Tuesday, March 4, 2003 | 11:27 a.m.
About 30,000 Southern Nevada women will lose their doctors in two weeks, medical officials said Monday.
Dr. Ken Jones, a Las Vegas Valley physician for 10 years, said he and his fellow OB/GYN, Dr. Rafael Juarez, will quit Henderson's Deseret Women's Care by March 19 because they cannot afford increased insurance premiums.
That leaves Deseret patients like Collette Gerber scrambling to find new doctors to deliver babies. Gerber is due to deliver a girl by Caesarean section in about 30 days.
"This problem needs to be addressed because women need to be able to get (prenatal) care early from someone they can trust," she said.
Jones and Juarez's departure will also be a blow to St. Rose Dominican Hospitals in Henderson, said Rod Davis, the hospitals' president and chief executive officer. Jones and Juarez are primary care providers for St. Rose, two of the 25 such specialists staffing the hospitals, Davis said.
The OB/GYNs left in the valley will be hard pressed to pick up Jones and Juarez's patients, Davis said.
"Unfortunately, until we can find replacement physicians, many of those patients may have to go out of the area to find physicians to cover them," Davis said.
Greg Bortolin, spokesman for Gov. Kenny Guinn, said a list of doctors accepting new patients is available from the governor's office.
State lawmakers this week are debating medical malpractice insurance laws and the conflicting reports about the numbers of doctors who have left Nevada or quit practicing because of rising insurance costs.
"In my experience, we are continuing to lose good physicians at an unacceptable rate," Davis said. "I'm not able to replace those physicians easily. So, unless something is done, I think the situation is only going to get worse."
If the situation does get worse, he said, the hospital may have to curtail services. If enough doctors leave, some services will be cut.
Jones said he and Juarez had "hoped that the market would stabilize and things would get better. But these (insurance premium) numbers, I was told, would only increase next year given the current circumstances in the valley."
Jones said he and Juarez's insurance costs combined were to increase to $365,000.
"You're at bankruptcy before you even open your doors," Jones said.
Their partner, Dr. Tracy Kvarfordt, is facing a premium of $97,000 and will remain at the Henderson clinic.
Jones said that "clearly what (state lawmakers) did in August wasn't that sufficient to stabilize the market."
In August, Guinn tried to resolve the medical malpractice insurance crisis that peaked with the temporary closure of the UMC trauma center.
Guinn offered a state-sponsored insurance underwriting plan to help doctors who couldn't get malpractice coverage then signed a special session Assembly bill that capped jury awards for pain and suffering at $350,000, allowing few exceptions. The state also provided an insurance association to improve access to malpractice coverage.
The reforms were the best possible solution to the problem, said Nevada Insurance Commissioner Alice Molasky-Arman, and need time to work.
She said insurance premiums are based upon past court costs and losses, and that the awards cap will have to be seen in the courts before it can be figured into insurance premiums.
"My feeling is that it won't become really stabilized until we have some certainty as to what the rates are going to be," Molasky-Arman said. "It's going to take another year or two to see any effects, maybe three years."
Bortolin said Nevada's current law, "if it passes constitutional muster and is given a chance to work, will in the long term stabilize the insurance market. And, we hope, lessen the cost."
But past or pending legal claims against doctors affect malpractice insurance rates too, Bortolin added.
"I believe the doctor that has decided to stay (at the Henderson clinic) does not have any legal claims against him and was able to get a very competitive rate," Bortolin said.
But Jones said neither he nor Juarez have a bad track record. A lawsuit against Jones was settled for $400,000 four years ago, and Juarez has two claims pending against him, Jones said.
"We do not have excessive claims -- we are below average when it comes to claims," Jones said.
Jones said the more probable reason for the increase is he and Juarez were covered by St. Paul, a company that decided in December 2001 to get out of the medical malpractice business. That is one reason for the problems in Nevada; St. Paul represented 60 percent of the state's doctors.
Jones said Kvarfordt is insured by a company called GE Medical Protective, or Med Pro, and would be in the same boat as he and Juarez should that company also stop underwriting.
That insurance company's spokesman, John Novaria, said it is writing new policies in Nevada but that doctors have to qualify as insurable.
"Dr. Juarez and I were rejected by the governor's (insurance underwriting) plan as being uninsurable," Jones said. "The problem is that with jury awards so high, insurers do not believe the cap is going to be effective."
Juarez could not be reached for comment today. Jones said Juarez was on his way to Carson City to talk to lawmakers Wednesday about his clinic's situation.
Jones said he will start interviewing for positions in California and Arizona. He said that he does not have much family here, but will have to start over again. He said he does not believe Juarez has decided where he will relocate.
The next two weeks will be spent completing patient work and calling in favors to find new doctors for his patients requiring surgery, Jones said.
Other women, he said, may be forced to have their children in emergency rooms.
Sun reporter
Ed Koch contributed to this report.
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