Increased malpractice premiums force gynecologists Crane, Phillips to close their office near St. Joseph's Women's Hospital.
By KRIS HUNDLEY
Published May 15, 2003
TAMPA - Dr. Richard Crane and his partner Dr. James C. Phillips have been able to cope with rising malpractice premiums in years past by shedding the riskiest parts of their practice.
About 17 years ago they gave up delivering babies and the liability that goes along with obstetrics. Last year Crane quit doing gynecological surgery to cut his exposure even further.
Now the two doctors have found the ultimate solution to what they consider a toxic mix of rising malpractice rates, obtrusive government regulations and paltry insurance reimbursements: They're closing their office near St. Joseph's Women's Hospital in Tampa on June 30.
"We had long discussions about how we were going to survive all this," Crane said of the partners' deliberations. "Around the first of the year we realized we have to quit."
Though Crane is 67 and Phillips is 70, neither wanted to retire. "I still have some fire in my belly," Crane said. "Only doing gynecology allowed me the serenity and time to spend with patients. The downside is that you can't make a living."
The two physicians, who have been in practice together since 1968, will be laying off a staff of eight. They've already notified their caseload of about 7,000 women that they'll have to find care elsewhere. Dr. Madelyn Butler, a Tampa obstetrician who has been in practice for eight years, said that won't be easy.
"In our group (of four doctors), patients wait up to six months for a routine exam," said Butler, ticking off the names of Tampa obstetricians who have left the area or pared back their practices in recent years. "And pregnant women who are obese, diabetic or have other health problems are going to have a problem finding a doctor. Doctors want to minimize their risk."
Crane's patients think their doctor will help them find a replacement, but they aren't happy about the change. Linda McEwen has been a friend and patient of Crane's for more than 30 years; her two daughters are also patients. "It's a tragedy they feel they have to retire," she said of the doctors. "I don't know what the solutions are."
The tipping point for Crane and Phillips came when they realized no matter how they scaled back their practices, malpractice premiums would only increase. Crane's premium temporarily dropped to $12,000 this year after he discontinued surgery; Phillips, who still performs minor surgery, paid $18,000 for coverage. But their insurer refused to give the doctors a quote on rates for the coming year, leading them to resolve the matter themselves.
"I told the insurer I don't want a quote," Crane said. "We're going to solve that issue, but not to my liking."
Crane understands the need for malpractice coverage. He has had three claims settled in his career; one case concerning premature twins went to court twice, with both decisions in the doctor's favor before a settlement was finally reached.
"I have seen mistakes and I have made them," Crane said with the candor of someone about to close his practice. "If you've never been sued, let me tell you, it tears out your guts and heart. Even if the jury decides in your favor, it tears the fabric out."
While Crane and Phillips will be free of insurance headaches in about 45 days, doctors who stay in business are keeping a close eye on the Legislature, hoping to see restrictions on malpractice awards pass during the special session.
Butler, whose insurance rose 45 percent this year even though she has had no claims against her, said doctors in Hillsborough County are "almost pre-riot."
"You are frustrated and feel powerless, like everything is coming at you," she said. "The trial bar says this is all a big bluff, but it's really stressful for doctors. If the Legislature doesn't do anything, I think you're going to see more doctors just quit."
