Archives: January 2020

January 2020 Newsletter

Iowa mothers facing fewer options for labor and delivery A rising trend of Iowa maternity ward closures is having a domino effect on expectant mothers and access to prenatal care. With 12 maternity wards closing statewide between 2016 and 2018, the already rural state is leaving soon-to-be mothers with fewer options – further away. Once known as a state offering a reasonable medical liability climate, recent sky-high judgements have impacted the willingness of physicians and hospital systems to remain in practice. Between 2017 and 2019, Iowa juries awarded plaintiffs more than $63 million in non-economic damages, adding up to nearly three times the $21.4 million awarded in economic damages. Now, half of Iowa’s counties lack any maternity services at all. “This situation drives up health care costs for all Iowans as malpractice insurance premiums rise, while putting patients, doctors and hospitals at risk,” writes Dr. Marygrace Elson, an OBGYN practicing in Iowa City and president of the Iowa Medical Society, in a recent op-ed. Ranking last across all states in the number of OBGYNs per 10,000 women, medical liability reform is a must, Elson emphasizes. To read more about the need for the Iowa legislature to take action on liability…

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High court ruling must avoid encouraging involuntary commitment

SOURCE: American Medical Association Giving mental health patients access to outpatient care and reserving involuntary commitments for situations that warrant them is crucial to patient safety because studies show that involuntarily commitments result in patients refusing help for fear their civil rights will be taken away. State laws over decades have evolved to support physicians in striking that balance. Now a plaintiff is asking Pennsylvania’s highest court to interpret a commonwealth law in a way that would ultimately force physicians who feared being sued to err on the side of providing involuntarily treatments for patients to whom they otherwise would have provided voluntarily outpatient care. The Litigation Center of the American Medical Association and State Medical Societies in December joined the Pennsylvania Medical Society and the Pennsylvania Psychiatric Society in filing an amicus brief in the matter. The brief asks the Supreme Court of Pennsylvania to uphold an appellate court decision that does not open physicians up to a new liability when they are making treatment decisions involving mental health patients. “Overall, studies have shown that 77% of previously admitted patients will not risk being institutionalized again, even if they know they pose a danger to themselves or others. Creating…

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Two-thirds of cardiologists have been named in a malpractice suit

SOURCE: The Gazette Most cardiologists have been implicated in a malpractice lawsuit, according to Medscape’s annual Cardiologist Malpractice Report, and in many cases the litigation causes them to stop trusting their patients. For this year’s Malpractice Report, Medscape asked more than 4,300 physicians in over 25 specialties whether they’d been sued, why they were sued, what happened and how that experience affected the way they practice medicine. Nearly two-thirds of cardiologists said they’d been named in at least one malpractice lawsuit—18% of whom said they were the only person named in the suit. Just 35% said they’d never been implicated. Wrongful death and complications from treatment or surgery were tied as the number-one reason for malpractice suits, according to the report, accounting for 34% each of the total pool. Other common reasons were failure to diagnose or delayed diagnosis (27%), poor outcome or disease progression (25%) and failure to treat or delayed treatment (23%); abnormal injuries, poor documentation and errors in medication administration prompted legal action more rarely. “There’s a whole host of what you could call psychological factors that can contribute to the filing of a claim,” David S. Szabo, Esq., a malpractice lawyer with Locke Lord, LLP, in…

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A malpractice cap can help maternity care access

SOURCE: The Gazette Last summer, Marshalltown’s UnityPoint hospital shuttered its maternity ward. The year before that, Washington County Hospital in southeast Iowa did the same. These closures weren’t outliers. According to the Iowa Department of Public Health, 28 Iowa hospitals stopped delivering babies between 2001 and 2018. Nearly half of those maternity wards (12) closed within a two-year span, from 2016 to 2018. We’ve known about some of the contributing factors for a long time — our shrinking and aging rural populations don’t need as much maternity care, and Medicaid reimbursement rates are too low to keep maternity services viable at more remote, financially strained facilities. But within the past few years, there is another concern: sky-high awards and settlements in medical malpractice cases. When I moved to Iowa 20 years ago, Iowa enjoyed the reputation of practical and reasonable juries and malpractice judgments — attractive for a physician looking for a place to practice. When a patient was injured, a jury would determine how much money they should award to cover “economic damages,” including things like treatment costs and lost wages. If indicated, juries could also order doctors and hospitals to pay “punitive” damages. But sometimes when a patient…

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