Reno Gazette-Journal from Reno, Nevada • Page 47

Reno Evening Gazette Wednesday, Feb. 27, 197447 Patients have to pau for 'defensive medicine' Nevada doctors hit by malpractice insurance crunch BvAMJVir. ncuvD The screening committee, which is one of only 50 or 60 in toms and be confident that he has an ulcer. But if 1 don't order all the tests and he turns out to have something more serious, he could conceivably have me for malpractice," noted a Reno internist. Executive Director Push said that even a five per cent increase the number of suits Is small when it is weighed against the fact that 1.1 billion people saw a physician last year.

Nevertheless, the rising number of suits has doctors and insurance companies concerned PAVFORPAIN One Reno orthopedist said "The personality of the patient has brought this (increase). A patient is unable to judge good and bad medicine, but somebody is going to pay for their pain." He feels that only certain types of patients bring suits. "Some people will never sue; others are always looking for an excuse. They are hostile people, losers in life." He cited the "depersonalization of society and doctors" as leading to this hostility. The state association's executive director hazarded some reasons for the increase in suits.

"Medicine is getting more and more sophisticated," said Pugh. "Not every doctor is up on everything that can go wrong with a patient. A patient comes to a doctor wanting to be completely cured, but we're not at that stage. Accidents happen, too, Several doctors observed that a doctor may be held liable if a patient does not have a successful recovery because of conditions that are beyond a doctor's control poor tissue, poor dietary habits and failure to follow the doctor's orders. And charts and records that are subpoenaed into court may be inadequate and misleading.

The consensus among doctors interviewed was that peer review to reduce malpractice is effective up to a point. If a physician alleges that another has committed there is always the danger of a counter-suit or a defamation-of-cnaracter charge. One physician said, "There's a lot of us that would do something, if. NO-FAULT IDEA Nevada State Insurance Commissioner Dick Rottman pointed out that some umbrella policies cover a defamation-of-character charge. The deductible amount that the physician has to pay before the insurance company takes over may be very high, however.

Chief Deputy Commissioner Gene Leverty said no-fault medical malpractice insurance is being considered in some states, although none has adopted it. The insurance commissioner's office says it encourages insurance companies to come into Nevada, provided they have at least $2 million in assets and will be financially strong in future years. This guarantee of financial responsibility is to protect physicians against suits made against them several years after treating a patient. A physician Is liable for at least two years after the discovery of malpractice, plus the seven year duration of the statute of limitations, For example, if a doctor treats a child, he is responsible until the child reaches the age of 21, plus the discovery period and the statute of limitations. This long-acting coverage is known as a "tail," If a doctor is insured by a weak company that goes out of business, he may have to pay five times the usual amount just to get a "tail" to protect against past damages, even if the doctor is no longer practicing.

Deputy Commissioner Leverty noted, "Your Insurance is only as good as your company' Most carriers are not big enough to handle large suits, so their premiums have to be high. the nation, reviews approximately 35 cases a year to determine whether a "reasonable possibility exists that malpractice may have occurred." The six-member composed of doctors and lawyers, finds this possibility in perhaps 40 per cent of the cases it reviews. Whitehead said suits which are not judged valid can still go to court, and there might be suits that never come before the committee. Doctors and lawyers agree that few malpractice suits are settled In court, however, because doctors realize the empathy that a patient receives from a jury and the hostility It has for a doctor. Every physician interviewed felt that juries should be composed of physicians in the field of medicine Involved in the case, Many disgruntled patients fail to file malpractice suits because of a widely held belief that doctors "stick up for each other." Richard Pugh, executive director of the Nevada State Medical Association, said, "The creed of the association provides that we should promote the profession.

You don't promote it by tearing it down." Pugh added, "The original intent of malpractice insurance was to protect the patient." What does malpractice insurance mean to the patient? "Patients pay tor the insurance." Pugh said, pointing out that the costs are passed on in higher prices and through the practice of "defensive medicine." "Defensive medicine" consists of subjecting the patient to a battery of expensive lab tests, X-rays and consultations. These may be unnecessary except to protect the physician legally from a charge of negligence, which constitutes malpractice. "1 can feel a patient's abdomen and listen to his symp- Nevada physician are experiencing, an "insurance crisis." Malpractice insurance premiums are rlBing while at the same time fewer companies are providing this tvDa of protection. two companies have gone out of business In Nevada within the last three months, leaving 90 doctors without Insurance, Doctors having the most difficulty are those in the high-risk fields surgeons, orthopedists, neurologists anesthesiologists end physicians that have been sued before. NO NAMES Doctors in Reno were reluctant to talk about the problem, and none would allow their names to be used.

Reno general practitioners pay an average premium of $650 a year if they have never been sued. Surgeons pay an average of $4,600, but, as one surgeon pointed out, one suit raised his premium $1,000. These rates sound high, but they might be only a small fercentage of a physician's gross income for the year, remiums in California have increased 400 per cent since 1968, with many high-risk physicians paying premiums as high as $20,000 a year. The number of claims in California has risen from 13 5 per 100 doctors to 18 per 100. All New York physicians have lost their insurance entirely, according to Medical World News, a trade publication.

Northern Nevada, however, is considered to be a low-claims incidence area, Reno attorney Jerry Whitehead estimated that not more than six suits have come before a jury in the last 14 years. Whitehead, who is head of the Medical-Legal Malpractice Screening Committee for Northern Nevada, said 85 per cent of all litigation is settled out of court. licensing Special vehicles exempted from highway Soeclal equipment forklift hit a highway specifically exempts the signals. to be used for night work, he special vehicles from Headlights are required said. Red flags for long requirements for turr i by state law if the vehicle is loads such as cranes and special signing for wide loads can also be required, he said.

vehicles such as forklifts, overpass and fell onto his graders, farm equipment cat, crushing it. Iri CUnf Th Washe County t. Commission Monday asked LJllLc licensing the district attorney office what licensing restrictions 1 ui-f wnai licensing restrictions FREE PICK UP SERVICE Special I. couia be the Nevada Department of zz" "rnr tevKeVtment of gad DCDIG0 Motor Vehicles registration -h-f lltle.vM staf ft a fnv Ritt PlaifrinllA tniri thft 7 DAYS A WIIK Hen CAltOJU-aXO UlTlOtUllt ocsiu ie via vi. vawa.

he has been able to deter- equipment is not subject to mine the only requirement licensing or registration for the vehicles is a brake under state law. light. He said today he believes Ciardella was asked his the law does give cities and opinion after Reno counties authority to require businessman Harry O'Brien special safety equipment. was killed In Reno Friday. A But he said the law MAIM BROS.

CUSTOM SMASHES McCurry't Your Photo Headquarters Since 1 900 Brings Back "The Good Ol' Days With This Huge mmmws TREMENDOUS SAVINGS HOW THRU MARCH 9th RICOH 500 With Cat fully Automatic Reg. $79.90 HONEYWELL Spot. Ha with f1.8 Reg. $259.90 $49008 too New in Reno Staffing Reno's new Coast Guard recruiting office are PO i.e. Robert C.

Wright, left, and PO 3.C. Michael D. Faulk. Previous Coast Guard recruiting in Reno was done by a monthly visit from the Sacramento office. Coast Guard opens Reno recruiting office The Coast Guard has opened a recruting office in Reno at 119 W.

1st St. Manning the facility will be PO l.C. Robert Wright and PO J.C.Michael D.Faulk. Wright has been in the Coast Guard for 18 years and has seen duty in such places as Alaska, The Great Lakes and the far East, He and his wife, Martha, have three daughters, Kristine, Anne and Susan. Faulk lived in the Reno-Sparks area for a number of years before moving to California and later joining the Coast Guard.

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