Fears of lawsuits drive out doctors


KIHEI – Moving to Maui was the “worst� economic decision Dr. Benjamin Berry says he’s ever made in his career.

A Wailuku physician specializing in obstetrics, gynecology and infertility, Berry told an audience of some 50 people that he is the last doctor still in private practice willing to deliver babies on Maui.

“You’re looking at a dinosaur,� Berry said during a Hawaii Medical Association Patient Access to Care Forum held Tuesday night at the Kihei Community Center. “And dinosaurs need nurturing.�

Barry’s story was among several aired in an appeal for reform of Hawaii laws on torts – legal claims alleging errors or wrongful actions by medical personnel.

“The bottom line is the five-letter word,� Berry said. “Money.�

More and more physicians throughout the state are closing parts of their practice or leaving because of the high price of doing medicine in Hawaii. The physician shortage is making it more difficult for residents to find the doctors they need to take care of them.

The Hawaii Medical Association, a professional organization for physicians and medical students, argues that the physician shortage has reached a crisis level on the Neighbor Islands, and that signs of the crisis are beginning to show up on Oahu.

The fear of malpractice lawsuits has caused physicians to stop performing high-risk procedures and to quit volunteering for on-call emergency and trauma care duty, according to the HMA.

HMA President Cynthia Goto, an obstetrician from Oahu, said the choices of places to deliver a baby are also limited on her island. But there are shortages in other medical specialties. These include orthopedics, neurosurgeons and anesthesiologists.

In organizing the forum, the association promoted its efforts to win passage of House Bill 1992, which limits noneconomic damages in malpractice claims to no more than $250,000 and establishes a limit of $3 million for noneconomic damages for injury that the law defines as “catastrophic.� The legislation is aimed at reducing premiums for malpractice insurance carried by physicians.

State Reps. Joe Bertram of South Maui and Angus McKelvey of West Maui both supported he bill during presentations on Tuesday night.

On Wednesday, McKelvey, who is vice chairman of the House Committee on Consumer Protection and Commerce, was poised to vote in favor of the legislation pending in the committee, but the vote was deferred until Feb. 13 over the definition of “catastrophic injury.�

On Tuesday night both Bertram and McKelvey were part of a panel for the medical association forum.

In discussing his support for HB 1922, McKelvey referred to Hawaii Medical Association findings on Texas, where he said medical liability reform led to an influx of physicians in all specialties.

Both legislators encouraged the audience to contact their state representatives and senators to support tort reform. Bertram said he believed the issue would “get a good hearing� this year, but also cautioned that it sometimes takes two to three years before legislation like tort reform can be passed.

Goto said she recognizes Maui’s need for upgraded facilities and more health care service options. But she said even new facilities would offer no benefits without medical personnel in place.

“We can build facilities and a new hospital, but if we don’t have physicians working in them, it’s really an empty building,� Goto said.

Berry said he moved here nine years ago and accepted a 40 percent pay reduction for the privilege of practicing in what he saw as paradise. He’s currently facing difficulties trying to recruit another doctor to work with him in his office, he said.

He said malpractice insurance costs him $63,000 a year. Based on current reimbursements by medical insurance companies, he said he is paid about $1,800 for each baby he delivers. That means, according to Berry, he must deliver at least 35 babies just to cover the insurance premium.
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