TBO.com - Tampa Bay Online
Lawsuits Very Painful For Emergency Room Docs
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Published: April 21, 2008
In "Doctors' Duties Need Regulation," (Other Views, April 3) Frank Petosa got one thing right: The issue of on-call specialists taking call in emergency departments is complex.
The rest, however, only distracts from the severity of the situation and does not accurately reflect what is happening with the emergency department crisis in Florida.
The numbers quoted reflect the total number of physicians licensed in Florida but does not consider physicians who live out of state, practice part time, are retired but keep their licenses active, have died or moved out of state.
The actual number of actively practicing physicians in Florida is important, and we are currently working to collect that data. A study done in 2007 by the Florida State University College of Medicine showed that approximately 34,000 physicians regularly practice in Florida, a far cry from the 56,752 quoted, and that not all new licensees are actively practicing medicine.
In addition, licenses are for general medicine and do not reveal the specialty of the physician. Many specialties do not interact with emergency rooms at all; thus, it is misleading to say that this many physicians are available to cover the emergency departments.
The survey also found that 13 percent of Florida's physicians plan to leave or significantly reduce practices within the next five years; that 25 percent do not actually practice in the state; and that the mean age of the physicians is 51. In short, trends indicate that the growing population of Florida, with a large percentage of senior citizens, will have fewer physicians available to take care of it, with many physicians near retirement and not enough young doctors coming here to replace those retiring.
The medical liability climate in Florida is one of the worst, if not the worst, in the nation. The suggestion that physicians in Florida enjoy more legal immunities than physicians in other states is far from true.
Florida has one of the highest number of malpractice lawsuits in the nation, and since 90 percent of lawsuits are won by the physician, then clearly a large number of frivolous lawsuits are still filed.
Florida also has the "three strikes" amendment, which means that any physician who loses any three malpractices cases, whether wrong or right, would lose his or her license. This also increases the number of frivolous cases, as physicians are forced to settle even if they did nothing wrong, due to pure fear of losing the case from jury sympathy and inevitably losing their career.
In addition, the peer review process, the one way hospitals review mistakes and prevent future occurrences, has been majorly jeopardized. Now, for fear of perpetuating the malpractice problem, hospitals and medical staffs will conduct less physician and hospital corrective actions, leading to possibly more medical errors, the same as if the airline industry stopped studying plane crashes to find the cause due to fear of litigation. Imagine where we would be today.
Taking ER calls and working in the emergency department is the most dangerous place in terms of liability that exists, and the fear of malpractice is the No. 1 reason that physicians do not take emergency call.
We as emergency physicians devote our lives to protecting you. We are available 24/7 for whatever comes your way. We are on the front line making sure that you receive the best emergency care available. But we can't do it alone.
We need specialists to help provide that care. In many ERs in our state, the specialists just aren't there. It doesn't matter if you have insurance, how much money you have, who you know. The care isn't there.
That means you, your mother or your child could be left waiting, as precious, lifesaving minutes go by as we painstakingly call every ER from here to the state line, trying to find someone, anyone who can help - sometimes too late.
Sovereign immunity does not "Teflon proof" physicians. The last thing we want is for our patients to receive poor care. When there is a question, the case is referred to the Board of Medicine for review, resolution and retribution.
This system, even under sovereign immunity, does not make physicians immune to paying a penalty or keep patients from seeking retribution. It only changes the process and allows us as physicians to care for you, without the constant fear of punishment for circumstances beyond our control.
We agree that sensible solutions need to be found. We know sovereign immunity is that solution. We are emergency physicians. No one cares more about your emergency care than we do. You trust us with your lives. You can trust us on this.
Mylissa Graber, MD, is vice president of the Florida College of Emergency Physicians.
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