Description of the Problem

Unchecked increases in medical liability jury awards coupled with the resulting increases in liability insurance premiums threaten the affordability of and access to quality medical care in the District of Columbia, particularly in certain critical specialties. These increases add to the cost of health care, which translates into higher health insurance premiums for District employers and employees. These increases also reduce access to quality health care, as physicians leave the District or stop performing high-risk procedures to minimize their premium increases.

And so, a failure to enact health care liability reform in the District represents a failure to address a major source of health care cost escalation and to stem the growing problem of decreased access to high quality health care services.

The District is not alone. As the health care liability crisis became front-page news in 2003, stories abounded about physician work stoppages in states like New Jersey, Florida, Pennsylvania, and West Virginia in protest of rising professional liability insurance premiums caused in part by runaway medical liability verdicts. The American Medical Association has declared 20 states in the midst of a medical liability crisis and several other jurisdictions, including the District of Columbia, near crisis. The problem affects not only physicians, patients and employers, it also affects hospitals, nursing homes, health insurers, and other parts of the health care industry.

2004 Survey of OB/GYNs: Disturbing News from a Beleaguered Specialty

Preliminary results of a 2004 survey of 190 DC obstetricians and gynecologists conducted by MSDC confirm that escalating medical liability insurance rates are forcing these physicians—one of the groups hardest hit by high rates—to make tough choices. Of those who answered the question on how the rates are impacting their decision to practice in the District, nearly nine out of 10 (88%) indicated they have moved, plan to move, or are considering moving their entire medical practice out of the District. And, of those who answered the question on how the rates will impact retirement plans, more than nine out of 10 (93%) indicated they have retired, will retire or are considering retiring earlier than originally planned.
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2002 AMA Survey of DC Physicians: Problem is Only Going to Get Worse

A September 2002 survey of DC physicians by the American Medical Association indicates that increased liability costs are causing physicians of all specialties to make changes in the nature of services they provide and the location of where they provide them. Here’s how DC physicians responded when asked: "In the next 12 months, are you considering changing your practice due to increases in professional liability insurance?"

Source: American Medical Association

These results show that a substantial percentage of DC physicians are considering terminating services in the District and/or significantly reducing workload hours. More than 28% are considering relocating and another 22% are beginning to refer complex cases to others.

The Need for Reform in the District is Particularly Acute

The need for reform legislation that includes caps on non-economic damages is particularly acute in the District of Columbia. The District of Columbia ranks first or second in five categories used to rate states for medical liability performance, including average and total payments to patients per capita, frequency of payments, and defensive medicine costs.

Anecdotally, the Medical Society of the District of Columbia has collected information indicating that because of these premium disparities, physicians are increasingly indicating a willingness to relocate (or actually are relocating) outside of the District, or at least provide high risk services in the Maryland and Virginia suburbs, if nothing is done to control rising liability insurance costs. Indeed, the Board chair of the Medical Society of the District of Columbia, a rheumatologist who has established an office in Chevy Chase, in addition to his DC office, in an effort to lower his insurance rates, has stated that he will "pay half the medical liability premium [he] currently pay[s] for just crossing Western Avenue."