"St. Paul recently announced they are abandoning medical pro-fessional liability insurance for physicians nationally. What does this mean for the physicians currently insured by them? St. Paul has announced they will non-renew each of their physician policyholders at their next policy renewal date.

"Central Illinois is a 'hotbed' of unjustified prosecutions against physicians, according to a prominent Peoria doctor. Chester Danehower, president-elect of the Association of American Physicians and Surgeons (AAPS), said every doctor in America should be worried about the growing trend, and every patient or potential patient should worry about the resulting erosion of medical care in this country.

With the definite resurgence of the medical liability crisis, a recapitulation of the AMA's campaign for the implementation of tort reform in the last several years is in order to better understand where we have been and where we are headed in our struggle for meaningful and substantive medical liability ("malpractice") tort reform.

Obstetricians Forced Out of Business

"Doctors who specialize in delivering babies and treating pregnant women are closing their offices, leaving states such as Florida and New York, or abandoning their profession because they can't get liability insurance, even at sky-high rates.

Introduction

Many incremental mandates during the past decade have brought about changes in the way medical care is delivered. Many of the changes have resulted in physician dissatisfaction and frustration with the practice of medicine. Physicians have become increasingly concerned with the increases in their overhead expenses, the reductions in reimbursement for the medical services they provide, the intrusion of third-party regulatory networks into the clinical decision-making process, and the threat of medical malpractice litigation.(1)

The old saying goes that if the flak gets heavy, you know you must be over the target! The heated responses of both Drs. Dunsker and Carmel to my article suggest we have actually scored a bull's eye and hit the target. Perhaps, tort reform itself will finally come into the cross hairs of enactment soon!

While both the Patients' Bill of Rights legislation, allowing patients to sue HMOs in state court for unlimited damages, and tort reform, providing physicians judicial relief in medical liability, have stalled in the 107th Congress this year --- these intertwined problems of health care litigation will not disappear for long from the political landscape.

In the Fall 2001 issue of the AANS Bulletin, "A Profession at Risk---The Medical Liability Crisis," the editors brought forth the momentous issue of spiraling medical liability for neurosurgeons.

Indeed, neurosurgery has been a profession at risk for quite some time, and many American neurosurgeons are quitting early rather than becoming grist for the trial lawyers' mill. This medical liability problem is number one for U.S. neurosurgeons and the AANS, yet it's not so at all for the umbrella organization, the AMA, which politically claims to represent all physicians.

If anyone is interested in reading about a physician (neurologist) who has learned the ropes of the court system and who entertains the reader with forensic medical tales, this is the book to read and savor. Although Dr. Klawans is a frequent medical expert witness for both sides of the versus, he does not hesitate to use the term "hired gun" for impartial medical experts and minces no words in describing the shortcomings of the tort system. In case after case, Dr.

This book is a thinly-veiled attempt to defend the status quo of litigation-on-demand - "better the devil you know than the one you don't." Essentially, it advises physicians to accept the system and conform to the rigors of legal imposition when caught in the net of a medical lawsuit. It defends contingency fees, the system which allows the attorney-litigators to keep as much as 40% of the malpractice award and in the end leaves the injured plaintiffs with only 20-30% of the original award.

In the early spring of 1995, the House of Representatives passed a bipartisan medical liability bill (tort reform) by a significant margin (247 to 171), despite a strong opposition by the trial lawyers. This legislation was a sweeping tort reform bill that would have gone a long way towards reforming medical "malpractice" and alleviating the adversarial and litigious climate in which physicians have been practicing medicine for the last three decades.