The long-running battle over the high cost of malpractice insurance has taken an ugly turn. Many doctors blame trial lawyers and their malpractice suits for causing huge jumps in insurance premiums. Lawyers blame it on the insurance industry.
A South Carolina surgeon dropped a patient when he found out her husband was a trial lawyer. In New Hampshire, a neurosurgeon told the head of the state's trial lawyers that he wouldn't treat him for non-emergencies. A plastic surgeon in Mississippi refused to treat the daughter of a state lawmaker because of his stand on malpractice suits.
At this week's meeting of the American Medical Association in Chicago, many doctors stayed out of the fray. They angrily shouted down a proposal by J. Chris Hawk, M.D., of Charleston, S.C., to refuse treatment for attorneys involved in medical malpractice cases.
But the actions of other doctors and hospitals suggests that plenty of them agree that taking out their anger on lawyers -- and sometimes their families -- is an acceptable response to what they see as a threat to their livelihood.
"If somebody takes a position that is very deleterious to your welfare, you have a right not to do business with him," said Clinton "Rick" Miller, M.D., a neurosurgeon in Portsmouth, N.H. Miller did just that, telling Tim Coughlin, president of the state's trial lawyers association, that he would not treat him for elective surgery because he lobbied against limits on malpractice lawsuits.
"He's one of the reasons I have $84,000 medical practice premiums even though I've never had a malpractice judgment against me in my life," said Miller, who also emphasized that he would treat Coughlin in an emergency.
Coughlin said Miller's anger is misplaced.
"His insurance company is charging him too much," Coughlin said Monday.
While Miller said he would have no problem treating Coughlin's family, Hawk would. He dropped a patient when he found out her husband was a prominent local trial attorney.
"I don't think it violates the Hippocratic oath," he said.
Nor, apparently did Michael Kanosky, M.D., a plastic surgeon in Mississippi. Just last week it was reported that Kanosky refused to treat the daughter of a state lawmaker who opposed limits in damage lawsuits against physicians in the state.
"He asked me who I worked for and then asked me who my father was," Kimberly Banks told The Associated Press. "I told him (State Rep.) Earle Banks. He told me, 'I can't see you because your father is against tort reform."
Kanosky was in Chicago for the AMA meeting but did not immediately return telephone calls for comment. He earlier told a Mississippi television station that he believed treating the woman would be a conflict of interest because his wife is a lobbyist for doctors.
Doctors say that such cases are rare. Ken Printen, M.D., the president of Illinois State Medical Society, said he has never heard of any doctor in the state refusing care to an attorney -- nor should it ever happen.
"To deny somebody treatment just because he's a lawyer, you just can't do that," he said.
At the AMA's annual meeting a committee recommended that the policy-making delegates reject Hawk's proposal, saying it would "jeopardize and sidetrack" the group's efforts to combat high insurance rates and malpractice lawsuits. The delegates endorsed the rejection by voice vote Tuesday without debate.
A number of doctors at the meeting agreed with the committee's concern. Several said that they would never deny medical care to a lawyer.
Joseph Selby, M.D., from Morgantown, W. Va., said his 12-year-old son has a friend whose attorney father recently won a $6 million judgment against the hospital where Selby works.
"Do I hate him? Would I not treat him? Would I not treat his son? Of course not," Selby said. "I don't criticize attorneys for doing what the law allows. We need to change our legal system."
But there are indications that the fight over medical malpractice is getting more contentious.
Earlier this year, a furor erupted over a database that was billed as the first to profile plaintiffs, their lawyers and expert witnesses in malpractice cases in Texas and other states. The Web site, DoctorsKnow.Us, shut down after critics accused it of blacklisting patients who had sued doctors for malpractice.
In New Jersey, George Ciechanowski, M.D., has sued the state's medical society, claiming other doctors have boycotted his practice because of his support for a medical malpractice reform plan they opposed.
And in Texas, a nursing student claims she was dismissed from her job at a hospital because her husband works for a firm that handles medical malpractice cases.
It all adds to "an alarming trend in a kind of vigilante-style behavior for what appears to be an extremist group of doctors ... looking to punish innocent patients and their attorneys who help them exercise their constitutional rights," said Dan Lambe of Texas Watch, a consumer research and advocacy group that helped publicize the Web site.
This anger is showing up in more subtle ways, too. Lawyer Ken Suggs said some doctors are becoming less willing to help attorneys when called to provide their expert opinions.
"It's a little bit harder to get their cooperation in those things," said Suggs, who like Hawk practices in South Carolina.
But Suggs agrees with fellow lawyers who think doctors' anger with them is misplaced.
"We've always considered this an insurance issue," he said. "Their malpractice insurance is rising, as is ours."