Friday, June 14, 2002 | 5:18 a.m.
WEEKEND EDITION: June 16, 2002
Jon Ralston hosts the public affairs program Face to Face on Las Vegas ONE and also publishes the Ralston Report. Ralston can be reached at [email protected] or (702) 870-7997.
AS POLITICAL operators, Nevada doctors have long been quacks.
For years, the physicians have practiced lobbying without a license and suffered mortal losses at the Legislature as the trial lawyers have gutted any attempts at tort reform through superior advocacy and political skills. When it has come to winning hearts and minds in Carson City, the attorneys have been the ones doing most of the brain and cardiac surgeries on the Gang of 63.
That, however, may be about to change, especially if the results of a recent poll are any indication. As I've said before, the doctors finally wised up and bought some juice in the form of public relations/lobbying pros Pete Ernaut and Mark Brown, who have many insider relationships, most importantly their personal and professional tethers to Gov. Kenny Guinn. And their efforts to take a real crisis -- doctors either fleeing or threatening to flee the state because of rising medical malpractice liability costs -- and turn it into a public relations steamroller for tort reform, appears to be working.
A survey taken a few weeks ago by national pollster Lance Tarrance for Brown's company reveals that not only are Southern Nevadans highly aware of the crisis, they also are sympathetic to the doctors and hostile to the lawyers. Tarrance had a blunt take on the results of the poll, taken of 400 Clark County residents and with a margin of error of 5 percent: "By and large, it's their (the doctors) election, if you can call it that, to lose."
Why?
First, after discovering that Southern Nevadans are overwhelmingly satisfied with their medical care, Tarrance found that four-fifths of the public is aware of the malpractice liability crisis. So the media attention has worked. The doctors have taken the first step.
Then Tarrance found that people are buying the doctors' arguments. Seventy-eight percent believe physicians will leave because their insurance premiums are "at such a high price that it makes their practices economically impossible." Seventy-two percent believe that high-risk practitioners in emergency rooms, trauma centers and obstetrics will leave to limit their exposure.
And then the showstopper for the doctors: Seventy-two percent agree that "the best way to deal with the issue of medical malpractice insurance is to place limits on how much a person can receive if they sue a doctor."
That is, caps, the holy grail the physicians have been on a quest to find for years. The public, the poll says, is on their side at last.
Tarrance didn't stop there, though. He tested the trial lawyer arguments, too. And the attorneys did not fare well. Consider the response when people are asked about the argument that "limiting what a person can receive in dollars if they (sic) successfully sue a doctor for negligence would restrict patients' rights to hold negligent doctors in Clark County accountable." The good news for the lawyers is that 47 percent of respondents agreed. But 41 percent disagreed, which means their best argument is a wash. Not a good sign.
Tarrance then pushed on some of the doctors' real goals. The public was evenly split on whether juries should still be able to impose any size verdicts "even if this causes many doctors to leave Nevada." But when asked specifically about the $250,000 cap to "provide lower medical malpractice insurance rates for all doctors and ensure that the best doctors will remain in Clark County," 60 percent said they agree and only 28 percent did not. Again, the holy grail seems within reach for the doctors.
Finally, Tarrance framed the issue for people to decide which was closest to their view:
"If medical malpractice jury verdicts keep getting higher, good doctors will leave Clark County and go elsewhere and the quality of health care will worsen, or doctors can still afford higher insurance premiums and large jury verdicts only help the people who have been insured."
Slanted toward the doctors a little, perhaps, but again a landslide -- 74 percent said that if the verdicts get out of sight, the doctors will leave while only 18 percent said the physicians can still afford to pay.
So, so far at least, Brown and Ernaut are earning their keep -- and it may be no coincidence that the governor now supports caps and is kind of, sort of calling for a possible special session, maybe. The doctors are making their point again today with a full-page ad driving home the consequences of the physician flight and hyping California's tort reform.
But the trial lawyers have been under some sort of political anesthesia and methinks they may be waking up soon. They have potent lobbyists of their own in R&R Partners' Billy Vassiliadis and Reno advocate Bill Bradley and they think they can show, using some polling data of their own from California, that if the right arguments are made, people will not support caps.
"Lawyers know how to debate better than doctors or politicians," Tarrance acknowledged. "I'm never one to count them out."
Maybe not. But thanks to a real crisis amplified by a public relations blitzkrieg, the lawyers, much like the politicians, have been rendered mute and almost irrelevant by some doctors who finally have learned how to practice political medicine.
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