Physicians will rally in Annapolis today to protest skyrocketing malpractice insurance costs, which this year have increased 28 percent for many doctors in Maryland and more for specialists.
The doctors want limits on pain and suffering awards rolled back to $350,000 from the current $635,000, along with curbs on lawyers' fees, a system that allows awards of future damages paid over time, and a change in the way lost wages and other economic damages are calculated.
The demands are angering many people who believe they should be able to sue doctors for malpractice and win large sums of money. Some victims of malpractice will rally not far from where the doctors will meet.
One of the doctors who will rally today is Alicia Cool, a family physician in Towson who was socked with a 28 percent increase in the cost of her medical malpractice insurance this year despite a near-perfect record for almost two decades.
Chris Sybert, Cool's husband who also runs the doctor's office, said he and his wife are considering a move to a more "physician-friendly" state to escape the increasingly burdensome costs on their small practice.
"I don't think people realize how critical the situation is, and not just with higher-risk kinds of specialty doctors," said Sybert, who plans to attend the rally at the Capitol today with about 2,000 doctors who support legislation aimed at reining in insurance costs. "If we don't get a bill this year, I'm not sure what we'll do."
On the other side are malpractice victims such as Gilford V. Tyler of Severn, who about eight years ago was in a car accident and lost a leg because of a medical error, he said.
"I'm a prime example of how unfair it already is," Tyler said.
Tyler, 30, sued and won $4.5 million in pain and suffering as well as $900,000 in lost wages. The $4.5 million award was cut to $500,000 because Maryland capped the amount.
"The [jury] gave me an award, then it was taken away," Tyler said. "And I still don't have a leg."
The battle between Maryland's roughly 10,000 doctors and victims of malpractice will heat up in the months to come as the General Assembly takes up the matter.
On one side are doctors such as Cool, the business community, which fears rising health care costs, and Gov. Robert L. Ehrlich Jr., who plans to submit his own bill this session. They argue that growing awards are driving doctors out of Maryland and into other states or retirement. They are seeking help from the General Assembly largely in the form of limits on pain and suffering awards.
On the other side are people like Tyler, trial lawyers and Senate President Thomas V. Mike Miller, who don't want jury awards capped further. Instead, they want the small number of doctors responsible for most lawsuits to stop treating patients, or at least be reprimanded.
"The problem is the cost of the system," said T. Michael Preston, head of the Maryland State Medical Society or MedChi. "Providers have to pay premiums that are becoming unaffordable and driving doctors out. The goal is to rebalance the need to have a working system of compensation for injured claimants with the affordability of that system."
State Health Secretary Nelson J. Sabatini said the situation is pushing doctors, particularly obstetrician-gynecologists, out of business.
"We don't have as big a problem as Pennsylvania or West Virginia, where physicians are leaving in droves, but we have a problem," he said. "Health care is going to be a priority this year."
In Maryland, 80 percent of doctors are insured by Hunt-Valley based Medical Mutual Liability Insurance Society of Maryland, which is owned by private-practice doctors in the state. The insurer raised its base premium rate for malpractice insurance by 28 percent this year.
Medical Mutual reports that the number of claims filed has not been rising in recent years, but the size of awards is growing: The average claim was $364,886 in 2003, up nearly 56 percent from $234,000 in 2000. The insurer paid out $93.2 million in 2003 compared with $47.3 million in 2000 in Maryland, according to the insurer.
Public Citizen, a Washington-based consumer group that opposes limits on malpractice awards, said in a report that "repeat offender" doctors pose bigger problems to the health care industry than large jury awards.
In Maryland, 3 percent of the doctors in the state are responsible for 50.8 percent of the malpractice awards to patients since 1990, according to data collected from the National Practitioner Data Bank, a federally managed information source. Some of the doctors have never been disciplined, the report says, and three physicians injured five or more patients.
The Public Citizen report also says malpractice awards have not risen sharply, once they are adjusted for medical costs. There have been just three awards of $1 million in each of the past two years.