Doctors Rally In New Jersey
More than 1,000 New Jersey doctors rallied or went home early Monday to protest rising medical malpractice insurance premiums and pressure state government to help them.
Many hospitals reported twice the usual number of patients coming into their emergency departments, mostly with minor injuries, flu and fever. But no major disruptions were reported as the three-day slowdown began and some events were canceled or scaled back because of the space shuttle disaster.
It was not clear how many of the state's 22,000 doctors participated. But some 700 health care workers and supporters gathered the Jersey Shore Medical Center here carrying signs reading, "Having a Medical Emergency? Try Calling 1-800-LAWYERS" and "New Jersey and MDs: Perfect Together."
"Not having tort reform included in legislation is like putting a Band-Aid on a gunshot wound to the chest," emergency physician Dr. Bruce Bonanno told the crowd. "The system's going to die."
Dr. Alan Zaccaria, president of the Monmouth County Medical Society, asked the governor and Legislature to enact a $250,000 cap on damage awards for pain and suffering, which doctors say is crucial for reining in premiums.
The American Medical Association, which opposes withholding patient services, says such vocal action by the nation's doctors is unprecedented. The AMA considers 12 states to be in crisis and lists 31 others as having serious problems with malpractice insurance.
In recent weeks, doctors in Florida, Mississippi and West Virginia temporarily stopped some patient services.
"I never dreamed of being politically involved in anything with this kind of magnitude," said Dr. Alan Zaccaria, a plastic surgeon in Little Silver who helped organize the job action. "I've been the most apolitical person in the world and now I've been thrown in the lion's den."
New Jersey is one of the most recent states where patients and lawmakers are beginning to feel the effects of the doctors' anger.
"We're losing our best doctors," said Dr. Steven Berkowitz, legislative chairman of the Orthopedic Surgeons of New Jersey. "We believe essential patient services, such as obstetrical care, trauma centers and neurosurgery, may soon be unavailable."
That's because doctors in such high-risk specialties are sued most often and some now face premiums over $200,000 a year. To get new policies in January, some had to reduce coverage or drop the risky part of their practice.
Consumer and patient groups argue doctors are part of the problem.
Dr. Sidney Wolfe, director of Public Citizen's Health Research Group, said New Jersey regulators don't do enough to discipline dozens of doctors who have repeatedly committed malpractice.
Bruce Stern, president of Association of Trial Lawyers of America-New Jersey, called for closer regulation of malpractice insurance carriers.
"The doctors have misdiagnosed the problem and prescribed the wrong solution," he said.
The level of frustration became evident last year when doctors in 10 states held at least two dozen rallies, visited their statehouses and Congress en masse, and put petitions and form letters in their waiting rooms for patients to sign. Such efforts continue this year, and at least 30 states are to debate some type of malpractice legislation.
Last fall, a study found up to one-fourth of obstetrician-gynecologists in some crisis states had stopped delivering babies or planned to do so because of unaffordable premiums. Other doctors in crisis states are retiring early or moving where premiums are lower.
Dr. David Sedor, a neurosurgeon in Wilkes-Barre, Pa., said that with only three malpractice insurers writing policies in his state, the only premium quote he could get for his upcoming renewal is for $290,000.
"It's heartbreaking, because all I ever wanted to do is come back and take care of people in my community," he said. "It's sad I might not be able to keep doing it."
In the neighboring state of West Virginia, about two dozen surgeons staged a nine-day walkout over premiums a few weeks ago. State lawmakers are trying to come up with a solution.
In Florida more than 800 doctors in the Palm Beach area stayed off the job for two days last week. In Mississippi, a dozen surgeons started monthlong leaves of absence from four Gulf Coast hospitals.
Last summer in Nevada, doctors temporarily closed the top level trauma center in Las Vegas, forcing critically injured patients to be transferred. The legislature adopted some reforms, including a $350,000 cap on awards in malpractice suits, but now doctors are complaining of loopholes.
Nationwide, doctors have certainly won lawmakers' attention. They cheered when President Bush renewed his call Jan. 16 for legislation cracking down on frivolous lawsuits and setting a $250,000 cap on awards for pain-and-suffering damages.