Nevada doctors face insurance crisis

Monday, Jan. 28, 2002 | 9:41 a.m.

A Minnesota company's decision to get out of the medical malpractice insurance business could force nearly 40 percent of Nevada's physicians to either pay painfully high premiums for new coverage or close their office doors.

"It's a serious issue, and we certainly have a sense of urgency about dealing with it," said Gov. Kenny Guinn, who met last week with about 25 doctors to discuss the situation. "We may lose some of the doctors we have and have a difficult time recruiting new ones."

St. Paul Cos., Nevada's largest provider of malpractice insurance, covering about 1,300 physicians, is stopping malpractice coverage, a company spokeswoman said. The malpractice insurance division of the conglomerate posted a $900 million loss last year, Andrea Woods, St. Paul spokeswoman, said.

For every dollar the company received in premiums from Nevada physicians, $1.88 was paid out either in jury awards or to settle claims, Woods said.

"Nevada has one of the worst loss ratios in the United States," Woods said Friday. "Our research suggests things are only going to get worse all over the country, so it made sense to get out of the market entirely."

Las Vegas surgeon Dr. John Ameriks, who is losing his coverage with St. Paul Cos., estimates his premiums could increase 500 percent.

"This is going to affect the availability of health care for the people of Clark County," said Ameriks, who has practiced here for 33 years.

It's not just St. Paul Cos.' clients facing rapidly rising rates.

Dr. Kenneth Misch thought he would have to shut his pediatrics clinic Jan. 1 after his insurance agent warned him to expect a 300 percent increase in his premium because of Nevada's track record for medical malpractice suits.

His office's sterling record didn't sway the insurance company, Misch said. A last-minute loan from a bank kept the doors open, he said.

Last week Misch was forced to lay off a member of the 14-physician Desert Valley Pediatrics practice.

"We are almost panic-stricken," Misch said Friday. "Something has to change, or there will be no doctors left in this state."

Nevada has one of the highest rates of medical malpractice suit filings, legal experts said. There's no limit in Nevada to what juries can award patients for damages in medical malpractice suits, unlike the $250,000 cap in neighboring California.

"We see lawyers moving here from as far away as Florida to take advantage of the no cap," said Las Vegas attorney John Cotton, who specializes in defending physicians and health-care providers. "You can't turn on the television without seeing one of their ads."

The Legislature could set a cap on jury awards, but the next session is a year away. Doctors need immediate help, Guinn said.

"We want to work with doctors on a short-term plan and at the same time look at the big picture," said Guinn, who added he also has meetings planned with several concerned attorneys.

If no action is taken, Southern Nevada's medical community could be reduced to a ghost town, Ameriks said.

"If every unfortunate, unexpected outcome turns into 'I've been injured and someone has to pay,' we will not survive as an intact society," he said.

Larry Matheis, executive director of the state medical association, agreed. "Doctors will be unable to get insured, which means they'll be unable to work," he said. "We'll see emergency rooms close. It will become a crisis for every one of us."

Ameriks said he was cheered to hear that Guinn met with physicians last week.

"The solution isn't in the hands of the doctors, it's in the hands of the citizens, the governor and the Legislature," he said.

Hardest hit by the premium increase are doctors in high-risk specialities, such as obstetrics and emergency medicine. Obstetricians are legally liable for the babies they deliver until the patients turn 18.com