DO - Ohio University College of Osteopathic Medicine

Wright is not alone. In 2004, 96 percent of the Ohio
Department of Insurance survey respondents said his or her
malpractice rates jumped by an average of 39 percent over
2003. More than a quarter were paying more than $50,000
a year, and one in five physicians was paying 20 percent of
gross annual income for insurance. Obstetrics and gynecology
physicians responding to the survey reported paying more
than 30 percent of their annual income to malpractice insurers.
Wright says that, financially, the high premiums hit
younger physicians harder, considering many are already in
debt from their education, practice start-up and young families.
“It can be a balancing act,” she says.
The Ohio insurance survey warned that malpractice insurance
premium increases are impacting Ohio doctors in a
variety of other areas, including influencing where physicians
see patients, what type of services they offer, how they provide
treatment and what business practices are forced upon
them, such as reducing staff.
Alumni of OU-COM can attest to that.
“ I had to find a stable climate and
not worry about a paycheck at
the end of the day.”
Michelle Wright, D.O.
The malpractice insurance crisis was a factor in George
Abate’s decision to locate his practice in Indianapolis. His
attendings warned him of how expensive it would be to
practice in Cuyahoga County, according to Abate, D.O.
(‘02), who at the time was completing his residency at
northeastern Ohio’s Metrohealth System. The issue also
impacts how he treats patients and the costs associated with
their care.
“As a resident we’re already taught to be defensive and more
aware,” Abate says. “You have to order more tests than may
be warranted, but (if you don’t, you) worry about missing a
breast cancer or something that may be indicated from an
MRI, which then adds more costs and more tests. That is
going to affect patient care.”
Abate also feels that the high malpractice insurance rates
reflect an even greater problem for medical care across the
board. “The rising cost of health care overall has the potential
to bankrupt the country,” he warned.
A nontraditional student while at OU-COM, Abate says his
perspective on the issue may be somewhat different than
younger colleagues. Along with other physicians, lawmakers,
educators and experts, Abate blames growing malpractice
lawsuits and astronomical plaintiff monetary awards.
“There need to be caps on claims,” he says. “If there is
harm to a patient, then they should be appropriately
reimbursed...Part of the problem comes down to the size
of the awards.”
That is one perspective, but Ohio’s cap for awards in
malpractice lawsuits, enacted nearly two years ago, has yet
to show any significant difference in premiums, several
physicians and insurance officials says. Legal experts report
that insurance companies tend to wait before stabilizing
premiums to see if such legislation will be overturned by
the courts.
Patrick Muffley, D.O. (‘97), who returned to his native
Southeastern Ohio to practice at Holzer Medical System of
Gallipolis and Jackson, agreed that Ohio’s cap has yet to
stem the problem, and no one knows how the courts will
respond. “Look at Wisconsin, which enacted a cap, then
was challenged and repealed,” he says. Muffley says some
changes in current law, such as requiring medical experts to
testify harm has been done to a patient before a lawsuit is
even filed, might bring more responsibility to the system.
Muffley, who relocated from Maine, saw his insurance
premiums eased by participating in a large group practice,
which is partly self-insured and helped reduce costs, he
says.
“It is affecting the way we practice medicine,” he says of
the more serious consequences litigation spawns. “When
you look across the country and see how the c-section rate
has jumped 30 percent, I think that is a response to avoid
possible future litigation. Muffley says physicians hasten to
order c-sections earlier than they might like because there
are too many malpractice cases in which plaintiffs claim a
c-section was done too late.
Janet Zurovchak, D.O. (‘88), agrees. She practices in Logan
County in western Ohio, where she’s delivered many babies
in a Bellefontaine, Ohio, hospital. “I don’t wait as long before
doing a c-section if there is anything that might be wrong
because this is a smaller, community hospital,” she says. Her
hospital doesn’t have a full-time anesthesiologist, and it can
take 30 minutes or longer to summon one or transfer a
patient to a larger metropolitan hospital in Springfield or
Sydney with better facilities, she says.
Higher premiums also changed Zurovchak’s practice in
another way. Her three-physician practice was forced last
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