An informal group of doctors, insurance companies and hospitals are pushing for a medical malpractice panel they see as the best way to heal rising insurance costs.
A bill they back was passed by the Senate recently.
At the heart of the plan is the creation of a panel that serves as a buffer between juries and the people who think they have suffered at the hands of doctors.
This is the measure that the healthcare community has invested hundred of thousands of dollars in for the past two years.
But as New Hampshire Public Radio's Dan Gorenstein reports, it's not clear whether this panel system will treat what ails malpractice premium increases.
An informal group of doctors, insurance companies and hospitals are pushing for a medical malpractice panel they see as the best way to heal rising insurance costs.
A bill they back was passed by the Senate recently.
At the heart of the plan is the creation of a panel that serves as a buffer between juries and the people who think they have suffered at the hands of doctors.
This is the measure that the healthcare community has invested hundred of thousands of dollars in for the past two years.
But as New Hampshire Public Radio's Dan Gorenstein reports, it's not clear whether this panel system will treat what ails malpractice premium increases.
_______________________________________________
The panel the medical community seeks is made up of a judge, doctor and lawyer who would review malpractice claims before they could ever get to a jury.
The medical community and its supporter say the need for a screening system is obvious.
A number of New Hampshire physicians including obstetricians and neurosurgeons have seen their malpractice rates more than double over the past four years.
And if that continues, the fear is the state will start hemorrhaging doctors.
State Senator John Gallus.
T.30
:12 ...the high cost of malpractice premium insurance is driving a lot of people out of certain fields....In certain parts of the North Country, you have no one delivering children, we don't do deliveries in North Conway, or Colebrook anymore. The practitioners in those two towns, couldn't afford to do it anymore, with so few deliveries and high cost of premiums.
But the New Hampshire Medical Society, the New Hampshire Hospital Association, Anthem, Cigna, Harvard Pilgrim, and other big healthcare players have offered a solution.
Create a screening panel that would determine whether negligence occurred.
The influential coalition would prefer to put that authority in the hands of professionals rather than 12 ordinary people.
Michael McCall works for the Medical Mutual Insurance Company of Maine.
McCall remembers a case involving a doctor his patient and one of the most common drugs on the market.
3:33 this is a case about a physician who prescribed some aspirin for a patient. And the patient on her own, elected not to take the aspirin. And went on to suffer some complications. Now I can't tell you with certainty she would have avoided those complications but she did not take the aspirin.
To McCall, and his defense team, it seemed clear, the doctor told the patient to take aspirin.
But according to McCall the jury started second-guessing the physician.
4:20 instead, their questions led us to believe that in retrospect, they were questioning whether the doctor could have said something differently, or more emphatically in his recommendation to take the aspirin.
Ultimately the jury was hung 6-6.
And that forced Medical Mutual to settle with the plaintiff.
To McCall, this illustrates the risk of bringing issues both technical and emotional to people who don't understand the context.
The insurance man says this would not have happened in Maine.
Since the late 80's Maine has had a panel that screens cases before they get to a jury.
In New Hampshire, doctors and insurance companies long for a mechanism like that.
They believe the panel would reduce jury trials, get cases resolved quicker...basically just save a lot of money.
Medical Society Vice President Palmer Jones says the numbers bear that out.
T.7
4:15 Maine charges obgyn 37 thousand dollars a year for liabil/ity insurance. They charge NH 62 thousand dollars a year, that is a sig. savings, if he can save that in his area, he can continue to practice in this state. Nuerosurgeons is the same thing.
Jones says on average Maine OBGYNs and neurosurgeons pay 30-40% less than their New Hampshire counterparts.
Jones says it's very simple the only difference between New Hampshire and Maine is the presence of the panels.
But critics like Senator Joe Foster don't think the neighboring states line up so neatly.
T.6
:13 Maine and NH are actually different in a lot of ways. In NH, one third of our physicians are covered by the Dartmouth Hitchcock system, and their prices are 30% lower, therefore similar to the rates in Maine. Also our per capita income in NH is very different, quite a bit higher that would lead to higher judgments and higher defense costs. Those at least in those two ways it's a very different environment.
What Senator Foster and other panel opponents can't understand is the need for the system.
The doctors have consistently said there is no frivolous lawsuit problem in the state.
So critics, including the powerful Trial Lawyers Association, wonder what cases exactly doctors are trying to screen out.
The answer, they argue, is in the steps the panel make people go through.
The plan used in Maine requires testimony, witnesses and cross examination at the panel stage.
National expert assistant law professor Catherine Struve studied the issue for the Pew Charitable Trusts.
She says the mini-trial phase would likely weed out smaller cases.
A layer for the patient, Struve says, is going to think twice.
8:08 that lawyer is going to be thinking, I need one or more experts, expert testimony on standard of care, on causations, and yes those experts are costly. They charge by the hour. And they are going to charge for their testimony before the panel and before trial. The meter is running on all of that, and therefore in the panel system it will be much more expensive.
The panel system may be more expensive for plaintiffs, but insurance companies say it's cheaper than a jury trial.
One insurance company who works in both states says its defense fees are about 12 thousand dollars cheaper in Maine.
But even Maine isn't some malpractice premium paradise.
Maine Public Radio:
More than a hundred doctors wearing white coats paid a house call today...to the halls of the state capitol.
A Maine Public Radio report from Augusta.
...They were there to warn about what they say is a pending medical crisis in their profession: that of mounting malpractice claims and spiraling insurance costs.
The recent Maine Public Radio headline proves, if nothing else, that satisfaction of malpractice rates is in the eye of the beholder.
The New Hampshire medical community hopes, however, a panel would at least slow the rate of increases.
And right now that's the only plan the medical community will even consider.
Orthopedic surgeon Dr. Gary Woods.
1:57 Maine is the only panel we know of in the US that does work.
But that conviction will soon be tested.
A very different House version of the panel plan is on track to meet the Senate bill in a committee of compromise later this spring.
At this point a compromise doesn't appear likely.
For NHPR News, I'm DG.
Delicious
Digg
Reddit
Facebook
Google
Yahoo