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Briefing and Opinion
October 22, 2004

Unhealthy Consequences

It is clear that insurance premiums have become so expensive in some states that doctors -- especially obstetricians, surgeons, and emergency room doctors -- have stopped practicing or moved to states where premiums are cheaper. We look at how health care is suffering through the eyes of the Smith family, two generations of doctors who think the public should be paying closer attention. Our report is from correspondent Celeste Ford.



The Smith family doctors

Dr. Leon Smith Sr. of New Jersey has practiced medicine for more than 50 years. The family patriarch watched four of his five children choose the same profession, but the Smiths say their family tradition is threatened by the high cost of insurance for medical malpractice. And they say it's limiting your access to quality healthcare. "I think the public needs to be aware, it's time to act," says Smith. "Don't sit back, or your children are going to be in trouble."

Dr. Michele Smith Blackwood
His daughter, Dr. Michele Smith Blackwood, is a breast cancer surgeon -- a high risk specialty -- and she says the cost of medical malpractice insurance drove her out of private practice in Connecticut. "It's probably the most crucial issue facing my generation of doctors," says Blackwood.

She says her medical malpractice insurance almost doubled to over $60,000 a year, even though she has never been sued. Blackwood moved to New Jersey for a staff position at Saint Michael's Medical Center which pays her liability coverage.




Dr. Leon Smith Jr. Blackwood's brother, Dr. Leon Smith Jr., is in another high-risk field, he's an OB/GYN. "The first time I delivered a baby in medical school, I knew that I wanted to do this for the rest of my life," says Smith. "I chose a field that intrinsically takes care of the highest risk mothers and their babies."

Smith has delivered more than 3000 babies and he's been sued twice for malpractice. Recently his insurance bill almost doubled to more than $200,000 per year, so Dr. Smith stopped delivering babies.

His brother says that's a shame. "Now the most complicated deliveries in the state of New Jersey are being handled by obstetricians not trained to the degree my brother and his partners are," says Dr. Stephen Smith.

In this climate, some doctors shy away from helping out in tough cases. "There's not that generosity of care that there was 10 years ago, says Leon Smith. Doctors ask themselves, "Why do I have to get involved in that case?" Stephen Smith

Last year the Smiths were among thousand of doctors across the country protesting the cost of insurance. But what about the horrifying cases of medical error? The 17-year-old who died when a surgeon at Duke University performed an organ transplant with the wrong blood type. Or the New York City surgeon who operated on the wrong side of a cancer patient's brain. In that case, attorney Harvey Wachsman negotiated a multi-million dollar settlement. Says Wachsman of the cancer patient, "She was destroyed totally because she had a tumor still there on the left side."



Wachsman is one of the country's top medical malpractice attorneys, winning hundreds of clients awards ranging from $50,000 to five million. He has an unusual courtroom advantage. Wachsman is ALSO a neurosurgeon.

"I want to see the public protected. thats why need these lawsuits," says Wachsman.

Harvey Wachsman
What does he say about the common perception that greedy medical malpractice attorneys are causing spikes in insurance premiums? "That's not the cause. Ever. The real cause is that insurance companies want to make more money. How do they make more money -- raise the rates."

Attorneys like Wachsman blames mismanagement by the insurance industry. The insurance industry blames the legal system, including trial attorneys. The Smith doctors blame all of them.

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Under pressure from the insurance industry and doctors, more than 20 states have adopted a cap on the money paid to patients for their emotional pain and suffering. The caps are supposed to discourage frivolous lawsuits. A Gallup poll conducted last year found that 72 percent of Americans favor these caps.

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Until there's a far reaching solution, Dr. Stephen Smith says everybody must pay more for healthcare because doctors are forced to practice defensive medicine. He disagrees with the trial attorney claim that they bring accountability to the field of medicine. "It has nothing to do with accountability," says Smith. Rather, the lawyers simply put pressure on the doctors to order extra, often unnecessary, tests and procedures because they fear lawsuits. All of which naturally drives up the cost of care.

This family of doctors says medicine no longer attracts the highest caliber students. They worry about the prospects for healthcare and whether there will be a third generation of Smith doctors.
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"What galls me the most is the future," says Dr. Leon Smith Sr. The situation is so bad that he fears good doctors will be discouraged from the practice entirely. With so much harrassment, he says, "it's just not worth it."