Medical malpractice in the health debate

On Sunday the obstetrics unit at Mercy Suburban Hospital in East Norriton, Pa. in Montgomery County will be shut down. The closure announced last year will take place four months earlier than originally planned due to dwindling resources and patients the hospital said.

As the sixteenth hospital to stop delivering babies in the Philadelphia region since 1999, Mercy Suburban could be exhibit A – really exhibit P – for advocates seeking to add limits on medical malpractice suits to the health legislation at the so-called bipartisan summit in Washington today.

The high cost of medical malpractice insurance for doctors and hospitals, particularly for obstetricians combined with low payments from insurers for delivering babies, is a prime cause of the closures of units such as the one at Mercy Suburban, Ken Braithwaite, regional executive of the Delaware Valley Healthcare Council of the Hospital and Healthsystem Association of Pennsylvania, which represents area hospitals said in a recent article.

“The failure to address these issues will likely lead to more OB closures.” Braithwaite said.

Opponents of restrictions on such suits, argue that the medical community needs to do a better job of reducing errors and policing itself. They could point to the case of Philadelphia doctor, Kermit B. Gosnell. The 69-year-old doctor had his license suspended after federal and state drug agents investigating on suspicion of illegal distribution of prescription painkillers raided his West Philadelphia clinic.

The state order suspending Gosnell's license said conditions at the clinic were "deplorable and unsanitary" with "blood on the floor and parts of aborted fetuses in jars."

It also said that an employee with no medical license routinely dispensed prescription drugs and performed medical exams while Gosnell was not at the clinic.

Gosnell's license had been temporarily suspended by the state board of medicine in 1996 for allowing a physician's assistant to treat patients. He got it back after paying a $1,000 penalty. And he was involved in a medical controversy 38 years ago, The Inquirer reported today.

The Philadelphia region has been at the epi-center of the clash over so-called tort reform. Since 2000 escalating malpractice costs led some in the medical industry to claim the health care system here would collapse without fundamental changes to the legal system.

The call for tighter restrictions on malpractice suits has been pushed by doctors’ groups, hospitals, business organizations such as the U.S. Chamber of Commerce and others for decades.

Even those doctors' groups that support aspects of the Obama Administration’s proposed health bill, have broken with the White House medical malpractice. For example, the Philadelphia based American College of Physicians said it supported caps on awards for pain and suffering and other so-called “non-economic” damages and other changes to limit lawsuits.

The issue has typically divided along party lines with Democrats opposed to lawsuit restrictions and Republicans in favor of limits. And during the last year, the malpractice issue has once again been divisive. Republicans and their allies have suggested suits drive up the cost of care as doctors order extra tests - practice defensive medicine - while Democrats and their supporters argue that more must be done to reduce medical errors.

Yesterday, the American Association for Justice, the Washington lobbying arm of plaintiffs’ lawyers said, “Over the last several months, opponents of health care reform have continuously used the medical negligence issue to distract from the real problems facing America’s health care system.  They have used distorted statistics, baseless anecdotes, or fictional talking points to attack the civil justice system and people who have been injured by medical negligence.”

The group points to the 44,000 to 98,000 deaths each year resulting from preventable medical errors. The lawyers’ group said it would “truth-squad” the health summit.

The proponents of limits on lawsuits were similarly engaged.

“Medical liability is a significant cost-driver in the medical system that has not been addressed in existing legislation,” the Chamber of Commerce argued. “Meaningful health reform must take on this subject by implementing caps on punitive damages that punish doctors and hospitals, creating specialized health courts, allowing medical expert panels to dismiss frivolous cases, making the loser of medical torts pay the other side’s legal expenses, and capping excessive trial lawyer reimbursements.”

In the meantime, women who had planned to deliver their babies at Mercy Suburban after this month were notified by the hospital in January that they needed to “arrange for an alternative provider to deliver their baby.”

“The community continues to have access to quality OB care from a number of hospitals-providers in Montgomery and Philadelphia counties,” the hospital said in a statement last month.