PA's Medical Malpractice crisis

  1. malpractice issue moves to pennsylvania's political prime-time hour
    pennsylvania healthcare leaders have said for more than a year that the state's healthcare system is in jeopardy from the rising cost of medical malpractice insurance.

    philadelphia inquirer, january 20, 2002

    by josh goldstein
    inquirer staff writer

    trauma centers and emergency rooms in danger of closing.

    doctors fleeing pennsylvania.

    your health care in jeopardy.

    for more than a year it has been hard to escape the persistent warnings from doctors and hospital executives that the region's health-care system could be destroyed by the rising cost of medical-malpractice insurance.

    trial lawyers who represent injured patients jumped into the public debate with radio ads this fall. they are now airing more radio ads and using telemarketing phone calls to warn that the doctors want to "take away many of your legal rights" and are doing too little to improve medical safety.

    all this - but particularly the threatened closure of trauma centers and emergency rooms at the end of 2000 and again last month - has gotten the attention of gov. schweiker and the state legislators.

    malpractice insurance is at the top of the agenda when the general assembly reconvenes tuesday.

    malpractice premiums are rising in new jersey as well, but the problem hit that state after pennsylvania.

    so far in pennsylvania, nearly $1 million has been spent on advertising and grassroots efforts, and $4.3 million on lobbying to influence public opinion and legislative action.

    doctors and hospital executives say the problems are real and insist they did not manufacture a crisis to win a political victory.

    since the beginning of the year, the sides have been meeting in harrisburg under the direction of the senate republican leadership to negotiate a malpractice package.

    the doctors say they are caught in a financial crunch between the rising cost of malpractice insurance and stagnant or falling reimbursements for medical care. they want restrictions placed on malpractice lawsuits, including caps on damages, and payment of awards over time.

    trial lawyers say that those restrictions essentially bar the courthouse door to many people injured by negligent medical care and that there must be a greater emphasis placed on reducing medical mistakes.

    the strategy of both sides in the malpractice debate has been to make the complicated legislative battle over tort changes resonate so that the public takes sides and gets involved.

    "the doctors with their advertising and the threatened closing of trauma centers have been effective in getting their message out to the public," said larry ceisler, a local public-affairs strategist. "the best advocacy an organization can do is when people feel it. i think the public is starting to feel this."

    but ceisler, who is not advising either side, said that there was the potential for a political backlash against the health-care groups.

    schweiker expressed concern about the use of scare tactics.

    "i'll admit to being a bit disappointed with a few of our hospitals who may have scared some of our citizens," schweiker said in a radio address earlier this month after the threatened closing of trauma centers did not occur.

    "we all know there's a problem, and arguably it's a crisis in affordability [of malpractice insurance], but some of our health-care professionals went a bit overboard in making their case."

    still, the pressure is on the governor and legislators to act quickly as a new round of hospital staffing problems looms next month when the policies of many area doctors lapse.

    the doctors and hospitals have spent more than $600,000 since last january to boost public awareness of the malpractice problem. about half the money was used for print and radio ads.

    the rest of the money went into grassroots efforts including posters and brochures encouraging patients visiting doctors' offices to call or write their state legislators.

    the pennsylvania orthopedic society sent 60,000 information packets that doctors handed out to patients encouraging them to contact the governor and their legislators.

    a $30,000 radio ad campaign by the hospitals and doctors begins airing on kyw-am (1060) and other stations statewide tomorrow. it warns that the failure to fix the malpractice system would mean lifesaving specialists might not be available.

    "hospitals are losing the trauma surgeons, neurosurgeons and other specialists that you expect to be there 24 hours a day," the radio ad says.

    the commercial tells patients to call their legislators and schweiker and "urge them to fix the medical liability insurance system. tell them to preserve your and your family's access to our excellent health-care system."

    the trial lawyers spent about $300,000 since last january, about half on ads, phone calls and outreach efforts. the rest was used to commission and publicize an academic study of malpractice in pennsylvania.

    "doctors, hospitals and others are asking the governor and state legislature to take away many of your legal rights to sue for compensation if you are injured by a doctor or in a hospital," the trial lawyers' telemarketing campaign says.

    "at the same time, the doctors are opposing strong patient safety legislation designed to lower [the] rates of medical errors in pennsylvania."

    as pointed as the pennsylvania campaign has been, the sides waged an even more bitter ad war in west virginia, where escalating malpractice rates became a major problem last year.

    doctors and hospitals in new jersey also have been hit with large increases in their malpractice premiums, but the problem there has not become as severe as it is in pennsylvania. new jersey already has some of the measures pennsylvania doctors and hospital executives are seeking.

    outside of the public's view an even more expensive campaign is being waged in harrisburg.

    the statewide association representing hospitals spent nearly $2 million lobbying in the state capitol from october 2000 through september.

    the pennsylvania medical society's lobbying effort over that time was $1.7 million. the trial lawyers spent $475,704, according to state records.

    and last week, the trade group representing the state's nursing homes joined the fray as the first to use television commercials in the debate.

    "we believe that nursing homes are facing problems akin to those of doctors and hospitals," said alan g. rosenbloom, head of the pennsylvania health care association.

    "the primary focus of this effort is to make it clear that this is a problem that effects nursing homes equally and that the solutions must address the problems the long-term-care community is facing."

    the ads are expected to run for at least two more weeks in the harrisburg area.
    josh goldstein's e-mail address is

    one hospital closed in my area. pediatrics is closing, five orthopedic surgeons have stoped operating, midwives practice closed, only 1 vascular surgeon left at the major hospital affilliated with my homecare agency. er which expanded 8 more beds has had patients lying in halways for 8 hrs last night, my colleage reported, as her mother admitted to ccu with arrythmia last pm. know it's a real problem that operating doctors malpratice at keast 100,000 year or more about 1/3 -1/2 of their revenues. office staff have been layed off and several practices closed. don't quite know what reffoms are needed.
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