Will Dr's quitting and facilities closing become a trend?

  1. I am concerned what is going on throughout the West, and most likely other places also. Dr's are departing, facilities are closing, which is putting more nurses out into the street.
    Why is this happening? Nearly every Dr. and facility says it is because of the skyrocketing malpractice premiums they have to pay. A case in point is the Trauma Center in Las Vegas, NV. They were scheduled to close their doors this morning, I don't know for sure whether they did or not.


    So, what is the answer, I don't know. But a good start would be to limit the lawyers take in any proceedings to about 3%, rather than 30% or more. I feel many of the lawyers take medical malpractice cases because they know if they win, they win big. Or because many cases are settled out of court, less work for them, yet still a nice paycheck.
    We have become a society who first words after mamma and pappa is "let's sue". We have to break this mold, but I don't have a clue as to how to do it!
    I would love to hear other's thought on this subject.
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    About 2ndCareerRN

    Joined: Mar '01; Posts: 1,050; Likes: 43


  3. by   CATHYW
    Oh, yeah, 2nd career! I believe there should be a cap on lawyers fees, down to a more realistic level.

    Primarily, there should be a level for which a person could sue for whatever happened to them, as in how insurance pays-loss of foot, loss of two feet, loss of legs, loss of eye, AND feet, etc. I do NOT want to deprive anyone of the only means of recompense that will make their future life easier, nor do I not want medical professionals to be penalzied (again, on a sliding scale, like traffic court) for what they have done. If a person is paralyzed, for example secondary to malpractice, and would need in-home care and multiple appliances, etc., for the life span, then these sorts of things should be calculated for the course of the life span, with attendant cost of living increases included. Then, a percentage of that, 25%, say, should be included in the total for "pain and suffering," and the DEFENDANT should have to pay the plaintiff's attorney's fees. If something reasonable does not happen,
    nobody will be able to pay the sky high malpractice insurance, and our litigious society will have sued itself out of access to most healthcare.
    No, I have never (knock on wood) been included in a lawsuit.
  4. by   LasVegasRN
    Tort reform. That's what I'm hearing from the physicians I work with. That's the only thing that will turn this mess around.
    HOWEVER... I'm hearing some other things that aren't so black & white...

    Of interest, not all the physicians are getting into this malpractice issue. One group of neurosurgeons said they are not leaving, and are not drastically affected by the malpractice issue. Is it because they are so high up on the physician payscale that it does not affect them? Maybe so...

    Another theory that's being heard by managed care and payor groups is that this is an elaborate attempt by the medical community to drive up their reimbursement. The networks and HMO's are getting requests by physicians and groups to increase their reimbursement rates or they will terminate. Is this a form of a collective blackmail? My opinion is no, we need to review payment for physicians instead of trying to undercut them. Medicare is already making some providers not accept medicare payments because it is just not cost effective.

    Theory number 2 is that the physicians will settle for nothing less than tort reform. Caps on pain and suffering, caps on attorney fees. Yes, this will lower their insurance rates to be sure. Does it help the patient who was a victim of malpractice? Hmmm...

    Theory number 3 - This is an effort by the insurance companies to "purge" the state of "bad" physicians. I'm not fond of this theory as I'm seeing "good" physicians leave because of the high insurance rates also.

    Yes, this is a big mess. A tragic mess. I'm going to log in to www.klastv.com to see what's going on at noon here and hope there was an 11th hour reprise, but somehow I don't think it's going to happen....
  5. by   colleen10
    Hi 2nd,

    I'm out in Pennsylvania which is one of, if not the highest rate of Mal Practice Insurance in the US and practically the world.

    I have heard through friends and relatives and even other posters on this board that OB/GYN's are saying that you can go to them for check ups but they won't be able to deliver your baby because they can't afford the insurance.

    In PA our Reps. are trying to pass Tort reform laws to limit Mal Practice. It is a very serious matter for our state as we also have one of the highest elderly populations in the US and are loosing our young people to other states. I believe I just read that PA is only second to Florida in elderly population.
    Pittsburgh is only second to Palm Beach.

    I had a discussion with some fellow classmates regarding this a few months ago. And one point that we all thought about was how we are sure that many of the mal practice claims are unfounded yet doctors and hospitals settle out of court just to be done with the matter and not risk a lengthy trial and more lawyer fees.
    We were wondering if the advances in medicine have served as some sort of security blanket for the public and when something goes wrong they automatically assume that the doctor was at fault. I mean that we were thinking that a lot of the public assumes that doctors are "mini gods" and can saves lives no matter what because of all of the technology and drugs that we now have. If you think back even within the last 10 years the advances that we have made in diagnosing and treating diseases - it really is pretty amazing. Maybe it is hard for some people to believe that even when you try everything and work your hardest and despite all of our advances not everyone can be saved or return to the way they were.

    I don't know. I'm just a student and that was just one point that was brought up but I thought it certainly was a different way of looking at it.
  6. by   santhony44
    I think the possibility of malpractice suits hang over most provider's heads most of the time. It's not just the money; being named and involved in a suit takes a big toll emotionally and physically and can also consume big chunks of time that should be devoted to patients, family, and so forth. There is also the factor of loss of trust- there will always be people who decide that anyone who was sued must be guilty; what's more, the provider loses trust in his or her patients. And don't forget the financial costs of "defensive medicine." CYA becomes a necessity. Unnecessary tests, procedures, and referrals are done "just in case."

    I think tort reform is going to have to happen sooner or later. If anything good comes of doctors quitting and facilities closing, then it will be something to stop of slow the tide of suits being filed at the drop of a hat.
  7. by   VickyRN
    Yes, tort reform is a NECESSITY. Something has to be done to curb the actions of lawyers preying on peoples' greed, ignorance and misery. These lawyers are not noble and could care less about these people they are representing--all they want to do is make a fast, easy buck. And all of us are paying for it (especially in the health-care arena)!!! It certainly doesn't help that most of the politicos in Washington are lawyers!!! Societal expectations need to be examined. There are a lot of insane procedures going on in the ICU's. IMHO, we need to rationally examine many of our so called "medical advances." A ninety-year old patient with multi-system failure on a ventilator, multiple drips in tow, is NOT what I would call a victory of modern medicine. Rather, I call such scenarios "nightmares of technology" and these tragic patients victims! I guess it boils down to our core values as a society. In our society money and youth reign supreme. People want to get rich quick--without working (the "lottery" mentality) and if suing works--sure, go for it!!!! Also, growing old and death is an inevitable and natural part of living--yet, we, in our never-ending quest for immortality and the fountain of youth, just don't want to accept this!!!
  8. by   Repat
    I understand what everyone is saying about lawyers, but, frankly, I don't see many insurance companies going broke. How about breaking a bit of the hold insurance companies have over our lives?
  9. by   pfleige
    Let's pray!
  10. by   mattsmom81
    i'm with you Repat! I've had a real eye opening education on how insurance companies operate in these 2 years following a serious car accident.

    I wonder how many people out there realize that if you try to collect ---even on your OWN policies--- you will probably need an attorney to FORCE them to pay?? (and of course, the attorney takes his cut. )

    Something needs to change here. Insurance companies have WAY too much power.
  11. by   slinkeecat
    In West(by GoD) Virginia... we are having a bad time with retaining dr's the malpractice insurance carriers dropped alot of dr's here and our GOV had to make an emergency Malpractice insurancepolicy thru the State PEIA public employees insurance agency. But Alot of public funding cuts have closed alot of outpatient mental health and group homes so we are seeing alot of mentally retarded pts coming in with lame psych diagnoses and it is really bad...no where to put these poor souls.... something has got to give
  12. by   mattsmom81
    More and more docs are forming corporations in my parts to have lives and have backup.....must be some monetary and legal perks in that idea too.

    My FP doc gives a 30% discount for cash so they don't have to mess with insurance companies....plus they set up a savings plan for their patients with a nice discount...a 'medical cost savings plan' which I think is innovative.

    Sometimes it's tempting to NOT buy all the ##XX0* insurance policies....but then I think I have too much to lose and having a policy limits the damages if someone sues me. So...we're kinda stuck.
  13. by   adrienurse
    Okay, I thought our doctors were leaving Canada to work in the States. Where are your doctors going?!
  14. by   P_RN
    They did close the Vegas Trauma Unit today. I saw the NBC report and they were taking the equipment away.

    My daughter suggested (and I think it is a good suggestion) that the Casinos either employ doctors or pay the malpractice insurance.
    After they are a BIG employer there.