Pa. Med-Mal ‘Crisis’ Over But Doctors Still Worried About Costs and Access

Five years after the latest medical malpractice insurance “crisis” began to roil Pennsylvania and other parts of the nation, some say a balance has returned to the system here.

But doctors and hospital executives continue to worry that high malpractice costs will limit patient access to health care, including emergency care.

While rates are still high, the largest malpractice insurers in Pennsylvania did not increase premiums this year.

“In Pennsylvania, the malpractice crisis is over,” said William M. Sage, the Columbia University professor who headed the Project on Medical Liability in Pennsylvania. The project, paid for by the Pew Charitable Trusts, studied malpractice over the last three years.

The sharp increases in medical-malpractice premiums that began in 2000 led many local doctors, particularly high-risk specialists such as obstetricians, orthopedic surgeons and neurosurgeons, to say they would restrict their practices or leave the state. Some doctors did end up leaving the state, while others stopped delivering babies.

But Gov. Ed Rendell said indications are that the situation has gotten much better.

“It is clear from every bit of evidence that the crisis has abated significantly,” Rendell told The Philadelphia Inquirer.

The Mcare Fund, a state government program that pays malpractice awards and settlements between $500,000 and $1 million, saw its spending drop to $232.6 million in 2005 from $320.3 million the year before and $378.7 million in 2003.

The number of malpractice suits filed in the state declined by more than one-third between 2000 and 2004. The number of suits brought in Philadelphia, which was viewed as the epicenter of the malpractice crisis, was reduced by nearly half during that period.

Some hospitals and other health-care providers, however, said they are still hurting.

“The crisis is not over,” said Andrew Wigglesworth, president of the Delaware Valley Healthcare Council, which represents hospitals in the Philadelphia region. “The only thing that has happened is some moderation in the rate of increase of our premiums, but we still have issues in terms of recruitment and retention of physicians.”

Similar spikes in malpractice costs occurred in the mid-1970s, mid-1980s and mid-1990s. That led some experts to view the most recent problem as part of a broader insurance cycle.

In 2002, the Pennsylvania General Assembly passed legislation to address the increases in malpractice costs. But some health-care advocates and trial lawyers warn that some of the changes already made bear an unseen cost.

“There are malpractice victims with legitimate claims which are no longer practical to litigate because of costs and barriers to bringing suit,” said attorney Gerald A. McHugh Jr. “Now that we have made changes in the legal system prospectively, we need to focus on improving patient safety, because better care will mean fewer claims.”