A tale of two MDs

Monday, March 20, 2006 | 7:08 a.m.

Nevada has had a medical crisis over the last four years as physicians have faced a choice: pay malpractice rates that were skyrocketing in some high-risk fields or leave.

Voters tried to ease the pain in 2004 by imposing a cap on the amount of damages patients could collect. The purpose was to reduce malpractice premiums, but so far, rates remain high - and many physician specialty fields remain underserved in the state.

The number of doctors in the Las Vegas Valley continues to grow, but high-risk specialties such as surgery and obstetrics/gynecology show some of the smallest increases.

In 2004 the state had added 212 licensed medical doctors, an increase of 7.3 percent. Of this amount, 96 specialized in internal medicine, 36 in pediatrics and 29 in family practice.

Conversely, the state added only 10 general surgeons and eight Ob/Gyns in 2004. The state also showed an overall increase in doctors last year, but breakdowns by specialty are not yet available.

Experts say continued concerns over malpractice litigation is one reason Las Vegas has a hard time attracting and keeping the high-risk doctors.

"When you have malpractice rates that are half or less in the Midwest than what they are here, it is going to hurt recruiting efforts," said Ron Kline, president of the Clark County Medical Society. "But this is more than just a financial issue."

The strain of living in a litigious environment also puts an emotional pressure on doctors, according to Kline.

"The stress that you could be sued at any moment also takes a toll," Kline said. "Lawsuits also damage a doctor's reputation, and trust is a very important thing for doctors."

The malpractice insurance increases reached critical levels for many doctors in 2002 when some insurers stopped offering coverage, and rates spiked almost overnight. Many doctors found they could no longer afford insurance.

Some took out loans to pay the higher rates or went to work for a facility that helped with their coverage, while others left town.

Dr. Lonnie Hammargren chose to give up his practice rather than pay the $275,000 in malpractice insurance it would have cost him to keep practicing. Hammargren was a prominent local neurosurgeon for 34 years and a former Nevada lieutenant governor and university regent.

"I was losing money every day, and I just had to quit," Hammargren said. "I'd like to practice and practice in the valley, but I just can't afford to."

Concerns over the flight of doctors in specialty fields and an inability to recruit replacements spurred a special session by the state Legislature in 2002 and the initiative in 2004 to cap damages in malpractice lawsuits.

Some say the legislation has helped to recruit new doctors and keep existing doctors here.

Others point out that it has yet to attract a large number of doctors in the specialty fields and could cause another exodus of doctors if it is struck down in the courts.

"I know there are doctors that are waiting to see what happens with this issue before they decide what to do," Kline said.