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Doctors in Mahoning and Trumbull counties take stand against rising malpractice costs
SHERRY KARABIN
Legal News Reporter
Published: March 16, 2012
Doctors in Mahoning and Trumbull counties say skyrocketing malpractice insurance costs are literally pricing them out of their practices.
In mid-February about 30 physicians held a news conference at Avalon Inn in Warren to raise awareness about their plight, warning that the high cost of medical malpractice insurance could one day lead to a shortage of doctors in the area.
“Reimbursement rates by insurance companies keep going down, but my malpractice insurance and other costs keep rising,” said Dr. Paul Musselman, clinical assistant professor of urology at Northeast Ohio Medical University and chair of the Division of Urology at ValleyCare Trumbull Memorial Hospital. Musselman, who practices in both Youngstown and Warren, was among those at the recent event.
“When I started practicing my reimbursement rate was about 70 cents on the dollar, now it’s about 10 cents,” said Musselman. “Obamacare promises even greater cuts. I’m also seeing a larger number of patients without insurance. The way things are going doctors are going to be cut out of business, if we aren’t sued homeless first.”
Musselman said over the past few years, five urologists have left the Youngstown/Warren area for various reasons and high malpractice insurance rates are making it harder to attract new doctors to fill the void.
According to Dr. Morris Pulliam, president of the medical staff at ValleyCare Trumbull Memorial Hospital, malpractice insurance rates in Mahoning and Trumbull counties are among the highest in the state.
“As a neurosurgeon my annual costs are well above $120,000 a year compared to the Columbus area where the price is in the $80,000 range, and Cincinnati where the range is $60,000,” said Pulliam. “If you practice outside Ohio, in parts of Montana for instance, it’s far less than $30,000.”
Pulliam said one of the main drivers is the frequency and size of malpractice awards.
“When tort reform was passed in Ohio, it put a cap on non-economic damages at $350,000, which did help to stabilize rates and even bring them down a bit, but this area is still well above a number of states, including some that have tort reform,” said Pulliam. “There is also still a big discrepancy between this area and other parts of the state.”
Pulliam cited a study by researchers at the Lister Hill Center for Health Policy at the University of Alabama at Birmingham, which examined state medical malpractice reform legislation from 1975 to 2004.
“One of the key findings was that if every state in the U.S. had a $250,000 cap on non-economic damages, there could be an annual savings of $1.4 billion or 8 percent of total malpractice premium costs,” said Pulliam.
While Pulliam and Musselman did not name the case specifically, they expressed serious concerns over a Trumbull County malpractice lawsuit that involved pediatrician, Dr. Tara Shipman.
Shipman delivered a child at Trumbull Memorial who was born with brain damage that led to cerebral palsy, and attorneys argued it could have been prevented if the doctor would have performed a caesarian section, thus allowing the child to receive sufficient oxygen while in the womb.
The case resulted in the largest jury verdict in Trumbull County, with the family of 11-year-old Haley Cobb being awarded $13.9 million in December 2010. The award was later reduced to $9.7 million. As attorneys for the doctor continued court arguments over the pre-judgment interest, a lawyer for the Cobb family obtained a writ of execution against Shipman in 2011. The order resulted in a representative of the Trumbull County Sheriff’s Office showing up at the doctor’s home to seize property in an effort to collect part of the award.
Although the order was withdrawn and the case remains under appeal, Pulliam and Musselman said the fact that the incident happened sends a chilling message to those considering practicing in the area.
“The area is already underserved, and now we have this reputation,” said Musselman. “Who is going to want to come here? If we can’t attract new talent, patients are going to face longer wait times.”
Pulliam said part of the goal is to get the legislature to examine the malpractice issue again so that if a jury awards economic damages “they are closer to the actual damage that was suffered. We would like to see a formula set up that stabilizes the amount of economic damages and reigns in non-economic damages.”
Pulliam would also like to see changes to the certificate of merit process. A certificate of merit is an affidavit by a qualified medical expert who has reviewed a patient’s records, and agrees that the provider departed from accepted medical practice in diagnosis or treatment, resulting in serious injury or death. Ohio requires these certificates to be filed in court with the lawsuit.
“I would like to have requirements that these affidavits can only be filed by a doctor within the same specialty,” said Pulliam.
Although he said these legal changes are important, he said the main goal is “to educate the public about the problems we are facing so that maybe they will think twice before calling a lawyer,” said Pulliam. “Even a suit that has no merit adds up in attorney fees.”