Physician liability in Tennessee ‘in crisis’: AMA

By Judith R. Tackett, Nashvillecitypaper.com
jtackett@nashvillecitypaper.com
February 15, 2006

The American Medical Association has designated Tennessee as a state “in crisis” due to a deteriorating medical liability climate.

Association President J. Edward Hill, M.D., said Tennessee joins 20 other crisis states where doctors are restricting services, retiring early or relocating because their medial insurance payments are too high.

A recent survey by the Tennessee Medical Association (TMA) shows that 81 of the 95 counties have no residing neurosurgeon in patient care, 49 counties are without a residing orthopedic surgeon in patient care, 47 have no emergency physician, and 42 don’t have a residing obstetrician-gynecologist, Hill said at a press conference Tuesday.

From 1995 to 2005, Tennessee physicians have seen liability premium increases as high as 127-212 percent, the TMA reports. A physician practicing internal medicine in Tennessee pays about $8,700 per year for insurance, a general surgeon pays $39,570 per year, and an obstetrician/gynecologist pays $59,570 per year.

The solution doctors suggest to keep premiums under control is medical liability reform.

Legislation is on the table in the state legislature for the fourth year and will be sponsored by Sen. Mark Norris (R-Collierville) and Rep. Doug Overbey (R-Maryville). Both legislators are attorneys and Norris said he is likely to file the legislation by the end of this month.

“When we started in 2003, I said the straws in the wind show we’re going from pre-crisis to crisis. We can stem that tide … by being proactive,” Norris said. “Well, we weren’t proactive. Now they put us in the crisis category. It’s early still in the game, and we can stem the crisis by taking positive action now which should have been taken three years ago.”

Norris said the question was whether reform proponents have enough new data and new information to make a more compelling case and convince legislators to take action.

Dr. Bronn Rayne, who chairs the TMA Board of Trustees, said the legislation’s three main points ask for a cap of $250,000 on non-economic rewards, which is basically pain and suffering; a sliding scale for attorney fees to ensure that more money goes to the injured patient; and requirements that each lawsuit contains an affidavit from a medical expert certifying a specific malpractice occurrence.

The American Medical Association (AMA) has observed the medical liability climate in Tennessee for at least three years and uses multiple criteria before designating a state as a crisis state.

“[Criteria] have to do with the legal environment, the legislative environment, the suit environment, the claims severity and grade of incidence … there is multiple things that affect the patient access to care,” Hill said, adding the AMA is also working hard on medical liability reform on the federal level.

Opponents of medical malpractice reform, among them the Trial Lawyer Association, believe placing a cap on non-economic damages would not solve the problem of high insurance rates and could eventually hurt the poor and the elderly when they lose their income.

Hill, in responding to such claims, said that doctors do not seek any restrictions on economic damages such as replacement of income or child care.

And TMA President Dr. Phyllis Miller said her organization is meeting with trial lawyers next week to discuss the issue and see if they can find some compromises.