Doctors: Trauma care may be forced out of state

By Emily Richmond (contact)

Wednesday, Feb. 6, 2002 | 11:10 a.m.

Physicians at University Medical Center's trauma center said this morning the lack of affordable malpractice insurance could force the only 24-hour trauma facility in Nevada to divert patients to other states.

St. Paul Cos., which insures many of the center's physicians as well as 40 percent of Nevada's doctors, announced in December it would stop providing medical malpractice insurance, citing heavy losses.

Other insurers are demanding premium increases of 300 to 500 percent, citing the high number of medical malpractice suits in the state and a lack of a cap on awards that makes coverage expensive, doctors say.

One physician has already been forced to withdraw from the trauma program and others are considering retiring, said Dr. John Fildes, medical director of the trauma center, which handles the most serious cases in a 10,000-square-mile area over four states.

"We have a few shifts later this month we're having trouble covering, and we're struggling to create a schedule for March," Fildes said. "We may come to a point where the trauma center won't be able to operate every day of the week, every hour of the day.

"This is a dire situation," he said. "You can't expect victims of car wrecks to survive a plane ride to the next closest trauma center."

The center is staffed by 12 community-based physicians, supplemented by specialists from around Southern Nevada, Fildes said. Doctors employed full time by the county are protected from being sued for more than $50,000, but the community-based doctors don't qualify, he said.

Gov. Kenny Guinn said this morning he met Saturday with doctors at UMC to discuss rising concerns about insurance costs.

"We are moving very quickly to try to hold open hearings for the insurance companies to discuss these matters," Guinn said. State Insurance Commissioner Alice Molasky-Arman has set hearings for March 4.

Guinn said he is working with a group of doctors to establish some type of self-insurance program, but added: "These things take time."

St. Paul Cos. six years ago bought the Nevada Medical Liability Co., a company doctors started in the 1970s during a similar crisis.

The Nevada Medical Association, meanwhile, is crafting legislation to limit damages on malpractice cases, a move the state's trial lawyers oppose.

"We're at a very critical stage right now," Guinn said. "We have to work together with doctors and trial lawyers to get a short-term solution quickly."

Cliff King, head of the property and casualty for the state Insurance Division, said today what makes the problem more difficult is that a doctor losing coverage may have to carry two insurance policies to replace it.