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SUNNY Temp: 67 °F Wind: CLM at 0 mph Wednesday, August 7, 2002 SECTIONS Home Page Local News Sports Business Obituaries Life Opinion - Politics AP News Weather Classified Archives Site Map EXTRA Cyberchef E The People Golf Job Network Headbone Zone Wellness Connection Movie Times Newspaper in Education Oregon CarZone Outdoor Journal Personals Prime Times Real Estate Tempo A & E TV Times W3 Magazine CLASSIFIEDS Find a Car Find a Home Find a Job Find Everything E SOUTHERN OREGON Destinations Automotive Communities Employment Entertainment Publications Real Estate Recreation Shopping Calendar ABOUT US FAQ What's New Advertise Home Delivery Classified Ad Contact Us Media Kit Jobs @ Mail Tribune Email Story to a Friend July 7, 2002 Dr. Nancy Hagloch, an obstetrician at Medford�s OB/GYN Center, examines Tamee McCullough of Central Point. Hagloch says she�s worried that high malpractice insurance rates in Oregon will force local doctors out of obstetrics or out of the state. Click the photo to see a larger (36k) version; use your Back button to return to the story. Mail Tribune / Roy Musitelli Graphics with this story: The rising cost of malpractice insurance (26k ) Malpractice suits grow more expensive (13k ) Related story: Officials seek solutions to malpractice problems Health care in crisis: an occasional series Priced out of the baby business Huge increases in the cost of malpractice insurance are driving some obstetricians out of the specialty, a trend some fear will hit the Rogue Valley By BILL KETTLER Mail Tribune Obstetricians usually have a happy outlook on life. There’s something sublime about the glow that radiates from expectant mothers, and there’s deep satisfaction in watching new life begin. There’s a little less joy in OB offices around Oregon this summer. Physicians who deliver babies have been hit with huge increases in malpractice insurance rates. Many will pay at least 50 percent more in 2002 than they did last year, and insurance companies already have told them to expect even higher premiums in 2003 and 2004. Obstetricians say the high cost of insurance will prompt some of their colleagues to retire early or stop doing births, as several already have done in Roseburg. Some women will be unable to get the care they want because there will be fewer physicians to serve them.Ultimately, the doctors say, patients will pay more. "It really worries me," says Dr. Nancy Hagloch, an obstetrician at Medford’s OB/GYN Center. "Some (doctors) are pulling out by dropping OB. Some may move to a different state where the malpractice rate is less." Physicians say multimillion-dollar awards in malpractice lawsuits have driven up the cost of insurance for every medical specialty, as well as for general practice. Obstetricians have borne some of the largest increases because pregnancy-related lawsuits that go to trial are more likely to produce large cash awards for plaintiffs. "These are very emotional situations," says Jim Dorigan of Northwest Physicians Mutual Insurance, a doctor-owned insurance company that formed in 1983 to provide physicians with affordable insurance. The company insures about 40 percent of Rogue Valley doctors and a similar percentage statewide. Dorigan says the average demand for damages in Northwest Physicians Mutual’s currently open obstetrics cases is $9.5 million. The average demand for all other cases is just $2.8 million. "Public tolerance for error is extremely low," he says. "When there are errors, it’s expensive." Malpractice cases typically include a plea for economic damages (the actual costs that will be incurred as a result of a medical error) as well as non-economic damages — typically known as "pain and suffering." Non-economic damages sometimes exceed real damages. A Myrtle Creek couple, for example, received an $8 million settlement in 2001 after suing a Roseburg obstetrician. The award included $5 million in non-economic damages. Jackson County juries awarded $10 million in an April 2000 malpractice verdict and $3.1 million in another malpractice case that ended in March 2001. Malpractice-insurance rates started to rise after the Oregon Supreme Court removed a $500,000 cap on pain-and-suffering damages in July 1999. In Hagloch’s medical group, the cost of malpractice insurance in 2000 amounted to $118 for each delivery. By 2001, it had climbed to $158. This year, it’s $280, and by 2003, it’s projected to be $382. Other obstetricians report similar increases. Dr. Dan Tomlinson’s malpractice insurance went from $5,000 in 2000 to $15,000 in 2002, and it’s scheduled to increase to $27,000 by 2004. "We’re paying more in insurance than a lot of people earn in a year," says Tomlinson, who works at Medford Women’s Clinic. Since the cap came off, Dorigan says insurance companies writing malpractice coverage in Oregon have paid out $25 million more in losses and expenses than they have collected in premiums. The number of physicians being sued hasn’t changed dramatically, but the amount of damages requested has quadrupled. Dorigan says the average demand for damages in Oregon medical-malpractice lawsuits was $850,000 in 1999. By 2001, the average demand had risen to $3.5 million. Actual awards made by juries jumped, too — from about $133,000 in 1999 to more than $342,000 in 2001. "From our inception in 1983 through 1998, we had only two claims paid out for $1 million or more," Dorigan says. "From 1999 to June 2002, we’ve had 14 settlements or judgments of $1 million or more." Oregon isn’t alone in its malpractice problems. Physicians have seen malpractice insurance rates soar in states such as Pennsylvania, Texas and Florida. Nevada had to create a state- supported fund to help physicians buy malpractice insurance, says Oregon state Rep. Dr. Alan Bates, D-Ashland. Bates says Oregon’s malpractice rates, coupled with the state’s low reimbursement for Medicare and Medicaid patients, create an increasingly unattractive work environment for physicians. Eventually, he says, that will mean fewer doctors will be available to see patients. "It’ll force physicians to leave the state," Bates says. "Primary-care physicians are going to be less and less available." Bates says rural communities and small cities will feel the pinch first, but it will spread to Eugene and Portland. "It may take three or four years. The public won’t recognize (the problem) until they see physicians leaving." Physicians acknowledge the need for patients to receive compensation for the real costs of fixing mistakes. They say Oregon needs a cap on pain-and-suffering damages to keep insurance settlements at levels that will allow physicians to continue to work here. "Choices that are made have consequences," says obstetrician Hagloch. "The money (for a settlement) doesn’t come from nowhere." "We need to realize that when juries start giving runaway awards, it’s a silent tax that everybody has to pay," says obstetrician Tomlinson. Trial lawyers say juries should have the power to determine a cash value for pain and suffering. "There’s no other source for redress in our system," says Chris Bouneff, communications director for the Oregon Trial Lawyers Association. "There’s nowhere other than the judicial system where people can go to have their cases heard." Trial lawyers take malpractice cases with the understanding that they’ll be paid a percentage of any damage award. Bouneff says the percentage varies from 15 to 40 percent, depending on the complexity of the case and whether any judgments may be appealed. He declined to comment on figures from Northwest Physicians Mutual Insurance that suggest jury awards have soared since the pain-and-suffering cap came off. "I can’t speak to their internal numbers," Bouneff says. "They won’t let (trial lawyers) look at them. We have no way of telling whether their numbers are accurate." Dorigan says his insurance company’s figures were compiled from court records of malpractice cases. "Those numbers are verifiable," he says. "You can verify them by going to the county courts." Bouneff says the increase in malpractice insurance can be attributed to bad management at insurance companies. "Insurance companies are persuading doctors that this is an issue of doctors versus lawyers or doctors versus patients. What this is really about is patients versus insurers." Popular support for juries remains strong, if a 2000 vote on malpractice-insurance reform is any indication. By a 3-to-1 margin, voters rejected an initiative (Ballot Measure 81) that would have given the Legislature the power to limit non-economic damages. Society’s changing perception of physicians and the medical system may also play a role when juries deliberate, says Dr. Eric Overland, a Medford critical-care physician. "There’s less trust in doctors," says Overland, who serves on the board of directors of Northwest Physicians Mutual Insurance. "You used to be able to count on the jury siding with the doctor and deciding for the doctor," Overland says. "Now you can’t trust that." Overland says jury members sometimes seem to use the legal system to express their anger with an increasingly impersonal culture that generally makes them feel powerless. "Managed care made people mad at the health-care system," Overland says. "There’s also lots of media exposure of people violating public trust. We’re continually assaulted by news of people in positions of trust who violate that trust. People are angry, and juries see (a malpractice case) as a way of making a statement." Overland says that ultimately, the community at large will pay for women and infants who have inadequate care during pregnancy. Women — especially those in rural areas — with problems that might have been addressed early in pregnancy will appear at hospital doors with serious health problems. "They’ll come to the emergency rooms," he says, "and the emergency rooms are not equipped to handle deliveries. "We may see more babies in the neonatal intensive care unit," he says, "which is a real financial burden for the hospital." State Rep. Bates says trial lawyers will need to work with physicians, insurance companies and consumer advocates to craft a solution before medical care deteriorates. "The trial lawyers need to be part of the solution," he says, "or they’re going to kill the goose that laid the golden egg for them." Reach reporter Bill Kettler at 776-4492, or e-mail [email protected] Printer Friendly Version Email Story to a Friend Subscribe Archive: Click to Search Mail Tribune Home Local News | Sports | Business | Obituaries | Life Opinion - Politics | AP News | Archives | Site Map E Southern Oregon | Classified Copyright 1997-2002 Mail Tribune. All rights reserved. Privacy Policy web master feedback A D V E R T I S E R S