As a practicing OB-GYN in Tampa and Florida Medical Association president, I was dismayed to read the recent St. Petersburg Times editorial, "Devaluing the lives of poor, elderly." The FMA finds the editorial's references to medical liability reform passed during the 2011 legislative session to be misleading.
The FMA, which represents more 20,000 physicians, across the state, worked hard this session to pass medical liability reform, including a provision addressing expert witness testimony — a measure we've been working to pass for over a decade. We've prioritized the passage of these reforms to increase access to care for all patients and ensure that there are enough physicians to treat them.
Unfortunately, the Times' editorial specifically targets HB 479, saying it forces "additional state regulation on medical expert witnesses. … The goal is to make it harder for personal injury lawyers to bring cases by intimidating and harassing the pool of medical professionals willing to testify."
In reality, HB 479 helps to fix a system in which out-of-state expert witnesses come to Florida and generate large fees by providing inaccurate testimony, knowing they can do so without being held accountable by the law or by reputation among their local peers. Requiring expert witnesses to obtain a certificate is about ensuring accountability, not harassing experts.
Patients and physicians deserve a system that is equitable and holds all experts accountable for their testimony. What the Times editorial fails to point out is that other states have already taken this approach, requiring physicians to be fully licensed in-state in order to testify in state malpractice cases.
The new requirements apply equally to experts for the defense and the plaintiff. Again, the Times editorial failed to explain that these measures will, in fact, increase the quality and accuracy of medical malpractice case outcomes by holding all expert witnesses to the same standards to which Florida physicians are already subject.
Passing legislation such as HB 479 makes Florida a friendlier place to practice medicine. This year, private practice physicians' offices support an estimated 486,700 jobs statewide, provide $3.4 billion in government revenue, and generate nearly $62 billion in overall economic impact for Florida. Each private practice physician alone supports an average of more than 19 employees.
Yet Florida has a tough time attracting new physicians and retaining our homegrown physicians because of the state's dangerous medical liability climate. Florida ranks among the worst states in the nation for paid malpractice claims and payouts. Our medical malpractice premiums are by far the highest in the nation.
The impact of malpractice premiums alone affects the overall cost of health care by approximately $124 billion per year. In Florida, the average liability premium for an OB/GYN is $200,000 per year. This means that $2,000 of the delivery cost for each baby goes to paying insurance premiums. Meanwhile, a culture of defensive medicine has arisen in response to a pandemic of malpractice litigation. These costs are passed along to patients and health care providers.
Yet the Times editorial criticizes the Legislature for creating a "two-tier justice system, where the poor or elderly would no longer have their injuries due to medical malpractice compensated to the same extent as others" by placing caps on noneconomic damages awarded to Medicaid patients. A two-tier system already exists in health care: those who pay for their care and those who don't. These caps on noneconomic damages are an attempt to provide Medicaid recipients greater access to care by giving physicians more of an incentive to treat them. Having medical care provided by the state free of charge does little for the recipient who cannot find a physician accepting Medicaid.
Hospital reimbursement in the Medicaid program was cut approximately 12 percent this year. It has been years since physicians have seen a fee increase, despite rising overhead costs. If we are going to continue to pay physicians below-market rates to see Medicaid patients, the least we can do is provide some level of certainty regarding the amount of damages to which they could be liable.
Other states that have enacted tort reform, including Texas and Mississippi, have seen a significant decrease in liability insurance rates and a dramatic increase in the number of physicians opening practices.
Medical liability reforms such as HB 479 will make Florida a better place to practice medicine, positively affecting patients' access to care and Florida's economy.
Dr. Madelyn E. Butler is a Tampa doctor and president of the Florida Medical Association.