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Malpractice Climate in Florida...Quinn????

Discussion in 'Emergency Medicine' started by kbrown, Mar 14, 2007.

  1. kbrown

    kbrown chicken
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    To anyone who has experience practicing in Florida....or Texas I guess, two areas known for great pay, but high malpractice costs/suits.

    I am trying to make my way to a place that is warmer and has plenty of access to water. Florida obviously makes this list. However, I have heard about the malpractice concerns in the state. How real are they, are you guys/gals enjoying your jobs in FL, and is there a resource out there that I could hunt down statistics on this issue?

    Thanks in advance.

    KB
     
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  2. CS_22

    CS_22 Senior Member
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    You already planning for life after residency KB?
     
  3. OP
    OP
    kbrown

    kbrown chicken
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    michigan weather sucks and the economy here is completely unstable. I can accept paying the high cost of living that we do here IF i were getting something great in return, like palm trees, a golden tan or year round water sports. BUT i'm not. so i am just looking at what i am predicting that i will want in my life when i have time for one. warmth, water and 12-15 shifts/month. yeah for being an attending.

    places in the running are az, nm, fl, tx. i know, no water in the first two, but at least they are warm.
     
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  4. GeneralVeers

    GeneralVeers Globus Hystericus
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    Coastal Texas is not too bad for sun, water, palm trees, and cheap cost of living. I'm told that the Summer is unbearably hot.
     
  5. docB

    docB Chronically painful
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    My understanding is that the med mal climate in FL and TX are both pretty bad.

    If you want a place with nice weather, water and a good med mal climate you should try CA. Tough job market and high cost of living though.

    Is it reasonable for someone to look at the med mal climate as one of the major influences on their job search? How much of an issue should it be? I'm curious what everyone thinks.
     
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  6. Jeff698

    Jeff698 EM/EMS nerd
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    MedMal in Texas is now outstanding thanks to some very hard work by our medical association. Several years ago, we passed comprehensive tort reform, with a cap, and backed it up with a constitutional ammendment. We also raised the standard of proof for cases dealing with emergency physcians and those consultants taking emergency cases to 'wilful and wanton', a very high level of proof indeed.

    As a result, we've had a huge return of medmal carriers, a 19% drop in premiums and so many physicians moving to our state that our medical board has been overwhelmed (not that it took all that much).

    Here's a link to the TMA page discussing this: http://www.texmed.org/Template.aspx?id=780

    Texas is a great place to practice. Just don't tell anyone. We'll keep it between the two of us. :)

    Take care,
    Jeff
     
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  7. Jeff698

    Jeff698 EM/EMS nerd
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    Here's an overview from that link I posted above:

    ********from the Texas Medical Association web site***********

    Proposition 12 Produces Healthy Benefits


    Access to Health Care has Improved

    Texas has added more than 4,500 physicians since passage of the 2003 reforms and is licensing an average of 400 more doctors per year than in the pre-reform years.
    The Texas Medical Board accepted a record 4,026 applications for new physician licenses in 2006. That is 38 percent more than 2005, which previously was the board’s busiest year on record.
    After years of decline, the ranks of medical specialists are growing.
    After a net loss of 14 obstetricians from 2001 to 2003, Texas experienced a net gain of 163 obstetricians.
    Texas experienced a net loss of 9 orthopedic surgeons from 2000 to 2003. Since tort reform, the state experienced a net gain of 154 orthopedic surgeons.
    Texas has experienced a net gain of 23 neurosurgeons since Prop 12, including one each in the medically underserved communities of Corpus Christi and Beaumont.
    Medically underserved communities are posting impressive gains.
    The Rio Grande Valley added 128 physicians in the two years after reforms. That represents a robust 10.6 percent increase in Hidalgo County and an even greater 13.3 percent increase in Cameron County.
    Jefferson, Nueces and Victoria counties saw a net loss of physicians in the eighteen months prior to tort reform. Currently, all three counties are producing impressive gains; adding much-needed specialists and emergency medicine physicians.
    The physician growth rate in San Antonio is 52 percent greater than pre-reform.
    The physician growth rate in El Paso is 5 percent greater than pre-reform.
    The physician growth rate in Houston is 45 percent greater than pre-reform.
    Lawsuits filings and Claims Losses are Down

    Claims and lawsuits against doctors and hospitals in most Texas counties have been cut in half.
    Premiums are Stable and Declining

    All major physician liability carriers in Texas have cut their rates since the passage of the reforms, most by double-digits. Texas physicians have seen their liability rates cut, on average, 19 percent. Two-thirds of Texas doctors have seen their rates slashed a quarter or more.
    Producing cumulative liability cost savings of $230 million for Texas physicians since January of 2004.
    Fifteen rate cuts have occurred in Texas since the passage of the 2003 landmark reforms.
    Earlier this month (January, 2007), TMLT, the state’s largest insurer of physicians began implementing a $48 million liability cost reduction; arguably the largest ever dollar reduction by a U.S. physician insurer.
    Reductions in premiums since the passage of Prop. 12 and respective savings:

    Texas Medical Liability Trust: 26.5 percent, and $138 million in savings plus two renewal dividends totaling an additional $45 million.
    APIE: 17.4 percent, and $14.8 million in savings
    Medical Protective: 19.8 percent, and $17.6 million in savings
    Joint Underwriting Association (JUA): 10 percent,and $6 million in savings)
    The Doctors Company, 24.5 percent, and $4.2 million in savings
    Advocate MD: 29.5 percent, and $5.34 million in savings
    Cumulative liability cost savings since January, 2004: $230 million.

    Competition in the Health Care Liability Market is Increasing

    Since the passage of Proposition 12, Texas has added:

    Thirty new medical liability insurers have entered the market since February of 2003.
    Texas physicians can competitively shop their policies.
    Thirteen percent of the commercial physician liability market is being insured by companies new to Texas since February, 2003.
    Doctors are leaving the Joint Underwriting Association (JUA), the state pool of last resort, in favor of the commercial market.
    Hospital Savings

    Many Texas hospitals are using their liability savings to upgrade medical equipment and expand their emergency rooms, launch patient safety programs, expand charity care and improve salaries for nurses

    Last Published: 1/25/2007

    *********************

    Since then, there's been another 2% decrease in premium prices overall.

    Take care,
    Jeff
     
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  8. NinerNiner999

    NinerNiner999 Senior Member
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    I will be working in Florida starting this July and as of two months ago, they had repealed the three strikes law. The climate is changing down there and was a minor consideration when I chose where to practice.

    I am a believer that it doesn't matter whether you are a bad doctor or a great doctor, if you are in the wrong place at the wrong time with the wrong patient, you will be sued.
     
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  9. DrQuinn

    DrQuinn My name is Neo
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    I left Florida for many reasons, one of them was the malpractice climate. I can tell you that if you are in private practice, and not in academics, the extra stressors are there. Mostly anecdotal, but even where I was, where my attendings were protected by "sovereign immunity," there were a ridiculous # of lawsuits. Even when I was in the "fast track" as a senior resident, I had three patients call lawyers while they were waiting, and all three times the lawyers were with the patient the whole time.

    Q
     
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  10. vtucci

    vtucci Attending in Emergency Medicine
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    We had the Head of the Malpractice Department of Morgan and Morgan speak to the Society for Business, Law and Medicine at USF COM. He informed us that the average EP is sued once every eight years in Florida.

    That being said, I partially agree with Ninerniner999. There definitely is a wrong place, wrong time effect. However, as a former attorney, personality plays a big role. The Malpractice attorney was very emphatic on this point. They look for doctors to put on the stand who will come across as arrogant/obnoxious, cold, condescending etc.

    The take home message from our malpractice talk was that doctors who appear to care are sued considerably less (regardless of competence) than those who appear harried, indifferent or cold. We certainly can't cultivate the same long-term relationships as family practitioners or many specialists but sometimes it just takes an extra minute to stave off the suit (I know sometimes EPs don't have that minute and that is the rub).
     
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  11. OP
    OP
    kbrown

    kbrown chicken
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    thanks all for the responses. much appreciated. i am only an intern, so i have a time, just trying to get a handle on some locations that i would consider.
     
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  12. CS_22

    CS_22 Senior Member
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    I'm just jealous that you get to start planning a whole year earlier than me... :smuggrin:
     
  13. RustedFox

    RustedFox We're all stars now. In the GOAT RODEO.
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    Thread NecroBump.

    So, I work in Florida. - I remember reading this thread when I was considering many of those same things that were important to the OP - "Warm. Water. Sun." I was all-but-convinced that working here in FL was a medmal mousetrap. However, after reading some of the links in some recent Birdstrike posts, I'm learning that "it might not be so bad after all here".


    Florida College of Emergency Physicians has been fighting this battle and this year pushed H.B. 385 and H.B. 614 (unsuccessfully, unfortunately) and at least on group of attorneys (med-mal defense) agrees there is a need:

    "Once again, legislation has been proposed in the Florida House and Senate to extend sovereign immunity coverage to physicians providing care in emergency rooms."



    The idea has gained traction in Florida to the extent that it has infuriated at least on group of trial lawyers:

    "Florida's doctor loving governor Rick Scott has signed a new law that gives sovereign immunity protection to private university physicians who treat patients at public hospitals. This means that doctors who work for the University of Miami a private university and my Alma mater are given the same legal protection from medical malpractice law suits as though they were employed by the State of Florida."


    Blast it, the links didn't carryover. Ah, well.

    Anyways, after clicking thru some of those sites, I learn about the "Good Samaritan" statue, the higher burden of proof for EPs, the "presuit" requirement.... and I say to myself - "Hey, this sounds kinda promising".

    Anyone want to weigh in ? Niner ? Birdstrike ? dchristimi ? What do you know that I don't ?
     
  14. RustedFox

    RustedFox We're all stars now. In the GOAT RODEO.
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  15. FSU2013

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    I have a hard time believing a med-mal lawyer from Morgan and Morgan walked into a med school and didn't spontaneously catch fire.
     
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  16. NinerNiner999

    NinerNiner999 Senior Member
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    Med Mal isn't as bad as it used to be - that's for sure. Currently there are caps specific to emergency physicians, limiting claims in patients who were unstable in the ED to $150k, and maxing at $500k for all other.

    Legislation proposed, as suggested above, seeks soveriegn immunity protection for all emergency physicians, caps damages at $200,000, and requires victims seeking additional judgement to appeal to the state legislature for payment. If this passes, it will be a huge win.

    http://www.mymedicalmalpracticeinsu...ida-physician-malpractice-insurance-lawsuits/
     
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  17. Croooz

    Croooz Senior Member
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    :thumbup:
     
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  18. RustedFox

    RustedFox We're all stars now. In the GOAT RODEO.
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    Any update on the story in that link, Niner (its dated January 2012)?

    Also, the "three strikes" law is gone, right ?
     
  19. daveyjwin

    daveyjwin Senior Member
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  20. RustedFox

    RustedFox We're all stars now. In the GOAT RODEO.
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    For those of us like me who aren't familiar with governmental processes and such, how does a bill "die"? It just gets ignored for so long that its no longer valid ?

    Sorry for my ignorance, I just have zero idea regarding how these things work.
     
  21. Glitterbox

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    It needs to get passed by both the House and the Senate. The House is straight majority vote. The Senate is where things get a little more complicated. There are multiple ways to kill a bill in the Senate.
     
  22. Apollyon

    Apollyon Screw the GST
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    Seriously, dude? Honest.

    [YOUTUBE]H-eYBZFEzf8[/YOUTUBE]
     
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  23. RustedFox

    RustedFox We're all stars now. In the GOAT RODEO.
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    HaHa.

    I wasn't about to rely on my Schoolhouse Rock knowledge as a legit answer. Thanks for finding that, though.

    ... Meeemorieeees.
     
  24. HunterGatherer

    HunterGatherer HunterGatherer
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    I too was about to bust out the school house rock link when I saw this. It was truly a gem of Saturday morning viewing in my youth.
     

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