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A Need for Change | Carolina Urology Partners

By Dr. Robert Gossett
Much attention is being given to Senate Bill 33, a medical liability reform bill passed by the state Senate and now being considered in the House. The measure seeks to reduce the need for defensive medicine, lower health care costs, and expand patient’s access to health care, especially in underserved rural areas, small towns and poor urban centers.

I am pleased that Sen. Kathryn Harrington (R-Gaston) and Sen. Debbie Clary (R-Cleveland, Rutherford) cosponsored this legislation and understand the need for reforms in the tort system.

Why the need for change? Defensive medicine, the use of unnecessary medical tests and procedures to ward off potential lawsuits, is widespread and drives up the cost of health care. Nationally, about three out of four physicians indicate they perform extra medical tests and procedures simply to avoid lawsuits. Doctors and other health care providers work under the constant threat of malpractice lawsuits and runaway jury verdicts, and they feel compelled to practice defensive medicine, which affects the pocketbooks of taxpayers and patients alike.

Government studies find that medical liability reform can save taxpayers money.  How much?

— $54 billion over the next decade according to the Congressional Budget Office, which also estimates that tort reform can trim medical liability an additional 10 percent, or $3.5 billion.

–$17 billion according to the bipartisan budget-deficit commission, co-chaired by North Carolina’s Erskine Bowles, which also recommended that Congress consider enacting a nationwide cap on noneconomic damages in medical malpractice awards.

In more than 30 years of practicing medicine, I have seen that patients can be hurt by mistakes, with bad outcomes often attributable to a poor physician-patient relationship and inadequate communication. We are all human, and honest mistakes do happen. When they do, patients should be compensated fairly. Senate Bill 33 ensures that injured patients be paid every penny of their present and future medical expenses, as well as all losses of future income and the value of future work. It also would provide up to $500,000 in “noneconomic damages” for subjective, unmeasurable harms such as pain and suffering.

Capping non-economic damages is not new. Over half of the states have set a limit, many at the lower threshold of $250,000. Under Senate Bill 33, North Carolina’s cap would be subject to an inflationary adjustment over time.

As a member of the North Carolina Medical Society, I support efforts to improve patient safety. Several years ago the Society supported raising doctors’ licensing fees to pay for more investigators and prosecutors for the state Medical Board, which licenses and disciplines our state’s physicians. In addition, the Medical Society Foundation and Leadership College have undertaken or endorsed many initiatives to improve the quality of health care. This includes greater use of electronic medical records and clinical data to help practices implement and measure quality improvements. We also endorsed a state law to encourage doctors who make mistakes to take responsibility and apologize to their patients.

Additional measures in the bill include simplification of medical malpractice trials to allow for periodic payment of future economic losses, allowing judges to set reasonable appeal bonds, strengthening expert witness procedures and setting a more realistic standard of fault for emergency room physicians, who are required by federal law to treat everyone who shows up, regardless of ability to pay, condition or history.

Enacting strong, sensible liability reform this legislative session will help to reduce defensive medicine, lower health care costs and improve patient access to health care across our state. If adopted by the General Assembly, it will go to Governor Perdue for her signature. I urge you to let your legislators and Governor know how important it is for us to take these steps at this time to ensure we have a strong health care system for all North Carolinians.

Dr. Robert Gossett is a urologist with Carolina Urology Partners – Shelby (formerly Cleveland Urologic Surgery).  He is chairman of the Board of Trustees, NC Medical Society Employee Benefit Plan providing health insurance coverage to more than 22,000 lives in NC.