JACKSON &045;&045; A Natchez physician told lawmakers Friday that doctors are leaving Mississippi or have announced plans to do so.

Those doctors have said the cost and, in some cases, the lack of medical malpractice insurance is a major reason for their departure, said obstetrician and gynecologist Dr. Tom Carey.

The insurance shortage is due to lack of tort reform, such as caps on non-economic damages and limits on venues where cases can be heard.

Carey, as president of the local Homochitto Valley medical Association, testified Friday to a legislative committee studying solutions to the insurance crisis.

Take Dr. Kim Cadle, a pediatrician who recently moved from Natchez to Arkansas. In May, insurance provider Medical Assurance Co. of West Virginia wrote Cadle and partner Dr. Jennifer Russ, telling them their coverage would expire in 30 days.

Cadle called the company &uot;and asked them if they would continue to provide her malpractice insurance if she left Mississippi,&uot; Carey said. &uot;(They) informed her that they would be happy to insure her to practice pediatrics in Arkansas.&uot;

That shows the insurance crisis &045;&045; at least, to this extent &045;&045; is unique to Mississippi, Carey told legislators.

Carey’s own insurance costs have gone from $39,809 to $60,205 in four years.

&uot;And two weeks ago my carrier warned me to expect a rate increase of 20 percent for 2003,&uot; Carey said.

Largely due to the insurance dilemma, it is difficult to recruit doctors, making needed specialties hard for patients to find locally.

For example, Carey has tried unsuccessfully for two-and-a-half years to recruit another gynecologist to town.

In 2001, 961 babies from six counties and parishes were delivered in Natchez, according to Carey’s figures.

&uot;A year after I moved to Natchez, there were seven physicians delivering babies, and I was part of a four-person practice,&uot; Carey said.

&uot;Today in Natchez, there are only three physicians delivering babies, and I am the only physician in my group who delivers.&uot;

At the same time, other areas are trying to recruit Carey, and so far this year he has received two to three times the normal amount of recruitment mailings he usually gets.

Louisiana officials are wooing Natchez doctors to start a hospital in the state &045;&045; and some are on the verge of taking them up on the offer.

That scenario &uot;is a better thing for us than for other areas of Mississippi, where physicians are leaving their communities entirely,&uot; Carey said.

&uot;At least if our doctors move to Louisiana, pregnant women will only have to drive 10 or 15 minutes to deliver their babies rather than (one hour) in many parts of Mississippi.&uot;

And largely due to a lack of tort reform, many doctors are reluctant to prescribe medications that have not been on the market at least two to five years.

&uot;If there wasn’t an advantage to these new medications, they (drug companies) wouldn’t keep producing them,&uot; Carey said.

He told legislators the main tort reform doctors are calling for is a cap on non-economic damages in lawsuits.

Yet legislators themselves struggle with what maximum price to place on a plaintiff’s pain, suffering and loss of wages, said Rep. Bobby Moak, a committee member from Bogue Chitto.

&uot;How do you put a cap on that?&uot; Moak said.

Rep. John Eads of Oxford warned Carey to expect reforms to take three to five years to implement. &uot;And you’re saying the crisis is right now,&uot; he said.

Meanwhile, Moak said the committee should issue its report by mid- or late August. &uot;The committee knows there is a problem,&uot; he said.