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| Guest Columnist | Harry M. Covert | Hayden Duke | Jason Miller | Ken Kellar | Patricia A. Kelly | Edward Lulie III | Cindy A. Rose | Richard B. Weldon Jr. | Brooke Winn |


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August 3, 2004

The Crocodile Is Crying

Richard B. Weldon Jr.

When is a crisis not a crisis? When a lawyer tells you it isn't, that's when! Medical malpractice is now the most serious non-crisis crisis facing Maryland.

Medical Mutual Insurance Company, a non-profit underwriter of medical malpractice insurance, filed in June for a 41% rate hike for the coming year. This rate increase comes on the heels of a 28% increase approved just last year.

41%! That means that doctors in Maryland, especially in the high-risk fields of obstetrics, neurology, and orthopedic surgery will face dramatic increases in insurance premiums in the next year.

Being philanthropic healers, these professional medical practitioners will gladly absorb these new costs into their profit structure. Oops, lost my mind for a sec...

These cost increases will be passed along to each and every patient in the form of higher fees and costs. Too bad that patient cost isn't the only negative impact of the malpractice non-crisis.

Doctors, nurses, and midwives are fleeing Maryland faster than a speeding bullet. Practices are closing down rather than risk the financial burden of a frivolous or questionable lawsuit.

Even bucolic Frederick County is not immune. A major obstetrics practice recently closed their midwifery, and more downsizing is in the offing.

This says nothing about the student doctors, forced to decide which medical specialty to focus on, who are avoiding the fields where the majority of suits are filed.

Patients are losing their opportunity to choose their provider, as fewer and fewer specialists are practicing in these areas. Likewise, costs are rising for those who remain in practice, as they must cover the additional overhead burden for insurance coverage.

A recent survey of Maryland obstetricians found that one-third of the respondents would stop delivering babies if malpractice rates increased by 25% or more. Uh oh, we're there already!

Why? How about a recent, and very well publicized, example of a successful trial lawyer who has built a political career (and sizeable personal fortune) on the backs of suing unsuspecting doctors and hospitals.

We'll call this country lawyer John. Let's say, just for arguments sake, that he practices law in North Carolina. John had heard of claims being filed by other country lawyers that argued that a failure to immediately order a Caesarean section removal of an unborn child might possibly be a contributing cause of serious developmental disabilities in the newborn.

John possesses a golden tongue and a gift for rhetorical argument that can capture a jury like few others. John has a passionate courtroom presentation, and often brought himself and the jury to the brink of tears.

In one of these cases, John argued before the jury as the unborn child, desperately crying out for help, begging the doctor for a decision to do a C-section so he could breathe. That decision never came.

John obtained a $23 million dollar award for his clients in these cases. Unfortunately, medical science had not been able to conclusively prove a nexus between time in the birth canal and these hideous disabilities.

In fact, 10 years or more have passed since Country Lawyer John won these verdicts. Empirical data now suggests no link exists, discounting all of those wonderful performances John worked so hard on.

But John did do something with his legal advocacy. He made the OB practitioners so scared that they now order C-sections regularly, whether or not a medical necessity exists. Patient's pay more (considerably more) for the C-section than they would for a normal birth, but at least Mom gets the scar! Something lasting to thank John for, I guess.

So back to Maryland and our non-crisis crisis. During the last four years, the total amount paid out by Medical Mutual jumped from $47 million to $74 million. Of the 15 malpractice insurance underwriters' active in Maryland in 1996, 12 have either withdrawn or gone out of business due to skyrocketing claims.

In 2003 alone, Maryland hospitals saw their medical liability insurance costs increase an average of 38%. That equates to $30 million dollars diverted from patient care.

So, when you hear a lawyer say that there is not a malpractice crisis in Maryland, remember the story of Vice Presidential Candidate John Edwards, that successful country lawyer from North Carolina. Why would we expect them to say otherwise?

Being that it's not fair to hit and run, I'll suggest some alternatives in my next column

Yellow Cab
The Morning News Express with Bob Miller
The Covert Letter

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