- The Washington Times - Monday, November 8, 2004

Physicians and surgeons in Virginia, stung by rising medical-malpractice insurance costs, want state lawmakers to cap pain and suffering awards and limit how much money lawyers can make in malpractice cases.

The latest demand by Virginia doctors follows similar calls for help from their counterparts in Maryland and the District, who are lobbying their respective lawmakers for tort reform — an issue that drew support from President Bush during his re-election campaign.

Last February, thousands of doctors marched at the Capitol in a daylong demonstration calling for tort reform.

Beginning in January, physicians said they plan to be in Richmond throughout the legislative session — as many as 100 strong on any given day, said Dr. Mitchell Miller, a family physician in Virginia Beach and outgoing president of the state medical society.

The “White Coats on Call” campaign, which kicked off during the medical society’s annual meeting in Arlington this past weekend, will differ from previous attempts by doctors to draw attention to the rising cost of medical-malpractice insurance premiums.

“If we think we’re in trouble now, it’s going to be an absolute mess 10 or 15 years from now,” said Dr. David Ellington, the incoming president of the Medical Society of Virginia, which represents about 6,700 doctors statewide.

Dr. Ellington, a family physician in Lexington, Va., said doctors want a $250,000 cap on pain and suffering awards, a reduction in lawyers’ fees in pain and suffering awards and for the state to allow insurance companies to pay physicians directly for out-of-network care.

Virginia House Speaker William J. Howell said yesterday that something needs to be done to give doctors a break on rising medical-malpractice premiums. But he added that he isn’t sure whether the answer is a cap on pain and suffering awards.

“This is a real critical issue facing Virginia, and I think the rising health care costs are attributable to the medical-malpractice awards,” the Stafford County Republican said. “The problem is, Virginia has a cap on medical-malpractice awards already that limits the total amount you can get, so having a cap within a cap might be a tough sell.”

Virginia limits total malpractice awards at $1.75 million, but that figure is set to rise to $2 million, Mr. Howell said.

Lawyers across Virginia plan to fight any move to cap malpractice awards or limit lawyers’ fees. They say capping awards is unnecessary because Virginia is among the most restrictive states in the country in its medical-malpractice laws.

“The doctors are proposing the $250,000 cap, and that is essentially what they proposed last year,” said Jack L. Harris, executive director of the Virginia Trial Lawyers Association, which opposes the proposal. “Virginia already has among the tightest medical-malpractice laws in the country.”

But doctors say they need the reforms to keep physicians from leaving the state or quitting high-risk specialties such as surgery, and obstetrics and gynecology.

“Without these changes, we’re going to lose valued medical professionals,” said Dr. Miller. “The health care delivery system is badly broken.”

If doctors leave Virginia, they most likely won’t open a practice in the District or Maryland, where insurance premiums are even higher, according to an analysis of liability premiums in all three jurisdictions.

Premiums have more than doubled over the past five years for most medical specialties in the District, Maryland and Virginia, according to an analysis by D.C.-based NCRIC Inc., the primary insurance carrier for the Medical Society of the District of Columbia, a trade group for D.C. doctors.

Virginia still lags behind Maryland and the District, according to the analysis, which is based on rates for $1 million to $3 million in coverage.

For example, neurosurgeons in the District pay $123,206 per year, compared with $98,122 in Virginia and $76,104 in Maryland, the analysis shows.

OB-GYN specialists in the District pay $122,323 annually, $115,837 in Maryland and $72,425 in Virginia, the analysis shows.

In Maryland, hundreds of doctors across the state have asked hospitals to let them practice without insurance. Some doctors at Prince George’s Hospital Center in Cheverly also have discussed staging a work slowdown to protest their high malpractice premiums.

Mr. Harris said his lawyers group plans to call on former patients injured by medical malpractice to show up in Richmond to lobby lawmakers against the tort-reform proposal.

“We will have our members there, and we will have their clients who have been injured there, because they have got a very important story to tell, and that is that they have been injured by someone who is negligent,” Mr. Harris said.

State lawmakers say tort reform and health care will undoubtedly be major issues in the upcoming session.

“Transportation is something that people tolerate, but health care is something that affects everyone,” said Delegate John J. Welch III, Virginia Beach Republican, who also is a chiropractor and proponent of tort reform.

Mr. Welch said the physicians’ strategy for the upcoming session is more likely to work than last winter’s mass demonstration. “One of the things I said to the doctors in the past was that we read your letters, and we hear about you, but we never see you,” he said.

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