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    Physicians wait for ACA malpractice impact


    A preview of what could happen in California if voters approve Prop 46 may be on display in Missouri. Two years ago that state’s Supreme Court overturned a law capping jury awards for pain and suffering at $350,000. Alan Weaver, DO, a solo family practitioner in the rural community of Sturgeon, says his premiums have gone from $1,350 to $1,600 per quarter as a result. Even so, Weaver considers himself fortunate.

    Weaver obtains his malpractice coverage through the nonprofit Missouri Doctors Mutual Insurance Company. “If I tried to get insurance through one of the bigger commercial groups the rates would be three to four times that. I know family docs paying $25,000 to $30,000 a year, without doing obstetrics,” he says.

    In practice for 27 years, Weaver says he stopped providing obstetric and gynecology services other than counseling and assisting in a local hospital’s emergency department (ED) about five years ago in order to hold down his malpractice premiums.

    Concern over rising malpractice premiums also caused William Thrift, MD, to eliminate some services to patients. A 27-year family practitioner in Prescott, Arizona, Thrift pays about $11,000 for malpractice coverage from Mutual Insurance Company of Arizona. He has stopped working in a hospital ED and treating fractures in his office. The ED work would require a $10,000 annual policy, while treating fractures would hike his premiums by an additional $15,000. “Malpractice is limiting what I can do,” he says.

    Thrift also tries to hold down his premiums by maintaining his board certification in family medicine and taking classes in how to document for telehealth. “I try to be diligent about documenting stuff and getting it in the record,” he says. “It’s a big risk when you don’t see the patient and you have to account for what you’re doing and why you’re doing it.”

    After providing obstetric services for about 10 years, Thrift stopped after being sued. Although the case was eventually dismissed, he recalls it as “four and a half years of anxiety, even if you’re fairly sure you’re right.

    “It’s really hard, not just on the doctor but on the family,” he adds. “A lot of our self-worth is tied up in what we do. So when we hear ‘you’re a bad doctor’ it translates to ‘you’re a bad person.’ And that’s very stressful.”



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