractice coverage.

Also proposed is a surcharge on insurance companies to help payfor part of Mcare, according to Roger Baumgartan, a spokespersonfor the Hospital & Health System Association of Pennsylvania, atrade group representing institutions throughout the state.

"Medical malpractice insurance cost is an issue that's beenbrewing for more than two years. I think no community inPennsylvania has been untouched by this. We have heard storiesthroughout the past year about doctors from every part of the statewho have moved out of Pennsylvania," Mr. Baumgartan said.

Mr. Baumgartan said state officials' proposals appear to be themain reason that the protest has been averted.

"That certainly seems to be what tipped it. But whatGovernor-Elect Rendell proposed is not a done deal--it stillrequires legislative action. The media says this is a wonderfulshort-term remedy, and clearly there is still more to do, but it'simportant to point out that there were also some long-term fixesthat were made last year," he said.

None of the Pennsylvania hospitals that had expected a workstoppage has seen their doctors go ahead with their plan, Mr.Baumgartan said, with the sole exception of Abington Memorial insuburban Philadelphia. Doctors there saw the institution close itstrauma center on Dec. 20, 2002.

Patricia Usner, a spokesperson for Delaware Valley Health CareCouncil, a trade association that includes hospitals and healthcareorganizations in Pennsylvania, also applauded state officials'latest proposals.

"Our reaction is that they do provide a short-term relief andthey helped forestall immediate problems on Jan. 1. As many as 21hospitals around Philadelphia, and possibly hundreds of hospitalsaround the state, had concerns that they would have to stop someelective surgeries," Ms. Usner said.

The governor-elect provided a short-term relief untillonger-term solutions are passed, she noted. There is also thestate's medical liability taskforce that is looking into possiblesolutions and will provide the governor-elect with a set ofrecommendations by April 1.

"Some hospitals had been notified that some surgeons would notbe doing elective surgeries as of Jan. 1. Other doctors wereplanning for leaves of absence or to inactivate their licenses. Butit looks like the problem is averted now," she said.

Although the immediate crisis has been averted in Pennsylvania,more than two dozen surgeons in the neighboring West Virginia havegone ahead with a similar walkout plan to protest their state'shigh med mal insurance cost.

"On Jan. 1, 18 surgeons began their 30-day leaves of absence andstopped working, affecting three Northern Panhandle hospitals inWest Virginia: Wheeling Hospital, Ohio Valley Medical Center andReynolds Memorial Hospital. Another 11 surgeons are taking a leavefrom Weirton Medical Center in Weirton," Tony Gregory, director ofcommunications at the West Virginia Hospital Association, toldNational Underwriter.

Mr. Gregory added that the governor's office and the stateadministrators are continuing to work with hospitals in those areasto address access to patient care.

"There is also willingness by the governor and the legislatureto reform the state's medical liability insurance. The legislativesession starts Jan. 8," he said.

Many surgeons in West Virginia who are participating in thewalkout are insured by the West Virginia Board of Risk andInsurance Management, which was mandated by the state legislaturelast year to cover premiums of doctors who are not stateemployees.

But those who signed up for leaves of absence argue morelegislative actions are needed, including making filing malpracticelawsuits more difficult and capping damage awards.

"They are concerned and frustrated with the medical liabilityclimate in West Virginia. However, the governor and the legislatureare making efforts to bring the matter to a solution," Dr. DonaldHofreuter, chief executive officer of Wheeling Hospital atWheeling, W.Va., told National Underwriter.

"I understand the concerns and frustrations of the surgeons--Iam also a physician. Our medical liability costs are higher thanthose in states like California where there is a $250,000 cap onnon-economic damages, whereas in West Virginia, it's one milliondollars. California has made significant medical liabilityreforms," Dr. Hofreuter said.

Howard Gamble, a spokesperson for Ohio Valley Medical Center inWheeling, W. Va., which has also been affected by surgeons'protest, said the hospital remains supportive of itsphysicians.

"What they are doing is trying to make the public aware of thedifficulties of practicing medicine in West Virginia due to anincrease in medical liability insurance costs," Mr. Gamblesaid.

"We understand physicians. At the hospital, we experience thesame situation--we pay over $10,000 a day for medical liabilityinsurance. We understand why they are doing it and we support them.We have a sister facility, East Ohio Regional Hospital, which isfive miles away, that could pick up some of the surgicalprocedures, and we have seen an increase in scheduling at EastOhio," he said.

Such walkouts, although rare, have occurred elsewhere in theU.S., according to Chicago-based American Medical Association, thecountry's largest physicians group.

In Las Vegas, for example, some 150 doctors at UniversityMedical Center resigned last July to protest high insurancepremiums, prompting the hospital to shut down its trauma center formore than a week.

The action prompted a special session of the state legislature,which enacted a law capping damages in trauma center malpracticecases at $50,000, except in cases of gross negligence.