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The medical
liability insurance crisis has escalated during the
past year with continued loss of liability insurance
carriers, skyrocketing insurance premiums, high jury
awards, reductions in high-risk services, physician
demonstrations and possible state and federal medical
liability tort reform.1-4
Although loss of insurance and rate increases have
not been as dramatic in anesthesiology as in obstetrics
and some other surgical specialties, most anesthesiologists
have experienced significant premium increases in
2003.
This year, the ASA Committee on Professional Liability
again conducted a telephone survey to a variety of
medical liability insurance carriers to assess rate
changes in various states in 2003. Premiums for anesthesiologists
in 20025 increased an
average of 28 percent from an average of $15,476 (range
of $4,855 to $58,089) to an average of $21,351 (range
of $7,216 to $124,598) in 2003. According to our informal
survey, states with average premiums of more than
$20,000 for anesthesiologists included Alaska, Connecticut,
Florida, Michigan, Montana, Nevada, Ohio, Rhode Island,
Texas, West Virginia, Wyoming and Washington, D.C.
Florida had the highest premiums in the nation. States
with the largest increases in premiums in 2003 (50-percent
to 150-percent increases compared to 2002) included
Florida, Michigan, Nevada, Ohio, Pennsylvania and
West Virginia. Rate increases have been particularly
problematic for physicians when medical liability
carriers in the state have withdrawn from the market.
Given the current volatility and crisis in availability
and affordability of medical professional liability
insurance, what are ASA and the Committee on Professional
Liability doing for its members? As in the past, ASA
continues to focus on improving patient safety to
reduce severity of injury through its sponsorship
of the Closed Claims Project (see related articles
that follow in this NEWSLETTER). ASA has
created several new initiatives, including a provocative
proposal on irresponsible expert witness testimony
spearheaded by ASA President-Elect Roger W. Litwiller,
M.D., which will be considered by the ASA House of
Delegates in October 2003.
The ASA Washington Office also maintains a list of
liability insurance providers by state. For more information,
contact Lisa Percy at <l.percy@ASAwash.org>
or by telephone at (202) 289-2222. ASA legal counsel
Michael Scott, J.D., Director of Governmental and
Legal Affairs, is currently polling ASA component
society membership to see if any anesthesiologist
has retired, left the specialty, moved or altered
practice due to premium increases not related to claims
for adverse anesthesia events against the anesthesiologist.
Mr. Scott’s survey is specifically in response
to a request by the White House to energize Congress
in passing federal professional liability reform legislation.
Please contact Mr. Scott at <m.scott@ASAwash.org>
or Karen B. Domino, M.D., at <kdomino@u.washington.edu>
if you have experienced such a problem.
2003 is proving to be an eventful year in the medical
liability arena.
| References:
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| 1. Treaster JB. Rise in insurance forces hospitals
to shutter wards. The New York Times.
August 25, 2002;sect A1. |
| 2. Peterson I. New Jersey doctors hold back
services in insurance protest. The New York
Times. February 4, 2003;sect A1. |
| 3. Adamson L. The way we live now: 2/2/03:
Testimony; surgical strike. The New York
Times. February 2, 2003;sect 6:18. |
| 4. Stolberg SG. House backs limit on malpractice
awards. The New York Times. March 14,
2003;sect A24. |
| 5. Domino KB. Another malpractice insurance
crisis brewing for anesthesiologists? ASA
Newsl. 2002;66(6):5. |
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|
Karen B. Domino, M.D., M.P.H., is Professor
of Anesthesiology and Adjunct Professor of Neurological
Surgery, University of Washington, Seattle,
Washington. |
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