In the absence of sweeping changes in tort laws, a lone healthcare consultant is proposing a unique way to solve the so-called crisis in physicians' insurance costs-at least for a small portion of America's doctors.
Delia Young, a consultant based in Kansas City, Mo., said she believes that the Federal Tort Claims Act of 1946 allows the federal government to confer the status of federal employee on at least some physicians who provide services to medically underserved populations in times of war, national emergencies or threats of epidemics.
Under the law, Young said, HHS Secretary Tommy Thompson can grant this special status to doctors who work in rural or depressed urban areas, shielding them from jury trials or punitive damages in medical malpractice cases for up to one year.
Considering the "declaration of war against terrorism," the conflict in Iraq and the ongoing threat of terrorist attacks involving the use of chemical and biological agents, Young asked in a statement, "how much more critical must circumstances become" for federal authorities to invoke the statute?
"I'm focusing on getting relief for people who cannot afford insurance," said Young, who works as a consultant to the Kansas City Medical Society.
Young, who said she met last week with top aides of Gov. Bob Holden, estimates that the coverage would apply to approximately 10% of the estimated 13,200 practicing Missouri physicians who are not covered by hospital insurance, work in a medically underserved area, and spend at least 20 hours per week providing care to the uninsured, the underinsured or patients covered by Medicare and Medicaid.
C.C. Swarens, executive vice president of the Missouri State Medical Association, expressed doubt that the law would do more than provide coverage to a tiny percentage of physicians while they were providing free services to patients. "We're skeptical that it would provide much relief," he said.
The potential impact of the plan to confer special status on these doctors is hard to measure. While Young said many states could qualify under the federal act, she acknowledged she doesn't know exactly how many. HHS officials did not return calls requesting comment.
The Metropolitan Medical Society of Greater Kansas City, which represents about 1,800 doctors in Kansas and Missouri, remains on the sidelines. "Who knows? It's a long shot, but stranger things have happened," said Ron Cosens, the society's executive director.
The Chicago-based American Medical Association said 18 states, including Missouri, are now in crisis over skyrocketing medical malpractice insurance rates that have forced some doctors to curtail services, retire early or move to areas with more modest premiums. AMA officials said they are interested in looking at any creative solutions to the problem of malpractice costs, but they remain focused on federal changes in tort laws.