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A word from President Michael Blaiss, M.D.

Malpractice reform now!

I just received my malpractice insurance premium notice for 2004. It is $9,534 for this year, up from $7,423.00 in 2003. That’s a $2,111 difference — about a 28-percent increase!

You might be thinking that I was sued last year. Wrong! I have only been sued once for malpractice — when I was a resident. I was dropped from the case when it was pointed out that I had seen the infant in the NICU two months after the event that led to the malpractice charges.

I recently received a letter from one of our colleagues in the South. He writes: “Our overhead goes up; the premium we pay to the insurance companies never goes down but goes up every year, and yet our fees go down — forced on us.”

The Wall Street Journal reported Jan. 27 that the malpractice insurance problem is getting so bad in Florida that up to 5 percent of physicians there are “going bare.” They are working without malpractice insurance and have sheltered their assets. Is there anything we can do about the malpractice mess?

Last year, it looked like we might get some relief from Capitol Hill. The House passed legislation that:
• Capped non-economic "pain and suffering" damages at $250,000
• Limited punitive damages to two times the amount of economic damages
  or $250,000, whichever is greater
• Allowed for periodic payment of damage awards
• Eliminated double payment of awards
• Provided for proportionate liability among all parties
• Limited contingency fees that lawyers charge their clients, using a sliding
  scale based on the amount recovered by the plaintiff

Unfortunately, this bill failed to get out of the Senate. In a Jan. 26 speech in Little Rock, Ark., President Bush pushed again for malpractice reform. "People ought to be allowed to recover from economic damages," Bush said. "But for the sake of a strong healthcare system, for the sake of making sure healthcare is accessible and affordable, we need a $250,000 cap on non-economic damages."

In the January 2004 issue of Health Affairs, Ken Thorpe reported that in the 24 states where medical malpractice awards are capped by state laws, physicians paid malpractice insurance premiums that were 17-percent lower than doctors in other states. He also noted that 60 percent of all settlement payments and jury awards are consumed by administrative costs and attorneys' fees. Just 40 percent of the awards in successful malpractice claims are received by patients.

Malpractice reform with the capping of awards is an important first step, but it is not the total answer. Again, Thorpe found that “the number of claims is rising and many of the claims turn out to be frivolous. In Louisiana, there is a $500,000 cap on awards, but there is an average of 30 claims per 100 doctors, compared with the national figure of 15 claims per 100 doctors." It is going to take major changes to bring this crisis under control.

What can you and the College do to help bring about change in the malpractice laws? You can work to influence your state representatives to back malpractice reform in your state. You can contact your elected officials in the House and Senate. Let them know your desire for action on malpractice reform. The more letters and calls generated, the more likely we can obtain the needed votes for changes in the laws. To contact your senator, visit http://www.senate.gov/general/contact_information/senators_cfm.cfm .
To contact members of the House, visit http://www.house.gov/writerep/ .

Bill Dolen, the College vice president, and I will be attending the AMA President’s Forum in Washington, D.C., this month. This meeting brings together the officers of the national medical societies with state medical officers to discuss common issues and work together on important matters for all physicians. Malpractice reform will be high on the agenda for this gathering.

The College also will sponsor a Capitol Hill Day on April 29. ACAAI officers will meet in Washington, D.C., with their elected representatives to voice concerns about important issues for the practicing allergist. I can assure you that one of the most vital topics for discussion will be malpractice reform. I believe the College needs to be more active in national issues affecting medicine and the allergy community. Our voice will be heard in Washington, and hopefully the Capitol Hill Day will become an annual trip for College officers.

I want to close with a quote from President Bush’s Little Rock speech. “Lawsuits don't heal patients. That's a fact. And they're driving a wedge between the docs and their patients. One of the most vital links of good medicine is the doctor-patient relationship. Yet many doctors fear what they tell a patient will be used against them in a court of law. We've got a culture of lawsuit here in America — a culture of lawsuits — a litigation culture, which is driving a wedge between the doctors and patients, and that's not right. When docs treat their patients, the only thing they should worry about is the health of their patients, not some trial lawyer breathing down their neck.”

Michael S. Blaiss, M.D.

Register now for the ACAAI Nationwide Asthma Screening Program
ACAAI members who are interested in participating in the 2004 Nationwide Asthma Screening program must register by March 15. Registration forms are posted on the ACAAI member Web site at www.acaai.org and information is available by calling the Help Line at (312) 558-1175.

Funded by an educational grant from AstraZeneca, the 2004 program includes a special state capital screening initiative. The initiative is based on success of pilot screenings in state capitals conducted in 2003. The sites were among 371 conducted at locations across the country.

Once members complete a registration form, the College provides a Site Selection Checklist with information about choosing a site and securing equipment for a screening. Tips on scheduling a state capital screening also are provided. A manual and kit of public education materials for conducting a program is provided after allergists report a screening program date and location.

Screenings are best scheduled for May, which is Asthma and Allergy Awareness Month and when the College conducts national publicity about the screening program. More than 73,500 adults and children have participated in the national screening program since it was first launched in 1997, and half of those have had symptoms suggesting referral for a professional diagnosis.

Allergy Practice Tip 4: Referral drop-off?
Advice from The Patient-Centered Allergy Practice
Track the number of patients referred each month from other practices. If the numbers start to change, call the referring physicians to find out why.

These tips are drawn from site visits in practices nationwide, conducted as part of The Patient-Centered Allergy Practice, a CME Series in Practice Management, supported through an unrestricted educational grant from Aventis Pharmaceuticals and endorsed by the American College of Allergy, Asthma & Immunology.

Join us for our next audioconference, “How to Make your Allergy Practice an Employer of Choice – an 8 Step Approach,” from noon to 1 p.m. Eastern time March 9. Call 800-251-4920 or e-mail info@physicianspractice.com for free registration and to get the handouts.

Compliance training right at your desktop
Medicare excluded an average of 5.8 physicians per day between January and June 2003 because of fraudulent billing practices. The office of the Inspector General of CMS has essentially mandated that all physicians implement a compliance plan that will help prevent this kind of outcome.

The JCAAI has developed a compliance plan specifically for allergists. It is Internet-based and available 24/7. It is more than a compliance plan, however. It is also a business plan. It has been developed in association with Karen Zupko and Associates, a practice management consulting firm. It is a plan not only for physicians, but, as required by CMS, for all of your staff.

The price is far below the price for any other compliance plan. If you are a JCAAI member, the cost is $180 for a one-physician, five-employee office. If you are not a JCAAI member, the price is $360, and also includes a one-year JCAAI membership, so you can find out what you are missing. For more information, visit http://www.jcaailearn.org.

NAEPP launches new school asthma program
The National Asthma Education and Prevention Program is offering a new asthma program for schools. “Managing Asthma: A Guide for Schools” is available on the Web at www.nhlbi.nih.gov/health/prof/lung/asthma/asth_sch.htm.