- The Washington Times - Thursday, December 9, 2004

California doctors and lawyers give mixed reviews to the state’s medical malpractice reform act, which Maryland doctors are promoting as a model.

California in 1975 became the first state in the nation to pass legislation capping jury awards in malpractice lawsuits. The Medical Injury Compensation Reform Act (MICRA) — which took effect in 1985 after a decade-long court battle — limits noneconomic damages, such as pain and suffering, to $250,000.

“I think it’s a reasonable solution for all parties,” said Dr. Lyle B. Hunt, a general surgeon in Paradise, Calif., located about 120 miles north of Sacramento. “There are some doctors who wouldn’t mind if no one could sue, but the reality is that people can be injured.”

San Diego trial lawyer Ken Sigelman, a board member of the Consumer Attorneys of California, a 3,000-member trial lawyers group based in Sacramento, said MICRA has deprived seriously injured patients of “reasonable compensation.”

“Further, there is no data that can be fairly interpreted to support the view that the cap has lowered doctors’ malpractice insurance rates in California,” said Mr. Sigelman, who also holds a license to practice medicine.

According to a July article in the Los Angeles Times, the Rand Institute for Civil Justice — a research subsidiary of the Rand Corp. think tank, based in Santa Monica, Calif. — found that MICRA has reduced jury awards in medical malpractice lawsuits by 30 percent.

California’s malpractice insurance rates have risen 168 percent since 1975, compared with 420 percent for the rest of the nation, according to the Insurance Information Network of California, a nonprofit, non-lobbying consumer-information group.

“We know that effective caps work and everyone who has looked at this has reached this conclusion,” said Dr. Richard Anderson, chairman of the Doctors Co., a national, physician-owned malpractice insurer based in California. “There are no doubts that this works, and the only people that have failed to reach this conclusion are the people that are bought and paid for by the trial lawyers.”

Dr. Jack C. Lewin, chief executive officer of the 35,000-member California Medical Association, agreed, saying that MICRA’s cap on noneconomic damages is the reform act’s “most powerful” element.

“In fact the cap probably could have been much lower, as low as $50,000 or $60,000,” said Dr. Lewin, a family practitioner.

Maryland doctors have said that a 33 percent increase in their malpractice insurance premiums that takes effect Dec. 31 will force them out of business or out of the state. Malpractice insurance premiums rose 28 percent last year and 10 percent in 2002 in the state.

A coalition of Maryland physicians seeking malpractice insurance reform, called Save Our Doctors, Protect Our Patients, has suggested a five-point plan that includes a tort-reform package modeled after MICRA and stronger “good Samaritan” protections for doctors.

The plan includes:

• More competition for insurance providers.

• Creation of “health care courts” similar to those in Indiana that block frivolous lawsuits.

• Rules requiring expert witnesses to have the same specialty as the doctors on trial.

Twenty-eight other states, including Maryland in 1986, have enacted caps on malpractice damages, according to the American Medical Association.

Maryland limits jury awards to $635,000, but Save Our Doctors wants it lowered to California’s $250,000 limit.

“It may not be a perfect plan, but it’s a plan and it works,” said Dr. Karl P. Riggle, a surgeon at Washington County Hospital and leader of Save Our Doctors. “What we are attempting to do is use the parts that have worked and add Maryland-specific parts to it.”

Higher insurance premium payments went into effect Dec. 1 and are to be paid in full by Dec. 31. The 33 percent increase will cost some doctors as much as $150,000 a year.

Medical Mutual Liability Insurance Society of Maryland, the state’s largest insurer of doctors, has said it is burdened by a surge in malpractice payouts.

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