Thursday, December 15, 2005

CostRx: High premiums killing specialties

The first installment of CostRx features an interview with Washington-based neurosurgeon David Curfman on how skyrocketing medical malpractice insurance premiums are driving up the cost of healthcare and driving doctors out of the profession.

Q. On the topic of soaring medical malpractice premiums, you have stated that, if something isn't done about the problem in the next five to 10 years, we will have a real crisis on our hands. Can you explain?

A. Well, I think it's going to be sooner then another decade. I very strongly believe that it's already an evolution. In probably the last three or four years, it's gotten fairly severe. My prediction in 2002 -- I gave a talk on this -- was that I thought both neurosurgery and obstetrics were going to collapse by roughly around 2009 or maybe 2010.

Q. Can you define what you mean when you say "collapse?"

A. What I mean by that is that a good portion of the people in the field who are remaining by then, those who are still paying the huge amount on a premium for malpractice insurance, their overhead is going to exceed their income to the point that there's no way that they can stay in business. In fact, there are many neurosurgeons -- and the same applies to obstetrics -- that, unless you dramatically change your profession from one of either solo practitioner (or) private practice -- in other words, non-institutional -- you're not going to be able to survive.

The few who have changed their practice have gone on to be part of a big HMO or have sequestered themselves in a government facility (like) a veterans hospital, or have gone with some hospitals where they're actually hiring neurosurgeons and obstetricians to do the work that they would have never have done as recently as five years ago. ... This is a crisis of major proportion that's hitting the big hospitals in the big cities -- inner cities -- that are faced with a lot of people who have no insurance or have very, very meager coverage on a Medicaid policy.