Magazine article Clinical Psychiatry News

Malpractice Insurance Rates Hit Crisis Level. (Pennsylvania, West Virginia)

Magazine article Clinical Psychiatry News

Malpractice Insurance Rates Hit Crisis Level. (Pennsylvania, West Virginia)

Article excerpt

Although malpractice insurance rates are rising all across the country, the pain may be worst for physicians in two states: Pennsylvania and West Virginia.

In 1996, Pennsylvania raned among the cheapest one-third of states in malpractice insurance rates. Since then, the rates have risen 120%-150%, according to the state's Medical Liability Professional Catastrophe Loss (CAT) Fund. Pennsylvania and West Virginia are noteworthy for the rapidity with which malpractice premiums have increased.

Although some physicians in both states say they are being driven out of state, that has not yet been the case for psychiatrists, said Dr. Ira Brenner, a psychiatrist and psychoanalyst in private practice in Bala Cynwyd, Pa., and president-elect of the Philadelphia Psychiatric Society.

Philadelphia is the epicenter of the Pennsylvania crisis. The roots of the crisis are multifactorial, but two events contributed significantly, observers say.

First, the number of companies offering malpractice insurance in the Philadelphia area has dropped from seven to three in the past 5 years, leaving physicians with fewer choices.

The second event was a $100-million malpractice award in the case of a 26-wee-old neonate injured during surgery that was brought against four physicians and two hospitals. The award was the largest in Pennsylvania history and the third largest in the nation in 10 years, according to a report from Jury Verdicts Research, Horsham, Pa.

That case was not an aberration, but indicative of a malpractice-suit-friendly climate in Philadelphia, observers say. In 1998, Philadelphia had the second-largest average malpractice award of any city in the nation, behind Washington, D.C.

Awards lie these deplete the CAT fund and increase the amount all physicians in the state--regardless of specialty--must pay into it annually. That's a separate cost over and above malpractice insurance, and many of the high-cost claims are not publicized, so psychiatrists often see their CAT costs go up without nowing why, irrespective of their own personal record or the records of psychiatrists in general, Dr. Brenner said.

If costs to physicians become prohibitively expensive, patient care is compromised, he said. With the expansion of managed care, more experienced psychiatrists have outpatient practices and are reluctant to accept referrals due to malpractice riss and limits on inpatient treatment. As a result, many of the sicest patients are treated by the least-trained psychiatrists.

Dr. Kimberly Best, a psychiatrist at Albert Einstein Medical Center in Philadelphia and past president of the Philadelphia Psychiatric Society, echoed this sentiment. …

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