Doctors going without malpractice insurance Physicians fed up with skyrocketing premiums

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Doctors going without malpractice insurance

Physicians fed up with skyrocketing premiums

The Associated Press

June 18, 2004

WEST PALM BEACH, Fla. - Dr. Rene Loyola says he has given up just about

everything to keep practicing medicine.

The surgeon owns no home or land, and has no savings other than a retirement

plan after 29 years in the profession. He says he frequently has to turn

away

patients who need his help the most.

Loyola blames all the trouble on soaring malpractice insurance rates that

forced him to join the thousands of other doctors nationwide who have

dropped

their liability coverage.

'On paper, I have nothing'

" On paper, I have nothing. I'm a pauper. My wife owns everything, " said

Loyola, who made the changes to protect himself from lawsuits. " It's a good

thing

we get along. "

The phenomenon of practicing medicine without insurance, or " going bare, " is

most rampant in Florida, where health officials say more than 3,000 of the

state's 89,000 licensed physicians have dropped their coverage.

Doctors say their only other options were to leave the state, or leave the

profession.

But critics, including trial lawyers and patient advocates, call the choice

irresponsible, arguing that going bare does nothing to solve the insurance

crisis or help legitimate victims of wrongdoing.

" You can't hide all of your assets and you can't hide all of your wages

forever. One way or another, we'll find a way to represent these medical

malpractice victims because they deserve it, " said Clem, president

of the

Academy of Florida Trial Lawyers.

Doctors who practice without insurance insist that they sympathize with

legitimate victims of malpractice, but they say skyrocketing awards from

juries and

frivolous claims have ruined the system for everyone.

" If I really injure somebody and do something wrong, I want them to be

compensated for it, " said Dr. Alan Routman, an orthopedic surgeon in Broward

County

who dropped his coverage. " But I don't want some crackpot jury to decide

that

I should lose everything I've worked for my whole life because of it. "

Soaring rates reach crisis point

A jury in one recent case awarded $63 million for a baby born with severe

brain damage after a risky forceps delivery in Palm Beach County. The case

ultimately was settled for less, and other such awards are often overturned

on

appeal. Even so, insurance companies say such cases are forcing them out of

the

malpractice insurance business. Several stopped writing malpractice policies

in

Florida in recent years, and others have had to obtain more insurance for

themselves to help cover large jury awards and settlements.

As a result, rates are soaring to a point of crisis in at least 19 states,

according to the American Medical Association. While the AMA cautions

doctors

against going bare because it creates risks for them and their patients, the

group makes no clear recommendation against it.

Several states, such as Massachusetts, Pennsylvania and Colorado, require

doctors to have insurance, and most hospitals, even in Florida, require a

minimum

level of liability coverage. Even doctors who are bare in Florida have to

prove to the state that they have $250,000 in assets to cover any claim

against

them.

" Nobody would elect to practice without insurance if they could help it. It

poses a risk to everyone and it just shows how desperate the situation is, "

said Dr. J. Palmisano, president of the AMA...

Other doctors, particularly those in high-risk surgical specialties and

obstetrics, have no choice but to go bare. Loyola, a general and vascular

surgeon,

said he was essentially told by insurers that he is uninsurable.

Many doctors limiting their practices

To help defend themselves, doctors are limiting their practices. Some refuse

to take emergency room patients because of the complications often involved

in

treating trauma patients. Others have stopped performing high-risk

surgeries.

In Palm Beach County, so many neurosurgeons have stopped treating trauma

patients that they have to be transported to neighboring Broward County for

care. ...

Similar shortages have been reported across the state.

Patients who sue a doctor without insurance could receive little or no

compensation, and they could meet only frustration when they try for a

settlement.

Marc Singer of Singer Xenos Wealth Management has advised more than 1,000

doctors on going bare. He said he tells them to consult with a bankruptcy

attorney instead of a defense attorney if a claim is made against them.

Then, settlement negotiations begin at zero and go up; rather than starting

with an insurance company's deep pockets and working down to a lower figure.

" When a doctor has zero insurance and offers $50,000, all of a sudden, that

settlement is acceptable, " Singer said. " Lawyers stimulate a lot of

litigation.

Some of it is legitimate and a lot of it is not. They're either going to

take

the more modest settlements or they're not going to get anything. "

Florida law protects many assets from legal judgments. Singer said doctors

can protect their homes, retirement plans, annuities, life insurance and

salaries. Anything more could be given to patients who win legal claims.

But many doctors believe going without insurance is a backward way to fix

the

problems.

" Doctors are going bare to try to avoid lawsuits and to try to protect their

assets. They're not going bare with any idea of how to protect the patient, "

said Dr. Gordon Baskin, who specializes in gastroenterology and internal

medicine.

He refuses to drop his insurance, which now costs $34,000 a year. A decade

ago, he paid about half that amount for four times the coverage.

" The fact is doctors are human, and doctors make mistakes, and when that

happens, how are you going to take care of your patient? " Baskin asked. " The

only

way is if you have the assets and the insurance company behind you. "

© 2004 The Associated Press. All rights reserved. This material may not be

published, broadcast, rewritten or redistributed.

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