Dr. Ron Elfenbein
2008-02-18 08:00:00.0
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BALTIMORE -

According to most national polls, access to affordable health care is among the very top concerns for most voters. A recent study from the Maryland Hospital Association and MedChi (Maryland’s state medical society) suggests that Marylanders ought to be particularly worried. The study found that Maryland has 16 percent fewer practicing physicians per capita than the national average, and this doctor shortage is expected to become severe over the next five to 10 years.

This might come as a shock to those of us who would expect our state to have a steady stream of talented doctors and surgeons pouring out of Maryland’s world-renowned medical universities. But increasing retirements, too few doctors coming into Maryland and too many doctors leaving the state mean that we will soon be facing a crisis in the ability of patients to have access to the care they need.

This study tells us that Maryland needs to take action to retain the new and experienced doctors we have and attract others to our state. While a variety of factors affect Maryland’s ability to compete for medical professionals, improving our liability climate needs to be part of the solution.

Frivolous lawsuits and runaway jury awards threaten our entire health care system and increase health care costs for all, as litigation costs are passed on to patients. PricewaterhouseCoopers estimates that 10 cents out of every dollar we spend on health care is directly attributed to the costs of liability and defensive medicine practices. In an era when health care costs are rising at more than two times our rate of inflation and account for more than 16 percent of our gross domestic product, or $6,700 for every American, lawsuit abuse presents a very real cost.

Personal-injury lawyers’ attacks on our health care system have also led medical students to avoid certain specialties due to liability concerns. Those who do pursue high-risk specialties are often forced to alter their practice as a result of lawsuit abuse. In a recent American Medical Association survey, more than 90 percent of high-risk medical specialists said that liability pressures were important in their decision to stop providing certain services.

This is not an esoteric exercise about losing good doctors, but an example — a life-or-death example — of how government has failed us. Taxpayers should expect access to health care as part of our quality of life. Many counties in Maryland no longer have any practicing neurosurgeons, otolaryngologists (ear, nose and throat) or thoracic surgeons. Outside of Baltimore City, almost every county in the state lacks enough qualified emergency physicians to simply staff the emergency rooms, let alone have any sort of backup or contingency plans in the event of a disaster, man-made or otherwise (bird flu, earthquake, flood, hurricane, terrorist attack, etc.).

We are increasingly in danger of reaching a point when patients needing emergency care (auto accidents, medical illnesses, etc.) or specialty care will suffer the consequences of this legal environment. We have already seen some of this begin to occur with multiple unnecessary deaths in rural areas of Maryland, simply because those with the needed expertise to care for the patients had left the region, citing the liability climate as one of their top reasons for leaving.

As seen in Texas and other states, common-sense legal reform will go a long way toward securing health care for Maryland citizens. If governmental services are truly important to our leaders in Annapolis, then the most sacred of those services — life-and-death health care — should be high on their priority list. Our state is producing some of the finest medical talent in the world at our institutions of higher medical learning, yet losing them to states with better legal climates and fewer frivolous lawsuits. It need not be so.

Dr. Ron Elfenbein is a practicing physician in Maryland, a board member of Maryland Citizens Against Lawsuit Abuse and a resident of Annapolis.