I'm becoming a Michael Moore fan

Guest Column: Medical Malpractice Editorial by Janelle Hupp, M.D.This editorial ran in the Wisconsin State Journal on Sunday, October 30.

I am a physician practicing family medicine in Black Earth. I am one of many physicians who moved to Wisconsin from Illinois. This state attracted physicians because of the quality of life and because of the medical liability environment. It was a dark day for doctors and patients when the Wisconsin Supreme Court struck down the cap on awards for pain and suffering for injuries associated with negligence.
I deeply believe it is justified and right that patients are compensated for preventable injuries that occur while under a physician’s care. Patients now, as in the past, always receive all damages awarded to them related to economic losses they incur as a result of these injuries. This includes lost wages and all medical bills associated with the care they need because of the injury.
I did not take the decision to leave my practice in Illinois lightly. After six years, I had a rapport with my patients. I did not want to feel like I was leaving them without medical care. At the same time, I wrestled with the fact that in order to justify the extremely high insurance premiums I was paying, I would need to expand the number of patients that I accepted beyond my comfort level. I made several changes to my practice in Illinois to reduce my insurance premiums before moving to Wisconsin. The first was to stop delivering babies, considered a high-risk procedure by insurance carriers. For my patients, this decision meant that they would need to drive 30 miles to the next community for their delivery.
Illinois physicians who never had a claim saw their liability insurance skyrocket. Imagine having your car insurance increase 15 – 50 percent without ever filing a claim. Making a bad situation worse, when medical liability rates soar, insurance companies leave the state, too. For physicians, this means fewer or no choices among carriers.
Add to the reality of rising premiums the reality of decreasing payments for Medicaid and Medicare, and you have a formula for disaster. While the situation was bad all over in Illinois, the southern, more rural areas of the state were hit hardest. Specialists relocated to other states leaving trauma centers without neurosurgeons; birthing centers without obstetricians. Hospitals were largely unsuccessful in recruiting new physicians to a state in the midst of this medical access meltdown.
My practice was saturated, and I was forced to see even more patients to pay the increasing premiums. I reached my breaking point and made the difficult decision to leave.

http://72.14.207.104/search?q=cache:reT9wa2FvgQJ:www.wha.org/pubArchive/valued_voice/vv11-4-05.htm+illinois+doctors+leave+for+wisconsin&hl=en&lr=&strip=1

Increasing Malpractice Insurance Has Some Illinois Doctors Leaving State
[FONT=Arial, Verdana]Malpractice Insurance Affecting Stateline Doctors
23 News/Sycamore
Brad Broders


Longtime Sycamore internal medicine physician Paul Stromborg is seeing his medical brethren leave in alarming numbers.
"We are all part of this community. We want to have the specialists to be able to take care of patients. We don't want to ship somebody to somewhere else," Stromborg said.
document.write('');In the last few months, DeKalb County obstetric doctors dwindled by 50 percent, from 14 to seven. Skyrocketing malpractice medical insurance costs are forcing some Illinois doctors to move to surrounding states.
"We're very interested in making sure that if there is a problem in malpractice, that they are appropriately awarded, but right now for some people, it's like winning the lottery," Stromborg said.
The state's malpractice insurance issue is also affecting DeKalb County's public aid doctors. With fixed state funds and rising insurance costs, some practices are in danger of extinction.
"We're not making money. It's quite simple. It's like any other business; you can't stay afloat if you're not making money," Joseph Baumgart said.
Illinois doctors want to enforce a maximum awarded in malpractice settlements, a policy already in place in Wisconsin and 27 other states. Stromborg says without this cap, premiums will continue increasing, which he believes will push more state doctors out and scare away younger doctors.
"If you are a gynecologist, you'd be nuts to practice in Illinois coming out of school when you consider the costs in malpractice insurance," Stromborg said.
They are costs which doctors say are forcing their colleagues out of state and leaving we patients with potentially less medical care in our communities.

http://www.wifr.com/home/headlines/1385347.html
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Higher salaries are paid in bigger cities. See the post which states how high salaries in NYC are.

Do you have absolutely any proof for your claim that medical salaries are going down?

Well I want to be the King of Egypt. BFD. The salaries shown above are very high. And after only 3 years they lowest you can possibly make, and that likely in an area with a lower cost of living, is 150K!
What risks in this litigious environment? You are parroting pat answers which don't make sense.

I live in London. You want to talk to me about expensive?

Tort reform is a red herring. The amount of money that insurance companies pay out due to torts has absolutely no bearing on what they charge for insurance. Want to know why? Because its ridiculously miniscule.
As for having heard of tort reform, I took a class in law school that delved very heavily into tort reform. So yes, I have heard of it. (And no, I have nothing once so ever to do with the plaintiffs' bar.)

That post doesn't answer anything.

Analysis: Insurance pricing doctors out


By Al Swanson
UPI Urban Affairs Correspondent
Chicago, IL, May. 3 (UPI) -- Billboards on Interstate 80-55 southwest of Chicago warn motorists "Drive Carefully, No brain surgeon in Will County."
Hundreds of doctors say the skyrocketing cost of medical-malpractice insurance is driving them from Illinois. Several hundred physicians rallied at the state Capitol last week to demand caps on malpractice awards and an end to "frivolous" lawsuits against doctors and hospitals.

"They must reduce our costs and improve the environment here, or we will do as promised and vanish however reluctantly into other jobs or other states where we are valued," Marsha Ryan, a spokeswoman for Physicians for Medical Malpractice Reform, told doctors and medical students gathered in Springfield.

Busloads of doctors came from across Illinois, not pushing any specific bill, but to ask lawmakers to do something about the growing healthcare crisis this spring.

The doctors say Illinois is one of the most expensive states in the country in which to practice medicine because of the soaring cost of medical-malpractice insurance.

Obstetricians practicing in Illinois paid an average $139,696 annually for malpractice insurance in 2003; neurosurgeons averaged $228,000, according to the Illinois State Medical Society.

The problem is especially acute in rural areas of central and Southern Illinois considered medically underserved. Many small communities lack doctors and can't attract them.

Medical groups say Madison and St. Clair counties in the Metro-East area near St. Louis have lost nearly 100 doctors each in the last few years.

http://washingtontimes.com/upi-breaking/20040503-033350-5671r.htm

Thanks for the spam, hgold, but do your research. Check what percentage of insurance company costs are the result of malpractice suits.

I don't think 100K is that much money, but as you say, most physicians make way more than that. Whining about malpractice insurance is hard to stomach.

And these articles can be followed up with many more to back up what I am saying.

Medical malpractice insurance rates are skyrocketing. Skyrocketing malpractice REDUCES compensation. Reduced compensation drives doctors out of pockets of the country.

And that...nicephoras...is why your assumption that salaries can't be decreasing is simply naiive.

And there are more factors as well that we haven't even discussed.

No, those studies showed that doctors USED to make that kind of money. Check out the trend...that is what I am referring to.

And again those studies are national studies...doesn't deal with the problem I posed, which is that doctors are being driven out of areas.

You are just ridiculous.

Who cares why malpractice rates are skyrocketing. They are....

Let's start slowly...do you accept that malpractice rates are skyrocketing?

While you appear to be a smart man on many issues, you appear to financially clueless. If you can't figure out that a national average is different that falling salaries in pockets of the country. And that doctors are leaving those pockets, we can't truly debate this.

I've been an accountant for over 20 years, but I guess I should learn about finance from you.

Believe me 100k in the cities I mentioned is not affluent.

You may have a lower standard of living in London, for all I know you are a student, but that is not how doctors and most professionals live. 100k doesn't cut it. Maybe sad in your mind, but true.

Re: If you want to know what physicians make... just ask them:

Strange, I'd expect exuberant malpractice rates to be most detrimental in rural areas.

Not if it is helping drive overall healthcare costs through the roof.

exactly....the patients are getting hurt.

You're grossly overstating the case.

Yes, malpractice is a problem.

Uh huh.

The beauty of the free market.

Some are, yes. Now the question is why.

I haven't tried to teach you about finance. I've tried to tell you a few things about tort reform (political windbaggery) and your riduculous claim of doctors making less money in large cities (something I know to be false from personal experience).
Incidentally, accounting and finance aren't the same things. And this isn't either.

Good thing they make a lot more than that. You're trying to tell me that of the numbers above, its the doctors in NYC who are making less as the doctors in Podunk Nevada make more? That's insane.

Dude, have you ever been to London?

You know, this is quite possibly the biggest softball anyone has ever lobbed at me in a debate. Its almost like daring Maya Angelou to write a poem. First, accusing me of knowing nothing about finance, then suggesting I make no money and don't know what living on 100K is like.
Lets just say that my standard of living is just fine. Well, I work too much, but at least I'm remunerated for it.

did you read the articles I posted about doctors leaving their practices to start new practices in other states?

How can you solve a problem whose solution you're unaware of?

Your solution of "tort reform" has nothing to do with the problem.

Incidentally, this trend isn't new, its been going on for a decade. And yet, in 2004, Doctors were still doing very well. Odd, that.

Perhaps they can make more in other states. I don't see the problem. If states want to lower their malpractice rates, they should talk to the insurance companies.

I never said tort reform is the solution. Never. You made that up. Now will you answer the question? Do you accept that malpractice premiums are high and skyrocketing?

So you are ok if most of the doctors leave your area to make more money in another state?

That is ok with you? I hope you never get sick.

Malpractice premiums are rising, yes. Usually, when costs rise, producers pass them on to consumers. As is likely happening in this case. I haven't seen too many of my doctors on Manhattan close their practice. I have seen them raise my rates.

If that started to happen, I'd want my state to compensate them additionally for moving there to work. The same way that states like North Dakota have been doing for decades.

Just answer these two questions - do you have any empirical (not anecdotal, empirical) evidence that doctors salaries are falling? Or that they are at the numbers you have cited, despite two surveys posted to the contrary? (Note, showing that a cost has risen does not show that profit has fallen.)

a) I never advocated tort reform
b) I didn't claim that doctor make less in large cities. I said that there are areas that can no longer sustain the medical community they once had. I said that if you live in an expensive city 100,000 is not affluent. I said the pockets that are having troubles include big cities. Do you not get the difference?

I expected better of you in a debate, but your use of straw man arguments in this one should embarrass you.

But you brought up the irrelevant 100K figure to begin with.