MACM. Message from the Chief Executive Officer. The JULY 2002

Transcription

1 MACM M o n i t o r The JULY 2002 Message from the Chief Executive Officer Mike D. Houpt, CEO A Publication of Medical Assurance Company of Mississippi As many of you have noted, you did not receive an issue of the MACM Monitor during the first quarter of this year, and this issue is also behind schedule. There are many reasons why we are so far behind, but the primary cause for the delay is that we are trying to process so many new applications. With St. Paul and other companies pulling out of the state, and those that claim that they are still here non-renewing most of their policies, we have been literally inundated with applications. It started last summer when St. Paul announced a 65% rate increase and Doctors Insurance Reciprocal imposed a 75% increase. We processed 370 applications in 2001, the most since Then we really got busy! St. Paul informed all of its policyholders that their policies would not be renewed at the next expiration, and Doctors Insurance Reciprocal told its insureds to expect another 90% increase. So far this year, we have received more than 515 new applications. Through the end of June, we had approved 187 applications, and we still had more than 200 to process. Because of the litigious climate in which we must now operate, we have been forced to become more selective in our application process. Physicians who may have been approved two or three years ago are, unfortunately, being declined now. These have been extremely difficult decisions for those of us who have had to make them. For more than twenty years we have been dedicated to helping Mississippi physicians, and now we find ourselves having to inform some physicians that we cannot provide the insurance that they need in order to continue their practice. I hope that they, and you, our current members, understand and appreciate how agonizing these decisions have been. We have tried to maintain the same high level of service that our members have come to expect despite the enormous increase in time allocated to processing applications; however, if you find that it takes our Underwriting Department a little longer to do something for you than it did in the past, please bear with them. I assure you that it is not for lack of effort on their part. I recognize that some of you may wish to help some of your colleagues who may have been insured by another company and now find themselves in a bind, but, trust me, telephone calls from physicians, clinic managers, hospital administrators, state insurance department personnel, attorneys, legislators, and even patients really do not help. They only add to a process that has already become overwhelming. Mike D. Houpt, CEO NOTE: This page ordinarily is devoted to a message from the President of the Company; however, Dr. Triplett suffered a mild stroke in early May and has since been involved in extensive physical therapy. We are most pleased to report that his recovery and therapy have progressed extremely well and that, he has now returned to work. Sponsored Carrier of of the Mississippi State Medical Association

2 2002 Caldwell Award During the House of Delegates meeting at the Mississippi State Medical Association Annual session, the annual Robert S. Caldwell Memorial Award was presented to Dr. Demondes Haynes. MACM presents this award each year to an outstanding resident at the University of Mississippi Medical Center in the interest of furthering medical-legal education in Mississippi. An ad hoc committee of UMMC faculty selects a resident who demonstrates quality in patient care, patient relations, and medical record documentation. Dr. Haynes is a native of Louisville, MS and graduated from the University of Mississippi before attending the University of Mississippi School of Medicine. He received his M.D. degree in 1997 and is currently a resident in Internal Medicine. Beginning July 1, Dr. Haynes will be Chief Resident and plans to begin a Pulmonary/ Critical Care fellowship in July, Dr. Shirley Schlessinger of the Department of Medicine at UMMC, in recommending him, stated, It is difficult to believe any other trainee of Mississippi could be more deserving of this award than Dr. Haynes. The Robert S. Caldwell Memorial Award is dedicated to the memory of the late General Surgeon from Tupelo, who was president-elect of the Mississippi State Medical Association and member of the original MACM Board of Directors at the time of his death. New Employees (Right) Susie Boyd recently joined MACM s staff as Receptionist in our Claims Department. She comes to us with over 20 years of secretarial experience. Susie is a native of Durant, MS and currently lives in Ridgeland with her husband and two children. (Left) Ken Vernon joined MACM as a Claims Representative last December. Ken is a graduate of the University of Mississippi and had 9 years prior claims experience. Ken is a native of Jackson, MS and currently resides in Brandon. He enjoys football, fishing and traveling. 2

3 2001 Trial Report Charles M. Dunn, COO / V.P. Claims This brief summary of medical litigation cases which reached trial during the year 2001 is provided only for the review and information of MACM insureds. INCISIONAL HERNIA This lawsuit alleged improper performance of plastic surgery, resulting in a subsequent incisional hernia which required additional surgical repair. Following a one-week trial, the jury returned a unanimous verdict in favor of the surgeon. AVASCULAR NECROSIS This lawsuit involved a Neurologist in a trial in January The lawsuit alleged that the patient was prescribed Corticosteroids for an acute ruptured cervical disc in an effort to avoid swelling, inflamation, and edema, which might damage the spinal cord or impinge upon the spinal nerve roots. The Plaintiff alleged that the administration of Corticosteroids caused multiple sites of avascular necrosis. Following one week of trial, the jury returned a verdict in the sum of $2.6 million dollars. URETER INJURY This lawsuit alleged that the patient suffered an injury to the ureter during performance of a urethral suspension procedure. Following a 4-day trial in February, 2001, the jury returned a Defense Verdict in favor of the surgeons. FAILED TO DIAGNOSE M/I This lawsuit against a Family Medicine physician alleged delay in diagnosis of an acute myocardial infarction. Following one week of trial in February, 2001, the jury rendered a Defense Verdict in favor of the physician. ANESTHESIA MONITORING This law alleged improper post-operative monitoring of the patient following orthopaedic surgery. The trial of this case in March, 2001, resulted in a Defense Verdict in favor of the physician. MAMMOGRAPHY/MALIGNANCY This lawsuit alleged failure to diagnose a malignant neoplasm of the breast on mammography. Following 2 days of trial, the presiding Circuit Judge issued a Directed Verdict in favor of the physician. COLONOSCOPY/PERFORATION This lawsuit alleged improper performance of a flexible fiberoptic colonoscopy, resulting in a colon perforation, sepsis, and patient demise. Following a 6-day trial, the jury returned a unanimous Defense Verdict in favor of the physician. IMPROPER TREATMENT OF FRACTURE This lawsuit involved Orthopaedic Surgeons in allegations of improper treatment of a fracture of the lower extremity, resulting in below-knee amputation of the lower extremity. Following one week of trial, the jury returned a Defense Verdict for one doctor and rendered a Plaintiff Verdict in the sum of $1.5 million dollars against another physician. FETAL DEMISE This lawsuit alleged that the plaintiff suffered a fetal demise due to delay in the delivery of the infant. Following one week of trial in June, 2001, the jury returned a Defense Verdict in favor of the Obstetrician. CERVICAL SPINE FRACTURE This Circuit Court case reached trial in July, The lawsuit alleged delay/failure to diagnose a cervical spine fracture by the Defendants, Emergency Medicine physician, General Surgeon and hospital. Following 1 week of trial, the jury returned a Defense Verdict. Continued on page 4 3

4 TRIAL REPORT continued from page 3 URINARY CATHETER PLACEMENT This lawsuit alleged that the attending Urologist and/or hospital personnel were negligent in performing urinary catheter placement. Following one week of trial, the jury returned a Defense Verdict on behalf of all of the defendants. LIGHTS, CAMERA, ACTION! DELAY IN TREATMENT: M/I This lawsuit alleged delay in treatment of chronic ischemic heart disease, resulting in the subsequent myocardial infarction and death of the 52-year old male patient. This case reached trial in United States District Court in August Following one week of trial, the jury returned a Defense Verdict in favor of the Defendant Cardiologist. DELIVERY/PAIN This lawsuit alleged that the Obstetrician was negligent in performing a normal delivery of an alleged large for gestational age(lga) neonate. The lawsuit alleged that this caused the patient to suffer from permanent, disabling pain in the region of the coccyx. Following the trial of this case in August, 2001, the jury returned a Defense Verdict in favor of the Defendant Obstetrician. DELAY IN TREATMENT OF M/I This lawsuit alleged that the Emergency Medicine physician was guilty of delay in the diagnosis and treatment of acute myocardial infarction, resulting in additional myocardial ischemia and subsequent cardiomyopathy. Following one week of trial, the jury returned a Defense Verdict in favor of the physician. IMPROPER TREATMENT OF FRACTURE This lawsuit against an Orthopaedic Surgeon alleged improper treatment of a fracture of the lower extremity, resulting in nonunion and delayed healing of the fracture. Following four days of trial in September, 2001, the jury returned a unanimous Defense Verdict in favor of the physician. URETERAL INJURY This lawsuit alleged improper performance of gynecological surgery, causing an accidental injury to the patient s ureter, which was promptly recognized and repaired without further complications. Following one week of trial, the jury returned a Plaintiff Verdict in the sum of sixty-five thousand dollars. INFORMED CONSENT This lawsuit alleged lack of informed consent regarding orthopaedic surgery involving the upper extremity. Following a 4-day trial in Mississippi Circuit Court, the jury returned a Defense Verdict in favor of the Defendant Physician and Clinic. 4 YOU RE IN THE SPOTLIGHT A Continuing Medical Education Program sponsored by MEDICAL ASSURANCE COMPANY of Mississippi at the Hilton of Jackson 1001 East County Line Road Jackson, Mississippi FRIDAY, SEPTEMBER 13, 2002 To register please contact the Risk Management Department at

5 So You Want to Go Bare? Some Points to Consider by Robert M. Jones, Esq. We have heard that numerous physicians are considering alternatives to malpractice insurance as a solution to their exposure during the current medical malpractice crisis. We understand that these alternatives include seeking asset protection, substantially reducing limits of coverage, going bare (i.e., practicing without any malpractice insurance), or just going bankrupt if all else fails! Before pursuing any of these alternatives, physicians should consider the following: Seeking Asset Protection In response to the medical malpractice crisis, attorneys and accountants have begun offering asset protection advice to physicians concerned about practicing medicine in this legal environment. This may include transferring assets to a spouse, converting assets into a judgment-proof form, and creating a family limited partnership. This is probably not a bad idea in and of itself; however, asset protection is no substitute for adequate malpractice insurance. You should use an attorney who has experience in areas of law relating to asset protection. The advice of an accountant may also be needed for the tax implications of asset transfers. If possible, get the attorney to confirm in writing that the asset protection plan developed by the attorney will protect your assets in the event a judgment is rendered against you in excess of any available insurance. Note: the asset protection plan must be implemented and your assets transferred to the protected person or entity prior to your having knowledge of any possible claim! Otherwise, the transfer may be set aside by a court at the request of a judgment creditor. event of a lawsuit. Medical malpractice suits, even frivolous ones, can be very expensive to properly defend. Medical experts are costly, discovery is extensive, and trials are lengthy. You do not want to use your own money to defend a malpractice action. If you are considering an asset protection plan which includes carrying only minimum limits of coverage or going bare, you will be trusting an attorney to give you proper legal advice in order to protect your assets. In the event that advice is not appropriate and your assets are placed in jeopardy, your only recourse will be to make a claim against your attorney s malpractice carrier (because your attorney will have already done his own asset protection). You should realize that all you will actually do is transfer your liability protection from your medical malpractice insurance company to your attorney s legal malpractice insurance company. In that event, you will be transferring your protection from the insurance company whose sole business is accepting and defending your medical liability risks to the attorney s malpractice carrier whose primary interest is protecting the attorney. Because of the claims made nature of malpractice insurance, there is one other matter to be considered if you are contemplating going bare. If you do discontinue medical malpractice insurance, you may find that it is difficult to repurchase malpractice insurance in the future after the crisis is over. Just Declare Bankruptcy Reducing Coverage to a Minimum, or Going Bare A theory is emerging among physicians that the lower your limits of insurance coverage, the less likely you are to be sued. Some carry this theory to the extreme by believing that a physician is least likely to be sued if the physician goes bare. There is no experience or data supporting this theory! Although we have heard several physicians propose this concept, we are not aware of any experienced medical malpractice defense attorney who agrees with it. If you hear another physician promoting this alternative, we suggest that you ask that physician for the name of the attorney who supports it. You will find that no credible attorney will be identified. In fact, our experience is that the plaintiff s attorney will always sue every physician who may be liable, regardless of insurance coverage. The plaintiff attorney can not afford to leave any potentially responsible physician out of a lawsuit or else the attorney could be guilty of legal malpractice. Although insurance is important for the purpose of indemnifying you against any claim, the other significant benefit of your insurance policy is the defense it provides to you in the 5 You as a physician have worked your entire career to get where you are. You are respected in your community and among your peers. The idea of just declaring bankruptcy in the event of a judgment against you is much easier to say than the reality would be. If you think sitting in a medmal trial is difficult, try sitting in bankruptcy court! And if you think that plaintiff attorneys pull out all the stops to get your assets, you haven t seen what lengths the bankruptcy courts can go to! This would not be a palatable solution. Our Advice In this medical malpractice claims environment, our advice is that you (a) maintain as much medical malpractice insurance as you can reasonably afford based upon the nature and location of your practice, (b) consider asset protection if you are inclined to do so, (c) practice risk management every day through good communication, accurate documentation and compassionate patient relationships, and (d) render the best medical care that you can! Finally, we recommend that you become fully informed about the legal, political and social issues relating to the ongoing debate over civil liability reforms; and that you become involved in some way in efforts to reform the system.

6 A.M. Best Affirms A- J. Walter Gilmer, CFO Monday, June 3, Chief Financial Officer, J. Walter Gilmer, CPA is pleased to announce that Medical Assurance Company of Mississippi s A- (Excellent) rating has been affirmed, by A.M. Best. According to Best,...the rating reflects the company s excellent level of capitalization, solid liquidity, and strong market position within the Mississippi physician market. The rating also reflects the company s continued maintenance of a high policyholder retention ratio. The recent increase in loss and reinsurance costs in the medical malpractice marketplace has put pressure on profit margins for the company and its peers. In response, management has discontinued the company s premium credit policy, increased policy rates and is conservatively reserving for emerging claims. Additionally, the company has placed an emphasis on stringent underwriting guidelines for new and renewal policies. Given the company s strong capitalization, conservative reserving philosophy, high policyholder retention, and recent initiatives implemented by management, A.M. Best views the rating outlook as stable. Information contained in this publicatin is obtained from sources considered to be reliable. However, accuracy and completeness cannot be guaranteed. Information herein should not be regarded as legal advice. Medical Assurance Company of Mississippi 404 West Parkway Place Ridgeland, MS The Monitor is a publication of Medical Assurance Company of Mississippi Contributions made by: Mike Houpt, Chief Executive Officer; J. Walter Gilmer, CFO; Charles M. Dunn, COO/VP Claims; Robert M. Jones, Esquire, General Counsel Editor & Designer: Kathy Dodd