Tort Reform: The Victim

by Dr. Steve Reintjes

The loser will not be the rare patient who truly suffers from malpractice or the rare physician who commits it. the losers in the tort reform debate are the citizens of Missouri.

This year, the debate over Tort Reform has generated headlines, political rhetoric, and attention in legislative chambers. The debate about Tort Reform is emotionally charged on both sides of the issue. The Missouri State Medical Society and the Missouri Association of Trial Attorneys have committed great energy and money in this fight. As a result, the issue of Tort Reform may be the defining issue in the Missouri Gubernatorial Race as well as many State and House Races. Who Loses? The loser will not be the rare patient who truly suffers from malpractice or the rare physician who commits it. The losers in the tort reform debate are the citizens of Missouri.

Review The Following:

• Missouri has lost 500 physicians in the last 4 years;
• One third of all OB/Gyns in Missouri have quit obstetrics in the past 4 years;
• 45 physicians have stopped practicing in Kansas City in the past 12 months;
• 20 percent of all the neurosurgeons on the Missouri side of Kansas City have quit or moved out of the area in the past 12 months;
• Five neurosurgeons out of 25 neuro-surgeons in private practice in St. Louis quit last year;
• 21 out of 79 neurosurgeons surveyed in Missouri are considering leaving the state;
• Two trauma centers in Kansas City have closed in the past 12 months due to lack of physician coverage.

This loss of physician manpower is not some regular demographic rotation due to retirement. These losses represent physicians with full active practices.

Additionally, there will be no replacements for these losses, no new recruits... For example, the fall Bulletin of the American Association of Neurological Surgeons published a lead article about Missouri titled A State in Crisis: Missouri. This publication described the malpractice crisis in Missouri and is distributed to neurosurgeons throughout the country. Futilely, I sent out hundreds of letters to prospective neurosurgeons at the end of 2003 trying to recruit a young prospect to our group. There was not one request, response or inquiry to my letters. Physicians do not gravitate to hostile malpractice environments. Interestingly, I have heard that the author of the article in the Bulletin of the American Association of Neurological Surgeons is also leaving the state. Professional recruiters now define good jobs by the tort climate in the state not by the meteorological climate of the state.

Nationally, 10 percent of active neurosurgeons have retired in 2001. There are 3 or 4 job openings for every resident graduating from a training program. In the field of cardiology, there are four times as many job opportunities as there is available among those finishing the cardiology residency. Some specialties like pulmonary medicine require years of re-cruiting to fill positions of immediate need.

I can't help but think about two recent patients of mine who suffered critical brain problems. These patients went to a hospital that used to have neurosurgical coverage. After the patients' evaluation and diagnosis were established in the emergency department, an emergency neurosurgical consultation was required. Because of the lack of available neurosurgical coverage, the patient was transferred to a hospital where I was stationed. By the time the patient arrived at my locale, their condition had deteriorated beyond the benefit of treatment and they died.

If the tort system is not reformed: more physicians will leave, replacements will not come, access to care will be restricted, and patients will die.

Who is the victim in the Tort Reform Debate? The Citizens of Missouri.

Dr. Steve Reintjes is a practicing physician at the KC Neurosurgery Group. He can be reached by phone at 816.561.4655 or by email at SReintjes@kcneurosurgery.com.