Is there a doctor in the house? NOT IN THE DELIVERY ROOM

NOT IN THE OR,ER, or TRAUMA CENTER Is there a doctor in the house?

NOT IN RURAL OREGON Is there a doctor in the house?

NOT IN THE FUTURE Is there a doctor in the house?

MEDICAL LIABILITY CRISIS Why?

Background , premiums increased ~50% 1987, cap on non-economic damages 1990, premiums reduced 50% 1999, struck down by State Supreme Court 1999-present, premiums increased by ~100%

Professional Liability Insurance Premiums Cap in effect

Claims “Paid” 123 claims/year prior to 1987 tort reform 67 claims/year 1987-present 46% decrease in paid claims

Claims “Paid” Cap in effect No increase in “bad medicine”

Claim “Severity” Cost of paid claims average cost of paid claim increased $286,000 (~300%) Greatest increase Aug May 2003 –113 claims paid over $250,000 –$92,286,400 paid

Claim “Severity” Cap in effect Claim severity increases without cap

Claim “Severity” Negative impact on multiple specialties

Number claims465 Average demand$3,225,206 Total demands$1,500,000,000 Claim “Pending”

$1.5 Billion Amount each Oregonian would need to pay…. $500

$1.5 Billion Amount each physician in Oregon would need to pay…. $330,000

Where’s the money going? Employment Policy Foundation Washington, D.C. Personal injury lawyers take majority. Patients receive ~38%. Caps on non-economic losses could save $54.8 to $97.5 billion annually. Controlling medical litigation could reduce health care costs 5%-9% without sacrificing quality.

Oregon Medical Association Physician Work Force Assessment % of Oregon’s physicians are age Increased cost of practice does not allow physicians to “slow down”. Early retirement –20% statewide –33% southwest Oregon –37% Oregon’s neurosurgeons

Doctors are moving out of state. 5% of Oregon’s physicians have moved. 15% of Oregon’s physicians are strongly considering a move. 20% of Oregon’s physicians under 50 yrs are considering relocating their practices. Oregon Medical Association Physician Work Force Assessment 2003

Patient care is negatively affected. Less high risk services are provided. Complex cases are more likely to be referred elsewhere.

Less High Risk Services

Increased Referral

The Crisis is Real! Medical liability litigation is out of control and destroying our medical system. Oregon is losing good doctors. Access to health care is at risk. Medical liability reform is needed now.

Medical Liability Reform Caps on non-economic losses. No caps on economic losses. Juries should decide on all economic damages and up to a reasonable cap on non- economic damages. Limit contingency fees of lawyers.

Medical Liability Reform Constitutional amendment General election, November 2004 Cost of $6 million

Medical Liability Reform What can you do? Educate your patients Educate your colleagues Give $1000 or more… Now.