Feeling the Pain

Malpractice insurance reform – an idea whose time still hasn’t come

by Kimberly Caldwell Steffen
Business New Haven
http://www.conntact.com/

There is no consensus on how to moderate the sharp increases in malpractice insurance premiums, how to make sure injured patients are compensated – or even whether Connecticut has a medical malpractice crisis at all.

Although some reforms were legislated in 2005, the big issue – whether “pain and suffering” damages should be capped at $250,000 – will not be decided until after a mandated review of claims and settlements in 2008. In the meantime, the debate rages.

Connecticut is in crisis, asserts Jennifer Barrows, director of communications for the Connecticut Hospital Association (CHA). She points to the fact that “most insurers are not willing to cover Connecticut practitioners. We are down to three providers [Glastonbury-based Connecticut Medical Insurance Co., Fort Wayne, Ind.-based Medical Protective Co. and ProSelect of Boston], which is concerning.”

Although the CHA doesn’t have hard numbers, Barrows says, “We do know that our hospitals are having significant trouble recruiting and retaining specialists – particularly in the areas of obstetrics, neurosurgery, specialized surgery and orthopedics.” Connecticut has the sixth-highest premiums nationwide and is in the top ten percent nationally, according to CHA figures. The average premium for all physicians is $69,500; the average premium for an obstetrician is $126,000.

University of Connecticut and Yale medical school graduates are not staying in Connecticut, but are setting up practices in states like California and Texas where more physician-friendly malpractice reforms have been enacted, according to Ken Ferrucci, director of government relations for the Connecticut State Medical Society. And established doctors, like one New Haven-area man in his late 50s who recently switched to a career in real estate, are closing their doors. Others, like Charlene Li, a family practitioner in Windsor, are dropping high-risk procedures from their list of services.

Li, who had delivered about 50 babies a year for 24 years, dropped her obstetrical malpractice insurance at the end of 2004. She’s never been sued, but the cost of that premium was a major factor in her decision.

In addition, the “tail” – insurance doctors buy to cover potential future claims even after they terminate a practice – made it very hard to find a family doctor interested in doing obstetrics with whom to partner. Tails typically cost two to three times the annual premium, which can be prohibitive unless one is committed to including obstetrics in his practice for the long term, Li says. The doctor with whom Li had been working for three years paid a tail of $75,000 when he moved out of state, she adds.
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