Note to Media: Tort Reformers Should Be Held Accountable for Their Claims

From Saturday's St. Louis Post-Dispatch: "Malpractice debate again puts Metro East under microscope," by Kevin McDermott. The article contained these unsubstantiated claims, among others:

Medical groups and their Republican allies claim an epidemic of frivolous suits against doctors, especially in the Metro East, has driven up malpractice insurance premiums. They claim the resulting exodus of doctors to other states has led to a crisis of scarce medical care in various parts of the state.

"The dirty little secret of Illinois is that the Madison County legal system has helped to create this crisis, and I think one of these days we're going to have to take that on," a visibly angry Rep. Julie Hamos, D-Evanston - an opponent of caps on litigation awards - said Friday in committee debate.

Like every newspaper article this past year, there is nothing to back up these claims--or others made in the article--about medical malpractice cases in Madison County, Illinois. The only real data about Madison County appeared only once, in a December article from the Belleville News-Democrat: "Report details malpractice suits," by Brian Brueggemann. According to that article, which was based on a report by the court clerk, there have been only eleven malpractice verdicts in Madison County since 1996. Doctors won seven. In the four cases won by plaintiffs, the amounts of the verdicts were $1.78 million, $470,000, $75,000 and $25,000.

These verdicts are nothing unusual for any area of the country, and are certainly not the cause of the "malpractice insurance crisis" in Madison County. In the period in which there were eleven verdicts, there were 269 cases filed, but there has never been any data presented about how these cases turned out (except that only eleven proceeded to trial). Who has the information? The insurance companies. One of them--Illinois Medical Insurance Inter-Exchange Mutual, or ISMIE--insures the majority of Illinois doctors.

But ISMIE's not talking. In the Post-Dispatch article, one skeptic said he thinks the "crisis" is trumped up:

Terrence J. Lavin, president of the Illinois State Bar Association, told the committee not to pay attention to media stories warning that Metro East-area doctors were moving to Missouri. He said he'd recently traveled to Missouri and saw media coverage there claiming that Missouri doctors were moving to Kansas to escape high insurance premiums.

"Every state where this goes, they say they're moving to the next state. ... They're scaring pregnant women to get this legislation passed," Lavin said. "... Forget the (information) they're selling on the front page of the Post-Dispatch or the editorial page of the (Chicago) Tribune. ... The 'crisis' is, too many doctors are injuring and killing too many patients without getting disciplined."

Lavin might be right. Around here, the doctors say "greedy lawyers" are causing them to leave Illinois and move to Missouri, but consider this headline, dated 5/2/03: "Malpractice 'crisis' drives docs from Missouri." No, the problem isn't the lawyers and judges of Madison County, Illinois. The problem is insurance companies and the doctors' failure to take them on. Don't believe me? If the Madison County legal system was to blame, then why are doctors and their press agents also claiming a "crisis" has occurred in Georgia, Florida, Nevada, New York, and Arizona?

I could make the list much longer, but I'll spare you the details. Everywhere you look, doctors who want more money (and who doesn't?) are blaming lawyers for their troubles. The doctors are right to think that lawyers are easy targets. But in targeting lawyers, doctors are being dishonest--and that's why they're no closer to solving their problems.

Related posts:

1. Doctors Battling Lawyers Open New Front Against Insurer (3/28/04)

2. Who's To Blame For The Malpractice Insurance Crisis? (3/25/04)

3. Did Crooked Executives Cause the Malpractice Insurance Crisis? (3/1/04)

4. Radical Doctor Proposes: Let's Heal Ourselves (2/13/04)

5. How to Make a Doctor Cry (1/14/04)

Comments

[Ted]

Evan, you and I both know that the bulk of medical malpractice claims get resolved in settlements based on both attorneys' perceptions of what a judge will permit a jury will deliver. So why do you persist in this transparently bogus use of a "verdict" statistic (which the newspapers are happy to repeat whenever a plaintiffs' attorney feeds it to them, including in the April 15, 2004 Belleville paper). First of all, it's simply not true that there is no data on settlements: it took me 90 seconds of googling to learn that the Edwardsville Intelligencer reported on March 15 that ISMIE Mutual has collected $26.6 million in premiums from Madison and St. Clair Counties in the last five years, but has paid out $33.5 million in claims. Even if its CEO worked for free, that translates into losing money. The average plaintiff payout in 2000 was $276,000, and jumped to $495,000 in 2003, and Madison County policyholders are 25% more often sued than other Illinois doctors. Anderson Hospital will be forced to turn away pregnant mothers, because it has lost 4 OB doctors in the last year. (The same article even mentioned your "never-mentioned" stat of eleven verdicts.)

So: doctors are leaving; payouts are outstripping premiums; insurance rates are going up to account for the increase in expected payouts; and uncapped damages and a runaway court system has resulted in a near-doubling in settlement costs over the course of three years. Sounds like a problem to me, unless you think Madison County doctors are particularly incompetent, and have gotten nearly twice as incompetent in the last three years.

[Evan]

Ted: In my post, I complained that Madison County is being unfairly blamed for a malpractice insurance "crisis" that apparently is happening throughout the country. Your comment proves my point, since the "statistics" you cite, which apparently come from this article, lump Madison County together with St. Clair County. St. Clair County is a separate county and is barely mentioned in the Post-Dispatch article.

I also said there is inadequate information about the cases filed in Madison County. Your numbers don't help. We can speculate on sound footing that some of the cases filed against doctors in Madison County were settled, but the vast majority were undoubtedly dismissed without the doctors' paying anything, since that is the nature of medical malpractice lawsuits--in the beginning, the plaintiff's lawyer is ethically and legally bound to sue every doctor involved in an incident, lest the lawyer blow a limitations period on a responsible doctor. Those doctors are later dismissed after the discovery stage of the lawsuit. Since the majority of payouts from doctors to plaintiffs is $0, the ISMIE's numbers about average payouts, which you cite, obviously do not include all cases, but are an average of payouts only in cases that settle. The true average is much, much less (and back to my initial point--why aren't these numbers published?)

Moreover, the verdict information I cite is very relevant because it serves as an indicator as to what juries will award in real cases, which is critical information to use in settling cases. In Madison County, juries are more friendly to doctors than to victims--as is true throughout the country.

Finally, the information about payouts outstripping premiums that appears in the article you cite is wrong (and aren't the numbers I was asking for, anyway): as ISMIE's website makes clear here (PDF), the numbers claimed to be "facts" in the article you cite are only estimates. Since medical malpractice claims often aren't paid out for many years after the claim arises, the premiums associated with the claims are held and invested; these days, the shortfalls are due more to low bond yields than anything else, in addition to incorrect estimates by the insurance companies.