WSJ.com - Patients Face Cancellations, Delays As Doctors Protest Insurance Rate

CAL/AAEM News Service pottsbri@yahoo.com
Mon, 19 May 2003 11:21:31 -0700 (PDT)


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Submitted by Paul Windham, MD

 

============================

 

 

Patients Face Cancellations, Delays As Doctors Protest Insurance Rates

By ALEX FRANGOS 
Staff Reporter of THE WALL STREET JOURNAL


For months, physicians around the country have been protesting the skyrocketing cost of malpractice insurance. Now, patients are starting to feel the impact.

Over the past week, in an escalation of tactics, between 5,000 and 6,000 Pennsylvania physicians either refused patients or shut their offices down completely in protest. In Jacksonville, Fla., about 100 surgeons and obstetrician/gynecologists shut down their offices on May 3, forcing public health officials to open an emergency operations center to coordinate care. That is a strategy usually reserved for hurricanes.

More doctors will be away from their offices as part of protests planned for Illinois, New York state and Washington state. A rally of as many as 5,000 physicians is expected to close many offices next week in New Jersey.

For patients this can mean canceled appointments, delays seeing specialists, postponements of elective surgery and trouble getting prescriptions filled. Emergency-room physicians have pledged to stay on the job -- some are required to by law -- to handle any overflow of patients who otherwise were headed to private offices. That has created overcrowding in emergency rooms in states such as New Jersey, which saw a 60% increase in traffic during a three-day doctor walkout in early February -- mostly people with runny noses and fevers.
QUESTION OF THE DAY


Should the government cap jury awards in medical-malpractice cases? 



Eric Dail, an obstetrician/gynecologist in Erie, Pa., left messages on the office voicemail referring noncritical patients to the emergency room last week. Most obstetrician/gynecologists say they will still deliver babies. Other practices are open with one doctor on duty.

Doctors say huge malpractice premiums are driving them out of business or forcing them to stop risky procedures requiring higher insurance premiums. Neurosurgeons in southern Illinois have halted risky brain procedures, forcing head-trauma patients to be flown by helicopter to St. Louis or Chicago. A goal of doctors is legislation to limit the amount juries can award for pain and suffering to $250,000.

This long-running debate is finally hitting patients. When firefighter David Doerrman twisted his knee in a three-alarm blaze last week, he limped to a Reading, Pa., hospital only to learn that orthopedic specialists in his health plan were in a work stoppage.

"You have to inconvenience people to get their attention," says John Dethoff, an orthopedic surgeon at the practice where Mr. Doerrman sought treatment.

Under normal circumstances, an orthopedic surgeon would have examined him within 24 hours. But the firefighter ended up getting an X-ray in the emergency room. When his battered knee didn't show a break, the ER doctor told Mr. Doerrman there was no more to be done until a specialist could take a look. He gave him an ace bandage and instructed him to take Tylenol.

For the week they were closed, Dr. Dethoff and his colleagues treated only severe problems, such as broken bones, at emergency rooms they are affiliated with. The recording on the office's answering machine informed patients, "During this time, routine office services including prescription services will not be available."

In Philadelphia last week, doctors left their offices to protest malpractice-insurance rates.


Protests are taking place in 18 states that the American Medical Association has said are in a medical liability "crisis." But actual slowdowns or halting of services have been confined to East Coast states -- largely New Jersey, Pennsylvania, Florida and West Virginia.

In the north Florida city of Jacksonville, most elective surgeries have been canceled after four surgical practices fulfilled a promise to shut down if the Legislature failed to enact a proposed law. North Florida Surgeons, a 20-person general surgery practice that provides 30% of on-call surgeons at area emergency rooms and all the full-time surgical staff at Baptist Medical Center, stopped treating new patients last week.

To coordinate urgent care among Jacksonville's seven hospitals, the county health department is using its hurricane-proof emergency operations center, which helps patients in severe need of medical help to find it. Elective procedures, such as biopsies for mammograms, are on hold for now, as are hernias, hysterectomies and joint replacements.

Patients will also notice some changes in the office. Many practices, including Prime Health Network, an 18 physician group in Drexel Hill, Pa., have replaced the glossy magazines in the waiting room with lobbying materials. "All waiting patients have left to do is read those pieces of information," says Mary Jo Shields, president of the group.

What should patients do? First, be sure your prescriptions will cover you until the doctor returns. While some doctors will refill prescriptions over the phone, others are directing patients to the ER.

Keep an eye on what the doctors are planning by contacting state or county doctors' advocacy groups, or the AMA Web site (www.ama-assn.org).

Another option: Take your business elsewhere. Many caregivers don't feel comfortable closing their doors and are continuing to treat patients.

Since his injury last week, Mr. Doerrman, the firefighter, has had to lie in bed, leg elevated, unsure of his condition or when he will recover. "I'm sort of imprisoned in my house until there's a decision about what can be done," he says.

Write to Alex Frangos at alex.frangos@wsj.com

Updated May 8, 2003




Brian Potts 
Managing Editor, CAL/AAEM News Service 
MS-IV, UC-Irvine

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<P class=articleTitle style="MARGIN: 0px"><STRONG>Submitted by Paul Windham, MD</STRONG></P>
<P class=articleTitle style="MARGIN: 0px"><STRONG></STRONG>&nbsp;</P>
<P class=articleTitle style="MARGIN: 0px"><STRONG>============================</STRONG></P>
<P class=articleTitle style="MARGIN: 0px"><STRONG></STRONG>&nbsp;</P>
<P class=articleTitle style="MARGIN: 0px"><STRONG></STRONG>&nbsp;</P>
<P class=articleTitle style="MARGIN: 0px"><STRONG><FONT size=3>Patients Face Cancellations, Delays As Doctors Protest Insurance Rates</FONT></STRONG></P><SPAN style="FONT: bold 12px times new roman, times, serif">
<P style="FONT: bold 12px times new roman, times, serif">By <B>ALEX FRANGOS</B> <BR><SPAN style="FONT: bold 10px times new roman, times, serif"><B>Staff Reporter of THE WALL STREET JOURNAL</B></SPAN><BR></P></SPAN>
<P class=times>For months, physicians around the country have been protesting the skyrocketing cost of malpractice insurance. Now, patients are starting to feel the impact.</P>
<P class=times>Over the past week, in an escalation of tactics, between 5,000 and 6,000 Pennsylvania physicians either refused patients or shut their offices down completely in protest. In Jacksonville, Fla., about 100 surgeons and obstetrician/gynecologists shut down their offices on May 3, forcing public health officials to open an emergency operations center to coordinate care. That is a strategy usually reserved for hurricanes.</P>
<P class=times>More doctors will be away from their offices as part of protests planned for Illinois, New York state and Washington state. A rally of as many as 5,000 physicians is expected to close many offices next week in New Jersey.</P>
<P class=times>For patients this can mean canceled appointments, delays seeing specialists, postponements of elective surgery and trouble getting prescriptions filled. Emergency-room physicians have pledged to stay on the job -- some are required to by law -- to handle any overflow of patients who otherwise were headed to private offices. That has created overcrowding in emergency rooms in states such as New Jersey, which saw a 60% increase in traffic during a three-day doctor walkout in early February -- mostly people with runny noses and fevers.</P>
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<TD class=plnEleven style="PADDING-BOTTOM: 5px; PADDING-TOP: 5px"><STRONG><FONT size=2><SPAN class=boldThirteen>QUESTION OF THE DAY</SPAN><BR></FONT></STRONG>
<DIV width="100%"><STRONG><FONT size=2><IMG height=1 alt="" src="http://online.wsj.com/img/g.gif" width="100%"></FONT></STRONG></DIV>
<DIV width="100%"><STRONG><FONT size=2><IMG height=5 alt="" src="http://online.wsj.com/img/b.gif" width="100%"></FONT></STRONG></DIV>
<DIV class=plnEleven><A class=plnEleven href="http://discussions.wsj.com/n/mb/message.asp?webtag=wsjvoices&amp;nav=messages&amp;msg=2844"><FONT color=#0253b7>Should the government cap jury awards in medical-malpractice cases?</FONT></A> 
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<P class=times>Eric Dail, an obstetrician/gynecologist in Erie, Pa., left messages on the office voicemail referring noncritical patients to the emergency room last week. Most obstetrician/gynecologists say they will still deliver babies. Other practices are open with one doctor on duty.</P>
<P class=times>Doctors say huge malpractice premiums are driving them out of business or forcing them to stop risky procedures requiring higher insurance premiums. Neurosurgeons in southern Illinois have halted risky brain procedures, forcing head-trauma patients to be flown by helicopter to St. Louis or Chicago. A goal of doctors is legislation to limit the amount juries can award for pain and suffering to $250,000.</P>
<P class=times>This long-running debate is finally hitting patients. When firefighter David Doerrman twisted his knee in a three-alarm blaze last week, he limped to a Reading, Pa., hospital only to learn that orthopedic specialists in his health plan were in a work stoppage.</P>
<P class=times>"You have to inconvenience people to get their attention," says John Dethoff, an orthopedic surgeon at the practice where Mr. Doerrman sought treatment.</P>
<P class=times>Under normal circumstances, an orthopedic surgeon would have examined him within 24 hours. But the firefighter ended up getting an X-ray in the emergency room. When his battered knee didn't show a break, the ER doctor told Mr. Doerrman there was no more to be done until a specialist could take a look. He gave him an ace bandage and instructed him to take Tylenol.</P>
<P class=times>For the week they were closed, Dr. Dethoff and his colleagues treated only severe problems, such as broken bones, at emergency rooms they are affiliated with. The recording on the office's answering machine informed patients, "During this time, routine office services including prescription services will not be available."</P>
<TABLE cellSpacing=1 cellPadding=0 width=265 align=right border=0>
<TBODY>
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<TD class=illustration><IMG height=181 alt="[Protesting Doctors]" src="http://online.wsj.com/public/resources/images/PJ_DOCTORS_DJ_C05072003205638.jpg" width=257 border=0><BR><FONT size=2><FONT color=#be7878><SPAN class=salmonEleven>In Philadelphia last week, doctors left their offices to protest malpractice-insurance rates.</SPAN><BR><BR></FONT></FONT></TD>
<TD width=12 rowSpan=2><FONT color=#be7878 size=2></FONT></TD></TR></TBODY></TABLE>
<P class=times>Protests are taking place in 18 states that the American Medical Association has said are in a medical liability "crisis." But actual slowdowns or halting of services have been confined to East Coast states -- largely New Jersey, Pennsylvania, Florida and West Virginia.</P>
<P class=times>In the north Florida city of Jacksonville, most elective surgeries have been canceled after four surgical practices fulfilled a promise to shut down if the Legislature failed to enact a proposed law. North Florida Surgeons, a 20-person general surgery practice that provides 30% of on-call surgeons at area emergency rooms and all the full-time surgical staff at Baptist Medical Center, stopped treating new patients last week.</P>
<P class=times>To coordinate urgent care among Jacksonville's seven hospitals, the county health department is using its hurricane-proof emergency operations center, which helps patients in severe need of medical help to find it. Elective procedures, such as biopsies for mammograms, are on hold for now, as are hernias, hysterectomies and joint replacements.</P>
<P class=times>Patients will also notice some changes in the office. Many practices, including Prime Health Network, an 18 physician group in Drexel Hill, Pa., have replaced the glossy magazines in the waiting room with lobbying materials. "All waiting patients have left to do is read those pieces of information," says Mary Jo Shields, president of the group.</P>
<P class=times>What should patients do? First, be sure your prescriptions will cover you until the doctor returns. While some doctors will refill prescriptions over the phone, others are directing patients to the ER.</P>
<P class=times>Keep an eye on what the doctors are planning by contacting state or county doctors' advocacy groups, or the AMA Web site (<A class=times href="http://www.ama-assn.org/"><FONT color=#0253b7>www.ama-assn.org</FONT></A>).</P>
<P class=times>Another option: Take your business elsewhere. Many caregivers don't feel comfortable closing their doors and are continuing to treat patients.</P>
<P class=times>Since his injury last week, Mr. Doerrman, the firefighter, has had to lie in bed, leg elevated, unsure of his condition or when he will recover. "I'm sort of imprisoned in my house until there's a decision about what can be done," he says.</P>
<P class=times><B>Write to</B> Alex Frangos at <A class=times href="mailto:alex.frangos@wsj.com"><FONT color=#0253b7>alex.frangos@wsj.com</FONT></A></P><!-- article end -->
<P class=article><I>Updated May 8, 2003</I></P></DIV></DIV><BR><BR><STRONG>Brian Potts <BR>Managing Editor, CAL/AAEM News Service</STRONG> <BR>MS-IV, UC-Irvine<p><hr SIZE=1>
Do you Yahoo!?<br>
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