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Doctors: Insurance driving us from state
By COLLEEN JENKINS, Times Staff Writer
CITRUS HILLS -- Citrus County doctors increasingly will be forced to practice medicine elsewhere if the Legislature doesn't enact meaningful tort reform, members of the Medical Society said at a news conference Thursday night. The strain of rising medical malpractice insurance premiums, departing insurance companies and nuisance malpractice lawsuits threaten to send doctors to states that have taken action on the medical community's behalf, doctors said. That could diminish local access to health care, they warned. "We're going to go where we can practice our trade," said Dr. Donald Carmichael, a general surgeon in Inverness. "There is a crisis. People that can retire are retiring. People who are too young to retire are moving out. They will cease to do high-risk procedures, and there will be a lack of care." "My partner and I have to deliver 100 babies a year just to pay our malpractice premium," said Dr. Armando Rojas, an obstetrician and gynecologist at the Genesis Women's Center in Inverness. Though not usually a politically active group, about 30 doctors gathered at Andre's restaurant to voice their concerns. Other medical professionals around the state have held public protests in recent months. No such action is planned for Citrus, but doctors said a desperate situation still looms locally. Just last week, one of Dr. Stephen Campbell's partners had to cut his malpractice coverage in half after the premium unexpectedly skyrocketed to $39,000 from $20,000. Campbell, a pulmonologist and critical care specialist in Inverness, had to persuade his colleague not to quit. The county can't afford to lose specialists, the health professionals said. Already, doctors said, the number of surgeons, pediatricians and obstetricians available in Citrus is low. "I think the chances of me being here another 12 months is zero," Campbell said. "I think the chances of my partner being here another 12 months is zero." What the medical professionals want, at the very least, is a $250,000 cap on noneconomic damages in medical malpractice cases. That was the recommendation made in January by a task force appointed by Gov. Jeb Bush to address the impact of mounting malpractice insurance premiums on the quality of health care in Florida. Noneconomic damages include compensation for pain and suffering, physical impairment, mental anguish and inconvenience. The insurance industry also supports such caps. Critics, including the AARP and lawyers, charge that they limit victims' rights and do nothing to lower the cost of malpractice insurance. But in its report, the governor's task force said no other strategy would immediately "alleviate Florida's crisis of availability and affordability of health care." So doctors were particularly dumbfounded to learn Thursday that the Senate committee on Health, Aging and Long-term Care had only hours before rejected 10-1 a bill that would establish the noneconomic damages cap. State Sen. Mike Fasano, R-New Port Richey, voted against the awards cap. At their meeting, local doctors said Fasano previously had promised he would support such limits. They argued that elected officials seemed insulated from the problem and thus ignorant of its consequences. "It's a horrendous statement," said Dr. Gus Fonseca, an oncologist in Lecanto. "It's a, 'Sorry, there's nothing for us to worry about.' " On Friday, Fasano said he was well aware of the hardships facing physicians. He said he always has supported the $250,000 noneconomic damages cap, but he wants a simultaneous law that will require insurers to be held responsible for their rates. "It is a situation that we need to deal with immediately," he said from his New Port Richey office. Yet, he added, "I could not support a cap without guarantees the insurance premiums would fall to assist our physicians." Doctors were quick to note Thursday that they are not against patients getting just reward when they truly receive poor care. In some cases, patients deserve it, they said. But the physicians suggested a system where the party who loses a lawsuit be required to pay all court and lawyer fees. That way, doctors won't lose thousands of dollars even when a jury finds they weren't at fault. Eighty to 90 percent of lawsuits are judged to be frivolous, Rojas said. About half the county's doctors and their peers from around the state are expected to take their pleas to legislators in Tallahassee on Thursday. They've taken out newspaper ads in local publications to inform their patients of the trip. "We probably are going to be token demonstrators because the dice has already been thrown," Fonseca said. "It's not a boycott. It's a cry for help." Also, many will post letters in their offices that outline what their needs are. They hope patients will copy these letters and send them to legislators in a show of support. In Tallahassee, the situation has been portrayed as a fight between doctors and lawyers, said Dr. Manoj Shukla, who specializes in pulmonary medicine and critical care. Residents need to know the truth. "This issue is not between doctors and lawyers," he said, passionately. "It is between us the people, the patients and the doctors, vs. them who control the dollar. It affects everyone."
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