Doctors, Lawyers Discuss Malpractice

The lawyer blamed the insurer, the insurer blamed the lawyer, and the doctor blamed them both at a panel discussion last night in Emerson Hall on the topic of medical malpractice and tort reform.

Speakers representing the medical, insurance and legal fields debated the problem of rising malpractice insurance premiums and its effects on the medical profession and patient care, as part of an event co-sponsored by the Harvard Pre-Med Society and a new student group called Exploring Policy In Health Care.

Dr. Thomas Sullivan, the current president of the Massachusetts Medical Society (MMS) and a practicing cardiologist in Amherst, Mass., argued that in addition to the serious problem of healthcare access, there is “a crisis in professional liability insurance in Massachusetts.” The state trains more physicians than any other in the country, but retaining those doctors is a growing problem due to rising insurance premiums, he said, citing 2003 reports which show that rates have increased 20-30 percent. As a result, he said, 33 percent of Massachusetts hospitals have closed in the past 20 years.

Sullivan said physicians in procedure-oriented specialties—such as neurosurgery, cardiology, and obstetrics and gynecology—have been hit especially hard by the premium hikes, and it has been particularly difficult to retain physicians in those fields.

“Doctors know they’re going to get sued. As long as there’s a bad outcome, you’re going to get sued,” Sullivan said.

Leo Boyle ’68, former president of the American Trial Lawyers Association and current president of the Massachusetts Bar Association, pinpointed two main culprits in the malpractice crisis: insurance companies and contending political parties. Trial lawyers and run-away juries are not to blame, he argued.

Boyle said that the insurance industry has been forced to raise premiums for doctors to account for severe economic losses suffered from risky investments—not only in volatile markets, but also in poor doctors.

The problem of malpractice is not only a medical dilemma, Boyle claimed, but a political one. He said caps restricting compensation for pain-and-suffering and medical bills are a political tool—they not only restrict the rights of the elderly and children, but also are ineffective in regulating premiums.

MMS was one of many national groups which has advocated capping malpractice awards in the hope of stemming the increase in premiums.

Dr. Barry Manuel, chair of the largest medical insurer in Massachusetts, the Promutual Group, claimed that over half of what insurance companies pay goes to lawyer fees, while doctors and patients suffer.

Manuel suggested instating a “no-fault insurance model,” by which insurance companies would pay claims directly to patients rather than going through the courts. “This insurance-based model is a fair, timely, efficient method that will remove the pervasive fear of litigation which has had profound effects on medicine,” he said.

But Manuel said that implementing the no-fault model is unlikely considering the dominance of lawyers in Congress.

Pre-Med Society member Gregory E. Stein ’06, who organized the debate, said that though most of those attending were pre-med, the entire student body should be informed about these issues.

“The forum was mainly initiated by students interested in medicine and health care policy, but it’s really a national issue dealing with everybody, since everybody receives health care,” he said. “The purpose was to introduce students to a debate that not everyone knows about. We perceive doctors as being in operating rooms and seeing patients, but they have to deal with politics just like everyone else.”