Doctors feeling pain of lawsuits

Following a trend that is reshaping health care across the state, a number of doctors at Southeast Georgia Health System are "deselecting" privileges, opting out of some surgeries and procedures they consider to be high-risk for malpractice litigation.

The deselection phenomenon has already left the Brunswick hospital unable to treat one common injury, even though there are doctors on staff who are qualified to do it.

"I don't think anybody will see jaw fractures," said the hospital's chief of staff, Dr. Bill Grubb. Patients may have to be transported to Jacksonville, 70 miles away, for treatment.

Jaw fractures are commonly suffered by indigent and uninsured patients who tend to get hurt in auto accidents or street fights, Grubb said.

The repair procedure, which is particularly difficult and often damaging to the patient's appearance, carries with it the threat of malpractice suits against the surgeon who performs it.

"You can bill whatever you want," Grubb said, "but you're not going to get paid. You are going to get sued."

The problem goes deeper than jaw surgery, doctors at the hospital say.

It is only a matter of time before other areas, notably obstetrics, neurosurgery and vascular surgery, begin to feel the squeeze of deselection, which has already affected smaller hospitals across the state.

But the cure for these ills is a matter of debate.

Last week, a group of 12 state senators prefiled legislation for next year's General Assembly session that would cap non-economic damages - awards for pain and suffering and for the prolonged medical care that some patients require after an injury - at $250,000.

Rep. Jerry Keen, R-St. Simons, introduced a similar bill into the House last year. That measure died before it reached the floor, but Keen said he and other supporters of changes in tort litigation - involving private or civil actions - were gearing up to push the measures again in 2005.

"You can definitely know that tort reform will be on the House for a vote," Keen said. "As for what will happen, I don't know."

Tort overhaul bills like these aim to stop rising malpractice premiums by ending multimillion dollar "jackpot" jury awards that some believe are driving up the cost of medicine.

Malpractice premiums are rising by as much as 50 percent a year in some areas, and doctors are dropping services as a result.

Paid medical expert witnesses act as hired guns for trial lawyers and push jury awards higher, Grubb said.

"We're just being eaten alive by these people," Grubb said. "It's a feeding frenzy that's going on"

In a survey conducted by the state in 2003, 14 percent of Georgia physicians said they had stopped performing certain high-risk procedures over the past year. The previous year, 18 percent of physicians said they had stopped procedures.