Tuesday, January 18, 2005
Improving Virginia's bleak medical climate...
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Watts is immediate past president
of the Roanoke Valley Academy of Medicine
and is alternate director of
the Medical Society of Virginia.
I am concerned as a physician about the deepening crisis in access to health care for our patients due to skyrocketing malpractice insurance premiums, inadequate Medicaid reimbursement and the growing number of uninsured.
I applaud two recent commentaries, by Dr. William H. Cook ("Low Medicaid reimbursements imperil kids' health") and Dr. Eric Swisher ("As area physicians leave, lawmakers do nothing"), which eloquently discussed these problems.
I appreciate this opportunity to discuss several legislative solutions proposed by the Medical Society of Virginia in its 2005 legislative agenda, as well as some local solutions provided by old-fashioned volunteerism.
The medical society's tort-reform agenda will consist of four separate pieces of legislation that have been derived in part from California's successful Medical Injury Compensation Reform Act. Proponents of the California legislation believe it is responsible for keeping medical liability rates affordable for California physicians since it was enacted almost 30 years ago.
The Medical Society of Virginia proposals are as follows (as quoted from its literature):
• Legislation to introduce a $250,000 cap on noneconomic damages that would include a limit on attorney fees collected on noneconomic monies awarded.
• Legislation to eliminate the collateral source rule, so that evidence of money paid by collateral sources can be admitted into evidence.
• Legislation to require medical experts to certify, by affidavit, that the standard of care has been breached before a case can proceed.
• Legislation to protect physicians when patients leave their care against medical advice.
The Medical Society of Virginia will seek increased Medicaid reimbursement across the board, for all Virginia physicians. This would quickly expand the pool of physicians willing and financially able to participate in this program for the needy. Medicaid reimbursement rates have not been increased in more than a decade, and it is unreasonable to expect Virginia physicians to continue to care for these patients at a significant financial loss.
Last year, almost 3,000 Virginia physicians gathered in Richmond on White Coat Day to make their concerns heard by the General Assembly. The medical society will build on this momentum in its White Coats On Call campaign, in which smaller physician groups will meet with their legislators in Richmond.
Physicians in our district will meet on Jan. 24 and Feb. 9. The Roanoke Valley Academy of Medicine will charter bus transportation to Richmond to encourage its members to participate in this important program.
On the local level, the academy has partnered with the Bradley Free Clinic to create Project Access of the Roanoke Valley to expand the system of health care available to the area's low-income uninsured. Since its inception in May 2004, Project Access has served nearly 500 needy patients, and there are currently more than 400 physician volunteers participating at no charge. Though this program is only a safety net, it provides a quick solution to a growing problem.
I was distressed to learn recently that only eight out of 500 Virginia medical school graduates elected to go into obstetrics. A recent Roanoke Times article bemoaned the fact that neurosurgeons are leaving the eastern part of our state. High-risk specialties are finding it harder to stay in our state.
Though the current medical climate in Virginia looks bleak, there are solutions in the making. I invite the support of our area physicians, as well as the public, to push for legislative assistance to keep Virginia's endangered medical system intact. The future of our region and state depend on continued access to quality health care.
