Chairman's Message => Spring 2003

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Spring 2003

Dear Colleagues,

As Yogi Berra would say, "this feels like de ja vu all over again". The mid 1980’s was a time of escalating professional liability premiums, insurance companies leaving our state and physicians stopping obstetrics. As President of the Florida Ob/Gyn Society, we developed and passed the Neurological Injury Compensation Association known as NICA. This no-fault system helped stabilize premiums, maintained access to quality OB care and provided injured infants with prompt payment of all needed medical care. More money went to families; less was spent for administration and legal fees.

In the mid 1990’s, working with the Children Services Council, we identified an area of critical need for prenatal care. The Dade County Health Department provided facilities and support personnel. Several of my colleagues were willing to provide free obstetrical care but were afraid to participate for fear of liability exposure. With former Representative George Albright, we developed and passed legislation that provided sovereign immunity to physicians who volunteered their services. With this reassurance, we increased access to prenatal care for hundreds of patients. Now I come before you as Chair of the Florida Section of the American College of OB/GYN, Chair of the Health Council of South Florida, National Patient Safety Foundation Executive Committee and a physician that reluctantly stopped delivering babies because of liability concerns. I am no longer willing to jeopardize my family’s financial security with the threat of a malpractice lawsuit. With professional liability insurance both unaffordable and unavailable, many of my colleagues have followed suit. In addition, according to a recent South Florida poll by RCH Healthcare Advisors, of those that still deliver babies, 48% no longer provide high-risk services. Patients must travel greater distances and have longer waits to access care. In the same poll, 78% of OB/GYNs have been sued at least once. Other high specialties report similar trends.

Research by the Robert Wood Johnson Foundation, the Duke University Center for Health Policy, Law and Management, and Harvard School of Public Health, as reported in the Institute of Medicine report "To Err is Human", have shown that the current liability system is seriously flawed. There is no correlation between lawsuits and the quality of care. The system does not fairly compensate injured patients nor does it deter substandard care. According to a recent article in USA Today, "Mounting evidence shows the (tort) system drives up health care costs for everyone, doesn’t protect the many who suffer from malpractice and has little impact on reducing the medical mistakes that cause thousands of needless deaths each year".

This flawed system is now in a melt down and is in serious need of short-term modification and long-term thoughtful solutions. As recommended by the Governor’s taskforce, one of the most important short-term changes is a limit for non-economic damages. There will be no limit for medical expenses and lost earnings. According to the Medical Liability Monitor, in the 21 states that have caps on non-economic damages, the average premiums are 23% lower. Sovereign immunity protection for physicians who provide emergency obstetrical services should also be considered. Hopefully through the work of this committee and others you will agree to legislative reforms to avert a crisis and maintain access to quality care.

I hope that this Committee is a beginning and not an ending. Discussion must continue to provide long lasting solutions, not just band-aids. Consideration should be given to expansion of the NICA and applying no-fault concepts to other special situations where patient access is being threatened.

If there is no change and the current trend continues, it will easier to sue a doctor than to get an appointment to see a doctor.

Dr. Gluck provided this testimony to the Florida House of Representatives Select Committee on Professional Liability during their hearing in Miami, February 13, 2003.