The malpractice environment may be starting to improve for emergency physicians in West Virginia 2 years after a comprehensive medical liability reform bill was enacted in the state.
“It's probably too early to see a huge improvement,” said Frederick Blum, M.D., president-elect of the American College of Emergency Physicians. “But the signs are encouraging.”
The first signs are coming from the insurance industry. Loss ratios for medical liability carriers have improved since the reform legislation was passed in 2003, according to a report from the state's insurance commissioner. The percentage of medical liability insurance premiums spent on claims and expenses in the state fell from 134.6% in 2002 to 128.5% in 2003. Ratios above 100% indicate that the insurer has an underwriting loss.
The 2003 law established a $250,000 cap on noneconomic damages and set an overall cap of $500,000 on economic and noneconomic damages for injuries sustained at trauma centers. The law also strengthened the qualifications required of an expert witness.
Within weeks of the passage of the law, physicians stopped talking about leaving the state, said Steven Summer, president of the West Virginia Hospital Association. “Retention changed almost overnight.”
And the malpractice insurance market has become more predictable, he said. The next piece will be a reduction in premiums for physicians, he said.
There has been a slight uptick in the number of emergency physicians practicing in the state, according to the West Virginia Board of Medicine. In 2003, 178 physicians licensed in the state designated their specialty as emergency medicine. By the end of 2004, that figure had risen to 188 physicians.
But physicians aren't out of the woods yet, said Dr. Blum of West Virginia University, Morgantown.
The law is already under attack by plaintiffs' lawyers, who are trying to have the reform declared unconstitutional by the courts. But physicians got a boost last year when a state Supreme Court justice hostile to medical liability reform lost his bid for reelection.