The malpractice environment may be starting to improve for physicians in one state 2 years after a comprehensive medical liability reform bill was enacted there.
“It's probably too early to see a huge improvement,” said Frederick C. Blum, M.D., president-elect of the American College of Emergency Physicians.
“But the signs are encouraging,” he said.
The first signs are coming from the insurance industry. Loss ratios for medical liability carriers have improved since the reform legislation was passed in 2003, according to a report from the state's insurance commissioner. The percentage of medical liability insurance premiums spent on claims and expenses in the state fell from 135% in 2002 to 107% in 2003. Ratios above 100% indicate the insurer has an underwriting loss.
The 2003 law established a $250,000 cap on noneconomic damages and set a $500,000 cap on damages for injuries sustained at trauma centers. The law also strengthened the qualifications required to be an expert witness.
Within weeks of the law's passage, physicians stopped talking about leaving the state, said Steven Summer, president of the West Virginia Hospital Association. “Retention changed almost overnight.”
And the malpractice insurance market has become more predictable, he said, adding that the next piece will be a reduction in physicians premiums.
One specialty hit hard by the medical liability crisis is emergency medicine. Since malpractice reform was enacted, there has been a slight uptick in the number of emergency physicians practicing in the state, according to figures from the West Virginia Board of Medicine. In 2003, 178 physicians licensed in the state designated their specialty as emergency medicine. By the end of last year, that figure had risen to 188 physicians.
But physicians aren't out of the woods yet, said Dr. Blum, also of West Virginia University.
The law is already under attack by plaintiffs' lawyers trying to get the reform declared unconstitutional by the courts. But physicians got a boost last year when a state Supreme Court justice hostile to medical liability reform lost his bid for reelection.
In addition to remaining active in state Supreme Court elections, the medical community in the state continues to push for further reforms, said Robert C. Solomon, M.D., faculty director of the emergency medicine residency at Ohio Valley Medical Center in Wheeling.