FCMA Survey

Insurance Costs

Threaten Patient Care

TRUMBULL — A poll of Fairfield County physicians by the Fairfield County Medical Association (FCMA) demonstrates the doctors are steadily changing the way they practice medicine due to skyrocketing medical liability insurance costs. These changes directly affect patient care, health care costs, and the future of the profession.

The medical association has conducted the same survey for the past four years. Each successive survey has shown that the situation is worsening. More and more physicians have stopped performing high-risk procedures, removed themselves from HMO panels, declined to accept patients with Medicaid and/or Medicare insurance, lowered the number of high-risk patients they treat, raised patient fees when possible, increased the number of medical tests ordered to defend against medical liability claims, and reduced the amount of free care given to patients.

“The landscape for physicians has fundamentally changed,” said Lionel Brown, MD, a hand surgeon who resides in Newtown. “Soaring insurance premiums are forcing doctors to change the way they practice and curtail free medical care.”

Noting that insurance premiums for some doctors have topped $180,000, the FCMA has urged the state legislature to enact comprehensive changes in the way medical liability cases are handled by the courts.

“Meaningful reform must be implemented; otherwise, patients will face a reduction of medical services, a shortage of specialists, and higher costs,” said Dr Brown. “We need medical liability reform that will provide an immediate 15 percent reduction in premiums — we remain convinced it can be accomplished with a reasonable limit on noneconomic damages and other modest legal system reforms.”

The impact of soaring medical liability insurance premiums extends beyond the doctor’s cost of staying in business. The issues, and the survey findings, cover three main areas of concern to patients and their families: The quality of care, the cost of that care, and the ability of doctors to run viable practices that use the latest technology.

On all three counts, the survey results are extremely disturbing, the FCMA said.

In terms of care, 38 percent of Fairfield County doctors report limiting the scope of their practice, up from 33 percent in 2004, which itself was up from 18 percent in 2002. Dozens of doctors report they have stopped delivering babies and performing high-risk procedures and surgeries.

Over a quarter — 27 percent — say they have been forced to limit the number of sicker patients with complex illnesses. In 2002, only 14 percent said they had changed their patient mix in response to medical liability insurance costs.

Doctors say they are practicing more “defensive medicine” by ordering more tests than in the past to protect themselves in case they are sued. In 2005, nearly two-thirds of doctors say they practice “defensive medicine,” up from 59 percent in 2004, 56 percent in 2003, and 36 percent in 2002.

Meanwhile, 36 percent of doctors have dropped Medicare and/or Medicaid, a slight increase from 34 percent when the survey was first administered in 2002.

Also, patients who have relied on free care may also find that option closed to them, with greater than half of all Fairfield County doctors — 51 percent compared to 35 percent in 2002 — saying they have cut back.

Finally, doctors say they are finding it difficult to recruit new physicians into their practices, as well as keeping up with staffing requirements, and upgrading their medical and business technology. One quarter of the doctors report problems recruiting new physicians, over half cannot upgrade their medical technology, and just under a third cannot keep up with staffing needs.

“We remain confident that the state legislature is serious about positive change,” Dr Brown said. “Numerous credible studies show the single most effective way for controlling escalating medical liability insurance premiums is by having guidelines on what a jury can award for noneconomic damages.” Dr Brown added that the FCMA remains open to other proposals for achieving the same goal as long as they can be proven by a professional actuary to reduce insurance premiums.