March 28, 2024

Medical Malpractice

Fear Factor: Medical Malpractice

Legal reforms have brightened the medical malpractice horizon, but physicians are still wary of lawsuits -- and still angry at high insurance premiums. More than 2,000 now choose to go without insurance.

Amy Keller | 3/1/2007

Illustration: James Yang

What's going on?

For one, med-mal insurance rates are still uncomfortably high for many physicians. "The good news is that medical-malpractice insurance premium rates are stabilizing in Florida. The bad news is that med-malpractice premium rates are stabilizing in Florida at somewhat astronomical levels," says Dr. Robert Brooks, associate dean for health affairs at Florida State University.
Brooks' research suggests that while med-mal insurance rates aren't pushing physicians out of the profession, they're forcing physicians to stop providing "some of the higher risk services which patients need."

Brooks says that more than half of about 1,300 physicians surveyed in 2004 reported that they had stopped providing certain services or provided them less often. The most commonly eliminated services included nursing-home care, vaginal childbirth, emergency department practice and mental health services. In the Florida Keys, for instance, the decision by many OB/GYNs to not perform vaginal deliveries means women who want to try to avoid cesarean "have to drive to Homestead or Miami," Brooks says.

Med-mal insurance losses in Florida dropped 43.6% from $989 million in 2003 to $557.5 million in 2005.

Another gauge of doctors' continuing unhappiness with med-mal rates is the number choosing to drop medical-malpractice insurance altogether -- "going bare." Since 2003, the number of Florida doctors going bare has increased more than a third to 2,039.

Florida is one of the few states that allow doctors to go bare, on the condition that they post a bond, establish an escrow account or obtain an irrevocable letter of credit to cover malpractice verdicts up to $250,000 and hang a sign in their waiting room informing their patients that they practice without insurance. Many choosing to go bare practice in Miami-Dade, Broward and Palm Beach counties, where medical-malpractice premiums are the highest. Among the specialists more likely to go bare are OB/GYNs, neurosurgeons, general, cardiovascular, orthopedic and thoracic surgeons, radiologists, trauma specialists, pulmonologists, gastroenterologists and nursing-home doctors. A 2006 survey by the American College of Obstetricians and Gynecologists found that 35.6% of Florida OB/GYNs aren't covered by liability insurance.

Tags: Politics & Law, North Central, Government/Politics & Law, Healthcare

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