Doctor policy reform pressed

Md. task force, senators seek malpractice remedy

Insurance bills going up 33%

Leaders agree to hold off on slowdown at hospital

October 05, 2004|By M. William Salganik and Andrew A. Green | M. William Salganik and Andrew A. Green,SUN STAFF

With heftier malpractice insurance bills scheduled to land in doctors' mailboxes in less than a month, efforts to reform the malpractice system are picking up steam.

State Sen. Brian E. Frosh, who heads a special Senate committee studying the issue, said yesterday that he is optimistic he can assemble a package of reforms that will win acceptance. The Montgomery County Democrat will ask his panel this week to accelerate its work with an eye to passing short-term and long-term reforms in a special session in November or December.

Also yesterday, four leaders in the threatened job action by Hagerstown doctors agreed to hold off after a meeting with Gov. Robert L. Ehrlich Jr. He promised them a role on a separate task force he has convened to study the issue, and the doctors said they will forgo the slowdown and try to persuade their colleagues to do likewise. Many of the physicians at Washington County Hospital agreed to refuse seeing patients except on an emergency basis beginning Nov. 15.

The malpractice insurer that covers most of the state's doctors, Medical Mutual Liability Insurance Society of Maryland, is raising its premiums 33 percent for next year, on the heels of a 28 percent increase this year. The increase would push the cost of insurance to more than $150,000 for obstetricians, the highest-risk specialty.

Doctors have been pressing for action before next year's legislative session to head off the premium increase. Without it, they say, doctors will leave medicine, cut back their practices or move to other states.

This week alone, Ehrlich's task force meets today, Frosh's special committee will hold a public hearing tomorrow and Baltimore doctors and hospital administrators will describe the impact of the malpractice system to legislators at a "town meeting," one of a series being held around the state.

Despite all the action, there isn't consensus. While Ehrlich and legislative leaders have indicated support for a special session, they haven't agreed on what combination of reforms would work.

Asked whether the dispute seemed any closer to resolution, House Speaker Michael E. Busch said yesterday, "Quite candidly, no. But we're going to see movement. Nov. 1, the bill comes due, and the issue is starting to be focused again."

Kenneth H. Masters, the governor's legislative liaison, said he expected efforts to reach a resolution to intensify.

"My sense is that we haven't yet arrived at the point of consensus," Masters said. "There are a lot of hurdles that need to be cleared. There are conversations going on, and my guess is that these conversations will increase."

So far, the Senate and the trial lawyers have been focused on a short-term solution: a state fund that would allow Med Mutual to freeze its rates. Ehrlich has been cool to that concept, saying what is needed is a long-term solution, including reforms in the way the court system deals with malpractice cases. The state medical society has said both are needed. Busch and the House leadership have also supported both - but it's not clear that all sides would agree on the same long-term package.

Frosh's support for a package tying the short-term fund to a package of long-term reforms opens the door to a possible compromise. Frosh said he envisions long-term measures that combine changes in the court liability system, new patient safety rules and new insurance regulations.

Frosh said he had been speaking to the governor, Busch and "stakeholders" to seek an area of compromise.

Dr. Karl P. Riggle, chief of surgery at Washington County General Hospital, said after the meeting with Ehrlich that a stabilization fund alone can't resolve this issue. "We don't want to see policy be adopted that only throws money at the problem," Riggle said. "That doesn't fix the problem. That only prolongs the inevitable."

Ehrlich said he agrees with the doctors' position and used his "bully pulpit" to persuade them to continue working in the interests of their patients. He said the doctors can't wait forever for a comprehensive solution.

"Patience is not limitless. There is a boiling point," he said.

Dr. Scott Maizel, a Baltimore County surgeon who is president of the Maryland Chapter of the American College of Surgeons, said he thought the most important potential reform was establishment of a special court that could judge medical fault fairly. Doctors, Maizel said, are anxious to see the issue resolved so they can return to focusing on their practices.

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