Ideas for malpractice insurance

Daniel H. Belsky, D.O.
Boca Raton

When I completed my residency in obstetrics and gynecology in 1961 and entered practice, my annual malpractice premium was $150. It would now cost me over $200,000 for the same coverage in the state where I practiced.

In order to rein in the runaway costs of malpractice insurance, I suggest the following:

Do away with contingency fees for attorneys. Have lawyers charge a fee for service, the same as they do when preparing a will. Upon successful settlement of a case, the attorney would have collected a fee for hourly services. If the case is decided against the plaintiff, the attorney would have already been paid for his or her services.

Have a system of compulsory arbitration for all malpractice claims. This system has worked successfully in dealing with injury in the workplace. An arbitration board — usually a union representative, a physician, an attorney and a lay person — reviews the claim. Responsibility is assigned, contributory negligence is determined, and the board recommends a dollar amount as award. Compulsory arbitration could be as effective in medical malpractice cases, helping to drive down the costs appreciably by limiting large legal fees.

Put a cap on awards for non-economic damages (i.e., pain and suffering).

Restrict suing physicians for punitive damages, where the doctor must seek private counsel, since malpractice policies do not cover this. The threat of punitive damages may force many physicians to rush to settlement.

Hospitals and physicians must police themselves better. It has been estimated that approximately 6 percent of doctors account for most medical malpractice cases. Establish a system of supervision for the chronic offenders, have mandatory re-training programs instituted by the hospitals and medical schools, and have the State Board of Medical Examiners play a more active role in the process by suspending or revoking the licenses of chronic offenders who defy rehabilitation.

Will young scientific minds continue to be attracted to the medical profession? I fear not; most will find other ways to pursue productive and creative careers in the sciences.
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