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photo by Ben Hillyer
National reform needed, local doctor says
Published Sunday, November 8, 2009
It’s been five years since the Mississippi State Legislature passed tort reform legislation, and Dr. Kenneth Stubbs remains just as grateful and just as vigilant now as he was then.
Though the number of medical malpractice claims has dropped by 91 percent from its peak, and the state’s largest medical liability insurer has dropped its premiums by 42 percent, Stubbs — the recipient of Natchezian of the Year award in 2008 in part for organizing local efforts drawing attention to tort reform — remains in a pre-tort reform state of mind.
“(Tort reform) has got to be a national mind-set,” said Stubbs, who practices internal medicine in Natchez. “Unless there is uniform tort reform, you’re still not going to see the full impact.”
Under current law, individuals may pursue civil claims against physicians and other health care providers for alleged torts — breaches of duty that result in personal injury. Mississippi legislators in 2004 put a $500,000 cap on pain-and-suffering or non-economic damage awards in medical malpractice cases, ending the state’s reputation as the “judicial hell hole for jackpot jury verdicts” — a phrase coined by Gov. Haley Barbour.
Frivolous lawsuits hit their apex in Jefferson County, where a pharmacist was named in more than 1,000 lawsuits. A Jefferson County jury awarded $1 billion to the family of a woman who had taken the drug Pondimin, a weight loss remedy known as fen-phen that is now off the market.
Due to the fears of high-award lawsuits, some doctors did not prescribe drugs that had not been on the market for at least five years.
A Congressional Budget Office analysis conducted last month concludes tort reform lowers health care expenditures, and a national tort reform package would reduce national health care spending by about 0.5 percent, or $11 billion in 2009.
The analysis also concludes a national tort reform package would reduce mandatory spending for Medicare, Medicaid, the Children’s Health Insurance Program and the Federal Employees Health Benefits program by roughly $41 billion over the next 10 years. Ultimately, a national tort reform package would reduce federal budget deficits by roughly $54 billion over the next 10 years.
Stubbs said if the federal government were to pass a national tort reform package, it would further dispel notions of Mississippi being one of the most litigious sates in the union.
“When (federal legislators) talk about tort reform, they never say Mississippi. The national leaders never mention we’ve reformed our laws,” Stubbs said. “I don’t know why our federal politicians haven’t thrown our name in the hat as a state that has amended our laws.”
Stubbs said the pre-tort reform mind-set still lingers in the medical community, which makes it difficult to recruit doctors to the state.
“When you talk to residents and students at distant medical schools, they don’t want to come to Mississippi, and part of what they mention is tort reform,” Stubbs said.
“You tell (the students) about the tort reform legislation, but the preconceived notion is, ‘Mississippi is a bad tort reform state, and you’re still the poorest state in the union. I don’t want to go there.’”
The Effect
Rep. Sam Mims (R-McComb) counters Stubbs’ argument that Mississippi has received no credit for its tort reform legislation.
Mims, who voted in favor of tort reform in 2004, said the legislation has made a tremendous impact in the state.
“We have seen the credit and will continue to see the credit for years to come,” Mims said.
“It was the most comprehensive package ever passed in the legislature, and I think other states across the nation have looked to us,” Mims said.
“We’ve seen the effects of doctors leaving and hospitals closing because of frivolous lawsuits in Mississippi,” Mims added. “I talk to doctors and they often tell me their insurance rates continue to decline because of the legislation we passed, so it’s not only making a difference from an economic standpoint, it’s making a tremendous difference from a medical standpoint.”
Immediately after the legislature passed tort reform legislation, business began to trickle in, Mims said. Toyota chose Mississippi over about a dozen other states for a new $1.2 billion, 2,000-worker auto plant. The automaker insists it will pull up stakes if the legislation is overturned.
“We know for a fact companies were staying away from Mississippi because we were having a lawsuit abuse problem,” Mims said.
“Toyota would not have come to Mississippi if we had not passed tort reform. To me, it shows the rest of the country and the rest of the world we are open for business and we want business to come to Mississippi, especially southwest Mississippi.”
Like Stubbs, Mims is in favor of national tort reform, and believes the issue is not getting the attention it deserves in Washington, D.C.
“We need to see a comprehensive tort reform package in the federal government. It would be a tremendous savings to us,” Mims said. “I do wish that the officials in Washington would focus on passing tort reform like we did here in Mississippi.”
Stubbs said a national tort reform package would lower barriers between neighboring states. Stubbs’ medical liability insurance is through Medical Assurance Company of Mississippi, which assures about 70 percent of doctors in the state.
According to MACOM policy, a Mississippi physician cannot reside in Louisiana, a Mississippi physician cannot perform surgery in Louisiana and 25 percent of a Mississippi physician’s income cannot be generated from another state.
If national tort reform was enacted, Stubbs said, such stipulations would not exist.
“If a doctor in Baton Rouge has certain expertise to set up a clinic (in Natchez), he could,” Stubbs said. “It would be much easier to get specialty physicians to serve areas if there was uniform tort reform.”
Stubbs and Mims both agree national tort reform is an issue southwest Mississippians should get behind. The first step, they say, is putting in a call to the state’s federal legislators.
“Contact your federal congressmen and senators and say, ‘Hey, if there’s going to be any health reform legislation, it should include tort reform.’ That cry has been echoed by many people,” Stubbs said.
Not done yet
Since Mississippi passed tort reform legislation, Stubbs said his malpractice insurance premium has plummeted by 10 percent each year over the last four years.
Stubbs said his premium was $3,600 a month for he and his two partners before tort reform. Now, his premium is $2,580 a month.
“(The legislation) directly improved expenses for my practice, but again I think it will take years for a (new mind-set) to set in.”
Stubbs, who was sued 11 times before tort reform passed, said doctors still practice defensive medicine when doctors run tests a patient might not need to avoid litigation.
“You can’t go into the emergency room with chest pain, and not get a CT angiogram, an EKG, x-rays and chemistry labs, and I’d be surprised if you don’t leave with a $5,000 bill,” Stubbs said. “But it’s not on the doctor’s nickel, it’s on the patient’s nickel and that happens every day. It’s so ingrained in the thinking process.
“(A lawsuit) basically says you’re an evil and bad doctor and we’re going after you,” Stubbs said.
“Patients don’t understand the impact that has on you — the way it impacts applications for insurance, loans, hospital privileges. It’s great emotional distress, and it was all for nothing.”
Comments
Posted by ntzslums (anonymous) on November 8, 2009 at 7:32 a.m. (Suggest removal)
"According to MACOM policy, a Mississippi physician cannot reside in Louisiana, a Mississippi physician cannot perform surgery in Louisiana and 25 percent of a Mississippi physician’s income cannot be generated from another state."
Well, at least one hospital and one the majority of physicians that hasn't let this policy effect the way the do business. Hats off to ALL those that keep ALL their business in Mississippi and didn't run across the state line.
Posted by ucantfixstupid (anonymous) on November 8, 2009 at 7:37 a.m. (Suggest removal)
tort reform is there Stubbs, now lets call it SAFETY OF THE PATIENTS. Doctors make mistakes also.
Posted by happyreader (anonymous) on November 8, 2009 at 8:23 a.m. (Suggest removal)
ntzslums, it's not the job of doctors to "keep ALL their business in Mississippi". If you're being financially and emotionally bled dry by opportunistic parasites in one location, you'd be crazy not to go somewhere that's more welcoming. Doctors are just like everybody else; they have to do what's best for their families.
And ucantfixstupid, doctors do make mistakes. But the whole point is that doctors are having to go to extreme, unreasonable lengths to cover their behinds because it has become accepted in certain circles to automatically sue if a patient gets worse. Most insurance companies would rather settle out of court than spend the money to fight a lawsuit, so it's usually an automatic payoff for these leeches. (Which then drives up the overall costs of health care.) It's like doctors are guilty until proven innocent. What if every health care professional decided that they couldn't handle the risk that they might make an honest mistake and left the field? That's basically what these "lawsuit hotspots" do to their health care... they just drive it away. Guess now they have to find someone else to sue.
A close family member of mine was a health care provider who had to deal with several frivolous malpractice lawsuits. After having just left court one day, he ran into a patient who was suing him. The patient basically told him that no personal offense was intended, but that he wanted to see if he could suck some money out of the malpractice insurance company. This kind of persecution of health care providers happens in courts EVERY DAY, so I have no sympathy for communities that harass their physicians right on out of town so that they have no one.
Posted by pollym44 (anonymous) on November 8, 2009 at 8:31 a.m. (Suggest removal)
I don't think people see dr's as evil, however having a kidney REMOVED when the problem was a bad kidney infection that could have been TREATED with drugs WOULD tend to support "BAD".
Posted by ntzslums (anonymous) on November 8, 2009 at 8:55 a.m. (Suggest removal)
happy reader, your "health care provider" is probably one of the very ones that doesnt mind GETTING money from a lawsuit, just as long as they are not the ones GIVING it.
and as far as doing what is "best for their families"; are you saying that the doctors that kept their practices in natchez were not concerned about the financial well being of their family???
Posted by itsmemame (anonymous) on November 8, 2009 at 9:11 a.m. (Suggest removal)
I commend Dr. Stubbs and all who worked diligently to get tort reform passed in MS, however, all of their work will be for naught if the Obama-Pelosi-Reid health care plan is passed. Physicians will be, in essence, working for the government. Not only should tort reform be nation wide but we all must fight to block government takeover of the system.
Posted by happyreader (anonymous) on November 8, 2009 at 9:19 a.m. (Suggest removal)
"happy reader, your "health care provider" is probably one of the very ones that doesnt mind GETTING money from a lawsuit, just as long as they are not the ones GIVING it.
and as far as doing what is "best for their families"; are you saying that the doctors that kept their practices in natchez were not concerned about the financial well being of their family???" - ntzslums
And you know this about my family member how...? My family never took part in any lawsuit. We preferred to actually earn our income. I'll thank you to not degrade my family, whom you have never even met and know nothing about.
No, I'm not insulting the doctors who stayed in Natchez. Did I say that? If the benefits of staying in MS outweighed the difficulties, more power to them. But I also don't fault those who couldn't take it any more and determined that it was no longer working for them and their families.
Posted by Barrister (anonymous) on November 8, 2009 at 2:46 p.m. (Suggest removal)
It is absolutely amazing to me that these doctors want everybody to feel sorry for them. No one feels sorry for me when my insurance rates rise. I simply pay up.
It would be refreshing to hear one of these doctors speak about patient care for a change. I don't want a politician, I want a careful, well-trained, caring doctor.
I wonder whether Dr. Stubbs treats his patients with dignity and respect? Or, does he triple book, subject patients to unreasonable wait times, do "drive-by" type examinations, and then drop the ball by failing to order necessary tests? Is he one of those high and mighty doctors that refuses to see poor people and talks down to his patients? I just wonder. . . .
If Dr. Stubbs is of that ilk, as are alot of the doctors which we are programmed to be so darned grateful that they live amongst us, ARE WE REALLY BETTER OFF?
I say go malpractice on another community . . . .
Posted by happyreader (anonymous) on November 8, 2009 at 3:06 p.m. (Suggest removal)
Barrister, just what do you suppose causes your insurance rates to go up?? I'll give you a hint. When doctors have to order lots of redundant tests - on the off chance that they might have to prove to a jury that they AREN'T out to kill their patients - your insurance company picks up the tab.
You seem to have a great deal of cynicism and suspicion of doctors in general. I don't know Dr. Stubbs personally, but I don't automatically assume the worst of him as you have. What has he ever done to you, that you would question his decency and professionalism? And then, right after that, you made a negative, sweeping generalization about most of the doctors in the Miss-Lou area. Honestly, I read some of the comments on this board, and I wonder why anybody would want to hang around and practice medicine in Natchez. Talk about a hostile environment.
Posted by mrbobo (anonymous) on November 8, 2009 at 7:30 p.m.
(This comment was removed by the site staff.)
Posted by ucantfixstupid (anonymous) on November 8, 2009 at 8:22 p.m. (Suggest removal)
AFTER WATCHING c-span THE LAST 2 WEEKS, THE REPUBLICANS DON't have a clue. There is only one thing that is for sure------ GREED. The Insurance Co. tell them every thing to do. I am going to change Parties real sonn if the Republicans don't stop the money laundring for big MONEY reasons. I say we as small people RULE-----------. to Hell with big MONEY IDEAS.
Posted by beetlejuice (anonymous) on November 8, 2009 at 8:40 p.m. (Suggest removal)
It is just me, or does it seem like Ken Stubbs likes to have his name in the paper - he seems to be the only one talking and may not represent all the MissLou docs
Posted by niderbip (anonymous) on November 8, 2009 at 9:46 p.m. (Suggest removal)
it's certainly not his fault if he's 'the only one talking'.
Posted by Barrister (anonymous) on November 9, 2009 at 6:54 a.m. (Suggest removal)
@ happyreader - In response to your criticisms, I am forced to remark that you seem so much for the doctors it make me wonder why?
Why do you assume that I am talking about health insurance? I don't know your personal experience but I am quite familiar with the wranglings that doctors must go through with insurance companies to get the tests paid for that patients actually need to. An example is when the insurance company will only pay for x-ray when the doctors needs an MRI. Do you want your insurance company calling the shots or your doctor?
Natchez doctors have aligned themselves shamelessly with the insurance companies and AGAINST the patients. You can call it what you want, the proof is in the pudding. And, to be honest, the quality of health in Natchez is sub-par, at best. But, even with that said, in that bucket of basically bad apples, there are a few that actually care about their patients and not JUST their bottom line.
My family has been effected by the negligence of two different physicians in Natchez - one instance was discovered in 2008 the other happened in 2008. Guess what? We have not sued the doctors. We got our loved ones out of Natchez to receive better care. The out-of-town doctors told us in EACH instance that the Natchez doctors committed medical errors. Failure to diagnose when the conditions were TEXTBOOK for one. /the other was failure to check kidney function when they giving a strong antibiotic to an elderly patient.
So, you tell me happyreader - who has the right to be hostile? We choose to consider ourselves blessed instead.
Posted by Krogers (anonymous) on November 9, 2009 at 2:17 p.m. (Suggest removal)
there's nothing wrong with getting a second opinion, and asking questions to be sure you are comfortable with the treatment.....
the Republicans have presented a bill- only 200 pages and it has good ideas in it- tort reform being one.....
the other liberal bill is 2000 pages, no one believes it will do the job of lowering costs
I hope it is defeated....
Posted by happyreader (anonymous) on November 9, 2009 at 5:48 p.m. (Suggest removal)
"@ happyreader - In response to your criticisms, I am forced to remark that you seem so much for the doctors it make me wonder why?" - Barrister
It's not some sinister secret, Barrister. It's because I can see the other side of the story. I come from a family of health care providers (not in the Miss-Lou), and I have training and experience in healthcare myself. I know how hard those jobs are. I have tremendous respect for those who can get up every day and go in to work to try to help and/or save lives. They have to live with the reality that they can't do the job perfectly, but the vast majority of them try to do the very best they can.
Personally, I can say that the smartest, most considerate physician who has ever taken care of me was one I found in Natchez. I won't name his name here, because he has done nothing to deserve the mud-slinging-fest that I'm sure would ensue from some. I'm very sorry to hear that your family suffered from health complications as a result of negligence. One of my loved ones also suffered a catastrophic illness that resulted in disability which was likely as a result of a pharmaceutical issue... only it happened in a big city hospital with an excellent reputation. (And they didn't sue either.) It's tragic, but it does happen everywhere, not just Natchez. : (
Ditto to you, Kroger! Keeping my fingers crossed and contacting my representatives...
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