Medical Liability: Reform Now or Pay Later

1
Medical LiabilityReform Now or Pay Later

• Location
• Date

2
A National Crisis

• Major initiative of President Bush
• Other states have enacted MLR is the past few
  years
• Neighboring states have already acted
• Widespread support for reforms nationally
• AMA leads charge in Washington

3
Crisis Signs in TN

• Losing key specialists - obstetrics,
  neurosurgery, cardiac surgery
• Average Ins rate up 89 in six years -some
  specialties up more than 100
• Facilities having trouble filling open physician
  positions
• Award totals doubled in 10 years and continue to
  climb

4
TNs Lawsuit Lottery

• Among physicians practicing medicine in Tennessee
  for past decade, following have faced legal
  action
• 70 of all doctors
• 92 of OB/GYNs
• 92 of orthopedists
• 100 of cardiac surgeons

5
Piling on the Problems

• Reductions in reimbursements combine to squeeze
  physicians financially
• TennCare continues to crush medicine
• Medicare cuts loom on horizon
• Trial Bar continue to tear at provisions that
  provide some stability
• Statute of limitations
• Expert witness rules

6
OB/GYNS Alone

• ACOG survey of OB/GYN members
• 1 in 7 OB/GYNs stopped practicing obstetrics
  because of the risk of liability claims
• 1 in 2 OB/GYNs has been involved in a claim in
  the last 4 years
• More than 76 have been sued at least once
• 92 of Tennessee OB/GYNs have faced legal action

7
OB/GYNS Alone

• Changes made by OB/GYNs due to risk
• Decreased high-risk OB care 22
• Stopped performing VBACs 14.8
• Decreased deliveries 9.2
• No longer practicing OB 14
• Decreased GYN surgical procedures 12.3
• No longer doing major GYN surgery 5.6

8
The Real Cost Factors

• Patients pay more every year for health insurance
• Patients will loose ability to choose their
  doctor and the security of critical services when
  they need them
• Physicians will become more selective of
  procedures and patients they will treat
• Defensive medicine costs Americans 10 Billion
  each year (3,500 per TN physician)

9
Medicines Prescription

• 250k cap on non economic damages
• Sliding scale on fee to plaintiffs attys
• Consideration of collateral sources for payments
• Periodic payments of awards
• Medical expert affidavit to certify claim validity

10
Myths

• There is no proof that caps work
• Courts serve as the 13th juror and strike down
  outlandish verdicts
• Insurance cos lost big in the market and just
  want to make up for losses
• Fear of lawsuits improves performance of doctors
  and make our system safer
• TN doesnt have those big awards like the other
  states

11
The Tough Question

• How can you tell a patient that has been
  horribly and permanently injured that its only
  worth 250k?

12
The Road Ahead

• SB2178 and HB 2122 filed
• SB to Senate Judiciary Committee
• HB to House Civ. Prac. Sub. if passes, then to
  House Judiciary Committee
• SB Calendar Rules to set when bill goes to
  floor. HB CR debates whether bill goes to the
  floor
• Conference Comm. if different versions

13
A State of Action

• TMA makes sure doctors voices are heard on
  Capitol Hill
• Testimony before joint State House and Senate
  subcommittee
• Provided legislative language for bills
• Conducted surveys of public/physicians
• Created www.saveTNdocs.org as a resource for
  supporters
• Developed grassroots toolkit to promote personal
  involvement by doctors/offices

14
A State Of Action

• Actively involved in key elections to help ensure
  victories by pro-reform candidates
• Position spokespeople to carry the message into
  their hometowns across the state
• Bring the message to patients in physician
  offices through a point-of-service campaign
• Meet with newspaper editorial boards to discuss
  medical liability reform
• Conduct grassroots training

15
New MLR Tools

• Significantly increase our government affairs and
  legal personnel and resources
• Statewide advertising strategy and campaign to
  influence lawmakers and the public
• Increased grassroots and public relations/media
  efforts
• Outreach to allies to join us in the fight for
  reform

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Take Off The Gloves

• We are tired of seeing good doctors being
  harassed for simply choosing to practice in
  Tennessee
• It is time to take action and save our profession
• If doctors cant afford to give the care, all
  Tennesseans will suffer

17
Roll Up Our Sleeves

• Learn more about the issue and how it impacts
  your practice and community
• Get medical liability reform info from TMA
• Educate your office on key points
• Write, call, e-mail or visit state legislators-
  ask for support of SB 2178 and HB 2122
• Write a letter-to-the-editor in local newspaper

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We Can Do It Together

• Provide issue information to patients
• Uncover and report stories of access problems to
  TMA
• Consider a financial contribution to the MLR
  Campaign from your practice
• JOIN - Support organized medicines efforts
  through TMA membership

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Need More Reasons?!

• The cost of medical liability directly impacts
  your practices bottom line
• Left unchanged, liability costs will reduce your
  ability to maintain staff needed to operate your
  office
• Eventually the lines will cross on the cost vs.
  revenue grid and the doors will close

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Help Save Our Profession

• For more information or to get involved, please
  contact
• Tennessee Medical Association
• [phone]
• info_at_tma.medwire.org
• www.saveTNdocs.org
• www.medwire.org