George Ciechanowski, M.D., says his opposition to caps on noneconomic damages has cost him referrals from fellow doctors and the presidency of the medical staff of Christ Hospital in Jersey City, N.J.
On Wednesday, Ciechanowski filed a lawsuit in state court against the Medical Society of New Jersey, the Hudson County Medical Society and the president-elect of the county society, charging them with organizing local doctors to "boycott" him.
The Jersey City pulmonologist tells Modern Physician that he decided to oppose caps--a highly popular issue among doctors nationwide but bitterly opposed by plaintiffs' attorneys--because he believes they won't help the profession.
"I had no intention of supporting the attorneys," he says. "I had no idea that this would escalate out of all proportion."
Officials at the Medical Society of New Jersey deny that that they or anyone else orchestrated a campaign against Ciechanowski, but they don't take any pains to hide their feelings of outrage against him.
Robert Conroy, the medical society's general counsel, tells Modern Physician that Ciechanowski allowed himself to be used by interests funded by plaintiffs' attorneys in a very tense political standoff over malpractice reform.
"Malpractice rates are such a fundamental keystone to physicians that the idea that you could be against them and still represent other physicians is absurd," Conroy says. "If he fails to conduct himself in a manner that is consistent with the views of his medical staff, then he should be voted out of office."
Ciechanowski says he demonstrated his solidarity with colleagues last January, when he and thousands of other New Jersey physicians descended on the state capital to demonstrate for malpractice reform. But he says he decided to oppose a bill in the Legislature that calls for caps because it was not clear that it would prompt carriers to lower premiums.
"The insurance companies offered physicians nothing," he says. "Caps are a trickle-down approach. I was a little disappointed with that philosophy."
Instead, Ciechanowski says he supported an approach in a rival bill supported by opponents of caps, which would create state subsidies for physicians who were most severely affected by premium hikes.
He says he was surprised when a letter he wrote opposing caps turned up in a brochure sent out in October to thousands of voters by a group called Consumers for Civil Justice. Physicians suspect the group has connections with trial attorneys, but it could not be reached for comment.
Democrats took full control of the Legislature in the Nov. 4 election. Conroy says redistricting and not the brochure caused the Democratic victory. But both sides agree that Ciechanowski's letter and his testimony against caps before the Legislature earned him the enmity of many physicians at a dark time for reform.
With Democrats firmly in control, Conroy says things would have to get much worse for physicians, such as the bankruptcy of one or two malpractice carriers, before caps again have a chance of passing in the Legislature.
After the Christ Hospital medical staff voted to remove Ciechanowski as their president on Nov. 17, he says he has seen his appointments slow down because several physicians have stopped referring patients to him.
Ciechanowski says he keeps away from colleagues in the doctors' lounge. "I don't particularly feel like going there because I have to see them," he says.
The lawsuit, filed in Hudson County Superior Court, charges the defendants with "intentional interference with prospective economic advantage," civil conspiracy and violation of the state antitrust law, among other things.
Conroy says the state medical society welcomes the prospect of going to trial. He says he hopes legal discovery will uncover evidence of the trial attorneys' ties to groups opposing malpractice reform.
"We're going to use this lawsuit to lay out the incestuous relationships of the trial lawyers," Conroy says.