Malpractice

After two years of hefty premium increases that touched off threats of a doctor exodus in Maryland and led to a legislative special session, the state's largest malpractice insurer said it does not need a rate increase for next year, leading some to question whether the much-debated malpractice crisis ever existed. Medical Mutual Liability Insurance Society of Maryland, which insures more than three-quarters of the state's physicians, said in a letter to doctors that claims payouts and defense costs dropped about 15 percent last year from 2003's record level, and are on pace to drop slightly again this year.

In the first concerted action by doctors in Maryland to force legislative reforms in the state's malpractice system, physicians in Hagerstown said last night that they will refuse to see patients -- except on an emergency basis -- beginning Nov. 15. The action comes eight days after state insurance regulators approved a 33 percent increase in malpractice premiums for next year for the insurer that covers most of the state's doctors, adding to the heated...

The public file on Dr. C. Thomas Folkemer at the state physician board would put most patients at ease. It shows that the Anne Arundel County doctor has been a family physician for 23 years, has never faced a disciplinary charge, and has privileges with nine HMOs and two hospitals. In September, the board renewed his license for another two years.The file does not tell of the woman who complained that Folkemer failed to test a breast lump that proved to be cancerous. Or of the heart attack that killed William Milliker two weeks after Folkemer allegedly dismissed his chest pains as nothing serious.

After fighting alongside Gov. Robert L. Ehrlich Jr. for malpractice reform, leaders of the state's doctors and hospitals stepped away from the governor yesterday, urging him not to veto the malpractice bill passed by the General Assembly last week. MedChi, the state medical society, and the Maryland Hospital Association said the immediate relief that the bill provides doctors on skyrocketing insurance premiums was essential and warned they would support an override if Ehrlich carries out his announced intention to veto the bill.

Minutes after routine surgery for acute appendicitis in October 2003, Staff Sgt. Dean Witt, 25, was being moved to a recovery room at a Northern California military hospital when he gasped and stopped breathing. A student nurse assisting an understaffed anesthesia team tried to resuscitate Witt and failed. Inexplicably, Witt's gurney was wheeled into a pediatric area. Lifesaving devices sized for children, not a 175-pound adult, proved useless, according to an internal report on the incident.

Looking to resolve medical malpractice cases faster, better and less expensively than the courts could, in 1975 the state of Maryland required all claims to start in arbitration. But today, as soaring legal-settlement costs and malpractice insurance premiums have doctors threatening to abandon their practices, one of the few components of the crisis on which Gov. Robert L. Ehrlich Jr. and key legislators agree is that the arbitration system has failed. On Wednesday, Ehrlich's malpractice task force recommended shutting down the state office that manages it. "It's almost unanimous - the current system should be abolished," said Donald J. Hogan Jr., an aide to the Republican governor who served as staff to the task force.

Confronted with rising malpractice premiums, Dr. Kenneth Greene, an internal medicine doctor in Towson, devised a creative solution: He wrote his patients asking them to chip in $10 apiece voluntarily. If a doctor asking his patients to contribute to the well-being of his practice seems unusual, consider that during the past week they've sent him $3,000 in increments of $10, $20 and $50 - enough to offset the increase in his malpractice bill. Greene called the response so far "very gratifying."

A state Senate committee showed some sentiment for malpractice reform yesterday, and Gov. Robert L. Ehrlich Jr. and House leaders said they would push forward to pass legislation this year that would curb the rapid escalation of malpractice premiums. A day of legislative maneuvering, however, ended with no official action and unclear prospects about what type of bill could be enacted this year. "We now are at the beginning stages of a health care access crisis. I want to stop it before it degenerates dramatically," the governor said.

Decrying another large increase in malpractice insurance premiums, Gov. Robert L. Ehrlich Jr. stood last week at a podium set up on the blacktop near the ambulance entrance of a Towson hospital. Fanned out behind him were more than a dozen doctors in crisp white lab coats. Over their shoulders, large red block letters atop the hospital entrance read, "EMERGENCY." There's disagreement, however, about whether another round of premium increases - the state's largest malpractice insurer filed last week for a 41 percent increase for next year, on top of a 28 percent boost this year - constitutes an emergency.

State Senate President Thomas V. Mike Miller said yesterday that he will craft his own plan to hold down medical malpractice insurance rates if the governor doesn't draft a more "moderate" bill. Miller, speaking in Annapolis at a rally of malpractice victims, labor leaders and liberal activists, decried Gov. Robert L. Ehrlich Jr.'s plan to limit rate increases as favoring big business over the rights of victims. He said afterward that this weekend he will review the findings of a Senate task force that studied the issue.