Thursday, December 30, 2004
As area physicians leave, lawmakers do nothing
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Swisher is an obstetrician in Roanoke. Despite escalating insurance costs and out-of-control medical liability claims, it has become obvious that there is no plan for legislative relief to the plight of our health-care system. Our community is beginning to lose physicians, and I fear the trend will only worsen.
My ob/gyn group, which was once a 12-physician practice, saw two young physicians leave in 2002-03. We expect to lose two more this year. The Lewis-Gale physician community has encountered a similar exodus.
I cannot help but worry that the increasing pressure of liability, stagnant reimbursement and skyrocketing malpractice insurance premiums will continue this trend. At least one physician in our community will retire early at the end of this year after an insurance premium increase to nearly $100,000.
It has become obvious that every physician in my specialty is simply a single lawsuit away from being priced out of practice by liability insurance premiums. With no claims, my premium increased 37 percent this year, to $50,000. I cannot afford further premium increases. I love practicing medicine, but not enough to fight this fight indefinitely and to the detriment of my family's finances.
The current problems with medical liability and the affordability of health care promise to have far-reaching implications. Even as fewer physicians remain in practice, this loss of providers is compounded by the shrinking numbers of new physicians willing to train in high-risk specialties.
This year, the obstetrics and gynecology residency programs were able to fill only 70 percent of positions with U.S.-trained physicians. A paucity of physicians in rural areas has been an ever-increasing problem, and now this promises to extend into more urban areas as training programs fail to fill. Driving long distances for specialty or even primary care will become more common.
I expect that the financial challenges of practicing obstetrics and gynecology will impact not only our access to care, but the quality of that care will suffer. I also expect that the threat of litigation will limit the procedures and services many physicians are willing to provide.
Once we have let this world-renowned health-care system falter, it will take decades to rebuild with new trainees.
Fortunately, the challenges that face medicine today have not prevented Anthem from paying CEO Larry Glasscock a $42.5 million package for his company's success. Atlantic Information Services also reported $16 million payouts to Anthem Vice President David Frick and Chief Legal Executive Officer Michael L. Smith. I suspect that the increased premiums passed along to the public have been useful in funding these financial rewards.
If your health-insurance costs have increased, do not be fooled into thinking that the health insurance industry is not reaping staggering profits. I also urge you not to assume that the increased costs of health care are enriching your physician. Physician compensation has been decreasing steadily over the past 10 years.
I realize that the concerns of the medical community are still largely drowned out by the powerful trial lawyers' groups, but I urge this community and our legislators to be more proactive in the effort to salvage our health-care system. Legislation continues to falter, and public support is the only means of rescuing our health-care system.
The current model allows excessive awards in the legal arena to sacrifice what is temporarily the best health-care system in the world. If you were waiting for communities to lose physicians and access to care, as we saw in West Virginia and Pennsylvania last year, it is now happening in Virginia.
