- The Washington Times - Sunday, December 26, 2004

HAGERSTOWN — The threat of emergency-room shutdowns on New Year’s Day has faded amid mounting expectations that Maryland’s General Assembly will act to curb skyrocketing medical malpractice insurance costs in a special session that starts tomorrow, doctors and hospital officials say.

“I think, in terms of a lot of physicians, they feel like something is going to happen,” said Dr. Karl P. Riggle, the Hagerstown surgeon who leads the statewide reform coalition Save Our Doctors, Protect Our Patients.

Dr. Riggle said many doctors, including himself, who balked Dec. 1 at paying 2005 premiums averaging 33 percent more than this year’s bills have decided to pay at least enough to cover the first quarter of the new year so they can continue practicing beyond Jan. 1.

The state’s largest malpractice insurer, Medical Mutual Liability Insurance Society of Maryland, released numbers Thursday that showed physicians were renewing their policies at about the same rate as last year.

In mid-December, before the special session was assured, Dr. Riggle had said some medical services across the state, including the trauma center at Washington County Hospital in Hagerstown, might be forced to close this Saturday because of a shortage of insured specialists.

There no longer appears to be an immediate threat of the Hagerstown trauma center closing, Dr. Riggle said.

Spokesmen for two other hospitals that faced doctor shortages — the Western Maryland Health System in Cumberland and Suburban Hospital Healthcare System in Bethesda — said they expect to be able to meet the needs of patients, including emergency-room visitors, after Saturday even if the special session proves fruitless.

Still, consumers may find some services less available in the new year — especially obstetrics and certain surgical specialties.

Some doctors are quitting because they have decided their 2004 premiums already were too high. Dr. Riggle said others who want to stay in business are cutting costs by dropping procedures that carry additional premiums.

For example, surgeons who perform a low volume of vascular surgeries can save $10,000 to $15,000 a year by eliminating that part of their practices, he said.

Similarly, a general surgeon might stop operating on children, or a neurosurgeon might give up intracranial procedures.

“In essence, here in Hagerstown, it is likely to go from where there were seven vascular surgeons two years ago, to five currently, to three at the end of the month. That means in terms of roster call, which is how the emergency room is run, there will only be three of eight nights when there will be a vascular surgeon available if Grandma has an aneurysm,” Dr. Riggle said.

Right now, there is no pediatric surgeon available in the Hagerstown emergency room 37 percent of the time. On Saturday, that number will rise to somewhere between 50 percent and 60 percent, he said.

The same thing is happening across the state. “There won’t be any hospital that will not be impacted,” said Suburban Hospital spokeswoman Ronna Borenstein-Levy.

Michael Preston, spokesman for the state medical society, MedChi, said many doctors are taking a wait-and-see attitude toward malpractice reform — but they won’t wait forever.

“I’ve heard from a number, particularly OB-GYNs, who are saying, ‘Look, I’ve paid my first quarter, but if we don’t see something happen, I don’t know where the second one’s coming from,’ ” he said.

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