Doctors rally at state capital to rein in lawsuits

JEFFERSON CITY, Mo. -- Dr. David Giem has delivered about 1,500 babies during his 26 years practicing medicine in Sullivan. Now, Giem says, his practice is threatened by the cost of medical malpractice insurance.

In the past year alone, he says, his malpractice insurance premiums rose about 600 percent.

"Just the rate of increase is bigger than last year's pre-tax profits," he said.

Giem was among more than 500 white-coated doctors and medical students who flocked to the Capitol on Wednesday to urge lawmakers to curtail personal injury lawsuits, which they blame for their rising premiums.

While lawmakers and others debate what is really driving premiums up -- expensive lawsuits or insurance companies' business decisions -- physicians said fear of being sued has changed the way they work.

"Doctors now practice defensive medicine," said Dr. John Niemeyer, a radiologist who practices in St. Louis and Sullivan. Even when they're not sure it's necessary, he said, "we take the CT scans ... because we're afraid this guy is going to sue us and take our homes."

Physicians say the cost of insurance affects patients as well.

St. Louis neurosurgeon Charles Wetherington, whose malpractice premiums tripled from $60,000 to $180,000 this year, has stopped accepting new patients covered by Medicaid, the government insurance program for the poor and disabled. Medicaid limits what it pays for various procedures, and Wetherington said it's not enough to cover his costs.

Several physicians also said fear of lawsuits could drive recent medical school graduates out of state. Rochelle Skitt, a medical student at Saint Louis University, said limits on liability lawsuits could help determine whether she stays in Missouri after graduation.

The Missouri Medical Association is supporting at least two bills revising the laws that govern liability lawsuits. Most notably, the bills would reduce the maximum punitive damages in medical malpractice lawsuits.

Changing Missouri's laws on personal injury lawsuits -- known as torts in the legal world -- is a priority this year for the Republican-controlled Legislature.

But Republicans and doctors face strong opposition from some Democrats and from attorneys who represent plaintiffs in tort cases.

Democrats cite a September 2002 report from the Missouri Hospital Association asserting that malpractice lawsuits are not the cause of rising insurance premiums.

Democratic Gov. Bob Holden believes the real problem lies with insurance companies and the rates they set for doctors, said spokeswoman Mary Still.

"He is sensitive to their struggle. And he wants to address that," Still said. "But he wants to help in a way that will make a real difference."

Rep. Richard Byrd of Kirkwood, sponsor of one of the liability lawsuit bills, encouraged doctors to lobby lawmakers, especially Democrats.

"This is a war," Byrd, R-Kirkwood, told the doctors at a Capitol rally. "The other side has a lot of ammunition. You're going to have to get the message out."

Just three companies are selling new medical malpractice insurance policies in Missouri this year, down from eight last year, said state Insurance Department Director Scott Lakin. He said two companies went bankrupt, two stopped selling policies nationally and one company is only renewing existing policies.

Lakin said he has been studying the rising costs of malpractice insurance for many months and will issue a report to the governor next week.

Doctors say they want lawmakers to reinstate a cap on non-economic damages in malpractice lawsuits. They say the cap was effectively removed last year when the state Supreme Court, in the case of a St. Charles man who suffered brain injury, interpreted the law to allow a single injury to be divided into multiple occurrences of negligence.

One of the bills backed by Republicans and doctors would lower the cap on non-economic damages to $250,000 per incident from the current $547,000 per incident.

But Missouri Watch, a new group formed to fight the Republican legislation, claims the cap has nothing to do with insurance premiums.

"There's no correlation between the (lawsuit) caps and the (insurance) rates," said Ellen Bogard, Missouri Watch's executive director. "The insurance cycle and the bad investments the insurance companies made are responsible for the rates."

She suggested lawmakers should instead target the insurance industry by limiting their rate increases or require the state Insurance Department to approve any increases.

Besides limiting jury verdicts, the Republican legislation also seeks to end what critics call "venue shopping," getting judges to move cases to counties where juries typically award bigger settlements. Other provisions in the bills would limit attorneys' contingency fees in lawsuits and require that a physician sign an affidavit saying a lawsuit has medical merit before it proceeds.

------

Lawsuit bills are HB273 (Byrd) and SB280 (Scott).

On the Net

Missouri Legislature: www.moga.state.mo.us