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Doctors receive a political education

As the battle over malpractice caps continues, protesting medical professionals are learning the course of activism never runs smoothly.

By COLLEEN JENKINS, Times Staff Writer
© St. Petersburg Times
published March 30, 2003

TALLAHASSEE -- Their pride told them not to bother with this public fight, to simply pack up their medical practices and move to a state that would appreciate their services.

Their love for medicine and for their patients urged them to push forward and stand behind their cause.

Thursday, their professional passion won out.

Nearly three dozen Citrus County doctors made their first trek to the state capital. They sought relief for skyrocketing medical malpractice insurance premiums. They wanted answers. They wanted action.

They got a political education.

"You've got to play a game, and the game is to show up here," said Dr. Donald Carmichael, a general surgeon.

"And we're not built that way," said Dr. Sheila Gillikin, who treats infectious diseases. "We have to make fast decisions. We can't move slow."

As a whole, the Citrus Medical Society is not a politically savvy group. The physicians' offices are scattered throughout the county, limiting the doctors' time with each other. They often are too busy even to make it to the society's occasional dinners.

But the issue of medical malpractice premiums has galvanized them into organized action. They can no longer afford apathy. If legislators don't pass reforms, including a $250,000 cap on pain and suffering awards in malpractice lawsuits, the doctors said they'll be forced to practice outside Florida.

"All of us have realized the only way you can win this battle is to get involved politically," said Dr. Meena Nathan, an internist in Inverness.

Hoping to avert disaster, their political voice has quickly evolved. It birthed last week at a local news conference. Then, on Thursday, they rallied in Tallahassee with several thousand doctors from around the state. The Florida House has passed a bill that supports tort reform; its fate now rests with the state Senate.

The House bill includes the cap on one type of malpractice jury awards. A Senate committee recently shot down the idea.

Local doctors were furious when they learned that Sen. Mike Fasano, R-New Port Richey, was one of the committee members who vetoed the cap legislation. They made their first appointment of the day Thursday with the senator, hoping to change his mind.

Problem was, they couldn't find him. Astute with stethoscopes, needles and forceps, the pack of physicians roamed uncertainly around the maze of the Capitol and Senate buildings looking for Fasano's fourth-floor office.

They arrived 15 minutes late. Fasano had a plane to catch. Only two doctors had a chance to discuss their cause, and they left frustrated by Fasano's adamant stance.

Lesson one: Newcomers need a map of the Capitol.

Lesson two: Politicians don't always tell you what you want to hear.

It wasn't a perfect start for the political novices, but the day improved as it progressed. At 1 p.m., the doctors, dressed mostly in white lab coats, filed into a meeting room with state Sen. Nancy Argenziano, R-Crystal River, and state Rep. Charlie Dean, R-Inverness.

Argenziano wanted to know how much they were paying in annual malpractice insurance premiums. Fifty thousand, $36,000, $125,000, they called out.

They wanted to know how to change the minds of Fasano and other senators who opposed the cap.

"They have every intention of doing tort reform," Argenziano explained passionately. "We need to get the best solution to really get this crisis taken care of right away. You can't just have one fix here."

If enough senators want it, the cap could be revived, she told them. She also read off a list of other provisions being debated: granting a $100,000 cap for lawsuits against doctors who treat trauma patients in emergency rooms, rolling back the insurance premium rates and increasing pre-suit mediation and arbitration.

In all, 13 tort reform bills are circulating through Senate committees.

Part of her job, Argenziano said, was also to listen to the perspectives of the insurance industry, victims and trial lawyers.

"I have to hear everybody's side of the story," she said.

Dr. Manoj Shukla protested: "There is only one side. It's the patients'!"

"But I can show you letters from patients saying don't take away my rights!" Argenziano responded.

She supported the medical community, she said, but this was how government worked. Give and take. Negotiate and compromise.

"We know we have to fix the problem," she said. "I hear your frustration. Unfortunately, government moves painfully slow. It has to take in the whole picture."

The whole picture was crystal clear as the doctors moved to the lawn outside the Capitol steps for the rally. There, they cheered and whistled as Gov. Jeb Bush, Lt. Gov. Toni Jennings and House Speaker Johnnie Byrd gave speeches in support of the $250,000 cap and the other recommendations made by the governor's task force.

"I must say I'm really proud of the medical profession stepping up to the plate in the political realm," Bush said. "I'm glad that the voice of reason is being heard today. Stay involved."

But they also booed and groaned as Senate President Jim King told them he would not be persuaded to back the caps. He pledged the Senate would respond to the problem in other ways.

It was a mixed ending to a day of mixed messages. Some elected officials had provided hope. Others left doctors with a bitter taste in their mouths.

Lesson three: Closing down a practice and spending $50 for a bus ride can be worthwhile. The doctors had done what they had come to do, though they were cautious to declare any definitive victories.

"The political process works, but you have to work on it," said Dr. Gus Fonseca, an oncologist who felt more aware of the inner-workings of politics by day's end.

Others looked for validation of their efforts.

"What you're doing today has really leveled the playing field with the trial lawyers," Argenziano said.

"This really makes a difference?" asked Dr. Armando Rojas, an obstetrician and gynecologist.

"Oh yes," she said. "You have no idea."

Maybe so, but the doctors are learning.

-- Colleen Jenkins can be reached at 860-7303 or

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