Two more hospitals have been hit hard by a medical malpractice insurance crisis sweeping across the nation.
In Mississippi, the state's only Level I trauma center is being taxed to its limits because there aren't enough neurosurgeons in outlying areas to handle all critically ill patients. A similar scenario is playing out in West Virginia, where a lack of orthopedic specialists has forced one hospital to take the unusual step of downgrading its status from a Level I trauma center to a Level III.
Together, the two high-profile cases illustrate a continuing physician-staffing crisis caused by sky-high medical malpractice premiums across the country, with scores of hospitals having to dramatically alter the way they do business (June 10, p. 30).
The University of Mississippi Medical Center, Jackson, the state's only Level I trauma center, has experienced a sharp increase in referrals from neurosurgeons, causing concerns about the hospital's ability to handle the extra patient load.
Before the malpractice crisis hit the state, officials said, the 654-bed hospital was admitting five to seven patients referred by neurosurgeons on a typical weekend. It now admits as many as 15 such patients. The hospital's daily census has grown to an average of 518 during the past six months from an average of 480 in 2000. In June, the average census was 534.
Hugh Gamble, M.D., a thoracic surgeon in Greenville, Miss., said the sole neurosurgeons in the Mississippi cities of Columbus, Greenwood and Meridian have all left. The Gulf Coast region, where five neurosurgeons practiced until recently, is down to just one, he said.
Mississippi Gov. Ronnie Musgrove called state lawmakers into a special session last week to address the issue of malpractice insurance. The state's medical association is lobbying for a $250,000 cap on awards for pain and suffering and a limit on contingency fees for plaintiffs' lawyers.
In West Virginia, 765-bed Charleston Area Medical Center dropped its status as a Level I trauma center late last month because there weren't enough orthopedic surgeons for on-call duty. The hospital downgraded to Level III trauma status, hospital spokesman Andrew Wessels said, meaning the center no longer has specialists available round the clock.
The two hospitals are not alone. A recent survey by the American Hospital Association found more than 1,200 hospitals have been affected to some degree by skyrocketing malpractice costs.
West Virginia lawmakers made some changes to the state's malpractice tort laws last year and set up a short-term malpractice insurance option for physicians, but physicians continue to clamor for more changes. In a position paper, the West Virginia State Medical Association calls for tort reform modeled on California's medical malpractice law of the 1970s. The West Virginia Hospital Association also supports tort reform measures that would make it more difficult to file medical malpractice lawsuits and would cap noneconomic damages.
Meanwhile, the American Medical Association is pushing hard for tort reform on the state and national levels. The Nevada Legislature, acting during a special session, passed a law last month capping noneconomic damages at $350,000. In July, the state's only Level I trauma center, University Medical Center, Las Vegas, closed for 10 days after 58 orthopedic surgeons walked off the job complaining about insurance costs.