There is no credible information that doctors have “fled” the Metro East area due to spiraling med mal rates.  Doctors still provide essential medical services there, and I have yet to see any study which lists any doctors by name and area of practice which have actually left their practice or an area where they had practiced due to increases in insurance rates. Underlying all this is an attempt by insurers to extort draconian changes in the protections consumers have from the carelessness of medical professionals. The best cure for suits due to medical carelessness is scrupulously following established procedures and practicing good medicine.There was a study several years ago in JAMA which showed that there were some 50,000 preventable deaths each year due to bad health practices (failure to wash hands, etc.) in hospitals. So, each year we lose a number of patients nearly equal to the all the deaths in combat in the Vietnam War are lost due to medical carelessness, and we still hear about the poor doctors and their insurance rates. I propose we prosecute these deaths criminally for involuntary manslaughter, which in Missouri is “recklessly causing the death of another.” The standard is whether the conduct of the accused “grossly deviated from what was reasonable under the circumstances.”Aside from attacking those injured by the doctors’ carelessness, doctors could also form groups which could collectively bargain for lower rates from insurers. If the overwhelming number of doctors who practice exemplary medicine brought themselves together, and excluded from the group the some 5% of them which cause over 50% of claims, their rates could go down. The laws which had prevented this practice were repealed in federal legislation in 1985. The doctors could also form risk retention groups, similar to insurance companies, which the doctors use their collective abilities to self-insure and provide an alternative to the nearly monopolistic and capricious regular medical malpractice insurance market. The same law which repealed the “anti-group” laws in states allows doctors a form of self-insurance pools.  Other states have taken measures to support doctors’ in paying for needed insurance coverage by various pools, insurance plans and incentives.We have a problem in America, it’s not a problem related to the meritorious suits filed by consumers injured through the carelessness of others. The problem is an insurance problem. The insurers have for too long been able to stick it to doctors and consumers, and its time that the legislatures in the various states and the Congress put a stop to abusive and improper insurance practices.    

Timothy E. Hogan

Des Peres