Are we surprised? Not me.

>Medical Malpractice Insurance Premium Spikes in Texas a Result of
>Economic Cycle, Exacerbated by "Repeat Offenders," Study Finds
>
>AUSTIN, Texas - The temporary medical malpractice insurance premium
>spikes in Texas are not caused by the legal system but by cyclical
>economics of the insurance industry, according to a Public Citizen
>report released today. In fact, the most significant long-term
>malpractice "crisis" facing Texans is the unreliable quality of
medical
>care being delivered, which is a result of frequent medical mistakes
and
>a lack of doctor oversight by the state medical board.
>
>Government data show that "repeat offender" doctors are responsible
for
>the bulk of malpractice payments. Between September 1990 and
September
>2002, 6.5 percent of Texas' doctors made two or more malpractice
payouts
>worth a total of more than $1 billion. These represented 51.3
percent of
>all payments, according to information obtained from the federal
>government's National Practitioner Data Bank. Just 2.2 percent of
the
>doctors made three or more payments, representing about a quarter of
all
>payouts.
>
>At a press conference held to unveil the report, Dr. Sidney Wolfe,
>director of Public Citizen's Health Research Group, also released a
>letter from Public Citizen to the Texas State Board of Medical
>Examiners, asking the board to investigate 272 doctors who have lost
or
>settled four or more medical malpractice cases but who had not been
>disciplined in the past 12 years. The letter also lists 45
physicians
>who have lost or settled six or more malpractice suits.
>
>Public Citizen released the report as lawmakers debate limiting
>non-economic damages to victims of doctor errors to $250,000 in
>compensation. The Texas Medical Association has hired a team of top-
gun
>lobbyists, including the state's former health and human services
>commissioner, the former insurance commissioner and the former Texas
>secretary of state.
>
>"The medical and insurance lobbies are pulling out all the stops,"
said
>Tom "Smitty" Smith, director of Public Citizen's Texas office. "But
>capping damages will only hurt those who have been most severely
injured
>by doctor errors. The short-term insurance rate increases have
nothing
>to do with the civil justice system and everything to do with
insurance
>industry economics."
>
>According to Public Citizen's report, Medical Misdiagnosis in Texas:
>Challenging the Medical Malpractice Claims of the Doctors' Lobby
>(available at www.citizen.org):
>
>- Medical errors cause 3,260 to 7,261 preventable deaths in Texas
each
>year. These errors cost families and communities $1.3 billion to
$2.2
>billion annually in lost wages, lost productivity and increased
health
>care costs. In contrast, medical malpractice insurance costs Texas's
>doctors less than $421.2 million annually.
>
>- Financial management problems at major insurers compounded Texas'
>malpractice woes; the number of malpractice insurers in Texas
dropped
>from 17 to four during 2001 and 2002. In at least three cases, the
>departing companies had severe cash-flow problems that went beyond
their
>medical liability businesses.
>
>- The number of doctors has been increasing steadily â€" not
dropping,
>as the medical and insurance lobbies claim. Between 1997 and 2002,
the
>number of physicians and osteopaths practicing in Texas increased
from
>31,459 to 37,188, an 18.2 percent increase.
>
>In the letter to the board (also available at www.citizen.org),
Public
>Citizen listed details pertaining to the doctors but did not name
them
>because their identities, which are in the practitioner data bank,
are
>not publicly available. The repeat offenders include a doctor who
>settled 26 malpractice lawsuits between 1994 and 2001 involving four
>incidents of retained foreign bodies in surgical patients, 14
incidents
>of improper performance of surgery, four incidents of wrong
treatment
>performed, two incidents of failure to diagnose, two treatment-
related
>problems, and two monitoring-related incidents. The damages totaled
$4
>million. Another doctor settled 10 malpractice lawsuits in 1998
>involving 10 anesthesia-related problems. The damages totaled
$975,000.
>
>In Public Citizen's annual ranking of how well states discipline
>doctors, Texas rates 32nd in 2001. The rate of serious actions by
the
>Texas medical boards in 2001 - 2.5 per 1,000 doctors - is barely a
>quarter of the rate in Arizona, the top-ranked state with 10.5
serious
>actions per 1,000 physicians.
>
>Solutions lie in reducing medical errors, Wolfe said. In addition to
>effective doctor discipline, states should require hospitals and
other
>health care providers to institute meaningful risk prevention
programs.
>Hospitals should implement measures to curb errors, such as using
>computers to order and track prescriptions (these can cut errors by
55
>percent), requiring proper hand-washing to reduce infections,
addressing
>the nursing shortage and reducing the long hours of medical
residents.
>Also, insurance risk should be spread, reducing the number of
>classifications of doctor specialties. Risk pools for some are too
small
>and thus overly influenced by: 1) a few losses; and 2) the
concentration
>in a few specialties of doctors handling the highest risk patients.
>
>"The long-term problem is a crisis of medical negligence," Wolfe
said.
>"If the state medical board remains unwilling or unable to seriously
>discipline doctors with multiple malpractice payouts, then the
terrible
>human and financial costs will continue to cause preventable deaths
and
>injuries."
>
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