Broken system?

Several hundred doctors, medical students and hospital workers rallied at the Capitol yesterday to press Congress for immediate medical malpractice liability reform.

The first national rally from the Coalition for Accessible Physicians, an East Rutherford, N.J., physician group, brought doctors from New Jersey, New York, Pennsylvania, Virginia, Maryland, Massachusetts, West Virginia, Delaware and Connecticut who said they are feeling a financial squeeze from rising liability insurance rates.

Doctors have held rallies in individual states, but there have been few national efforts to address the double-digit growth in medical malpractice insurance rates, said Dr. Ruth Schulze, the coalition's chairwoman.

In the District, where doctors are increasingly heading to Maryland and Virginia to avoid high insurance rates, general surgeons have seen their annual premiums jump from an average rate of $60,506 to $69,270 this year, said the NCRIC Group Inc., a Washington health care consulting company. The average rate was $35,467 in 2000.

Dr. Schulze, a Ridgewood, N.J., obstetrician and gynecologist, and hundreds of other doctors clad in white coats yesterday marched from Union Station to the West Lawn of the Capitol to rally primarily for a law that would cap jury awards in punitive and noneconomic damages.

The group blames trial lawyers and health care insurers for rising insurance rates.

Dr. Schulze, said the main goal is for Congress to pass a federal law modeled after California's 1975 law, which has a $250,000 cap on awards for noneconomic damages, also known as pain and suffering.

"The first thing we need to fix is the abuse in the legal system," she said.

The coalition also wants health courts, in which judges would focus only on malpractice cases.

Trial lawyers said those measures would shield negligent doctors and force patients to choose between "bad care and no care."

"No one should be allowed to bring or get anything for a frivolous lawsuit. But in legitimate cases, we should let a jury decide what is appropriate compensation for a child paralyzed for life," said Todd A. Smith, president of the Association of Trial Lawyers of America.

Sen. Rick Santorum, Pennsylvania Republican, advised the doctors to focus on electing senators in November who will break the Senate's filibuster on medical malpractice legislation that has come from the House.

"The problem is the Senate, where lawsuit abuse does not get a fair day in court," Mr. Santorum said to a cheering crowd that chanted "tort reform."

Dr. Steven Fletcher, a general and vascular surgeon at St. Barnabas Medical Center in Livingston, N.J., said lawsuit reform would reduce the amount of defensive medicine he performs.

About 70 percent of the blood-clot checks he conducts are not are not medically necessary, but "we have to do them just in case," Dr. Fletcher said.

Defensive medicine, includingmedical tests and procedures performed mainly to protect a doctor from a lawsuit, costs an estimated $60 billion annually, Department of Health and Human Services data show.

Although his insurance rate is relatively low at $12,000 this year, New Brunswick, N.J., internist Dr. Sergio Sanchez said he is worried his premium will spike.

"It's only a matter of time," Dr. Sanchez said in between phone calls to his patients during the rally.