WILLIAMSPORT, Pa. (ABP) — High-priced malpractice insurance, which is prompting many physicians across the country to reduce their practices or leave the field, is also limiting health care for patients who use free and Christian-operated clinics.
In Kentucky, a free clinic operated by Green Valley Baptist Association was forced to close down in July 2003 due to malpractice insurance costs. The clinic had been running for three years and treated an average of 600 patients per year.
Many physicians — 25 percent to 30 percent by some estimates — are scaling down what they do in their practices in order to dodge insurance costs.
As only “frail humans,” some physicians facing higher insurance rates and growing public mistrust of doctors “can't handle” staying in the medical field, said James Redka, a family physician in Williamsport, Pa. Often they retire early or perhaps go into mission work, he said.
“By quitting the practice, they're hiding behind what's safe rather than what's right,” Redka charged. “Healing is God's grace, and we [physicians] are to assume a position as servants.”
If the malpractice crisis is creating a loss of practicing doctors, it may be gain for medical missions.
“As doctors are less satisfied with their daily practice, they look for other places to feel used and to give care to people in Jesus' name,” said Fred Loper, acting executive director for the Baptist Medical-Dental Fellowship. “This may be one reason they become interested in health-care missions on a volunteer basis.”
According to Curtis Harris, an endocrinologist and trustee of the Christian Medical and Dental Association, some physicians are leaving the practice five to 10 years early and donating money they would have spent on malpractice insurance to a church.
However, Harris said the Volunteer Protection Act of 1997 offers hope and relief. The act grants immunity from liability for volunteer doctors working for nonprofit organizations. Harris, a lawyer who also teaches at the University of Oklahoma College of Law, said the impact of the act is “understated” because many free clinics are unaware of its implications.
While the federal act doesn't protect the clinic or doctors from being sued, it does limit doctors' liability if the claim falls within the act's scope of protection. Under the 1997 act, doctors must have the appropriate license to practice and must only practice within their area of expertise.
According to Kathy Strange of the Green Valley Baptist Association, which operates the Kentucky clinic, administrators received information on the Volunteer Protection Act, but they understood there was an application process, and they didn't get that worked out before they had to close.
“With the climate of malpractice insurance costs, we made the decision to not look more into medical ministries or re-opening our clinic in the future,” said Strange, director of community ministries for the Baptist association. “We checked on several of our former patients, and they had found health care through an internship program at the emergency room and doctors that worked at our clinic.”
For Christian health care that isn't nonprofit, liability protection costs can cripple clinics' abilities to help patients. At Cornerstone Family Health in Williamsport, Redka said, the yearly increase in insurance costs makes it difficult to hire physicians at the clinic's already substandard wages.
Besides hindering new employment, insurance rates for pediatricians — which will double this year — could cost St. Mark Professional Medical Center its pediatrician, according to Kathi Jackson, director of operations at the suburban Chicago clinic.
“If we lose our pediatrician, we will still be able to send his patients to our family practitioner, but not the kids that need specialized care,” Jackson said. “The practice will suffer in the instance that we will have to refer patients outward to receive optimal care if we can't sufficiently treat them here.”
Jackson said many pediatricians, neurologists and obstetricians leave Illinois, where there is little insurance regulation, for Indiana, where there is a cap on malpractice damage awards. Although some states have passed medical malpractice reform bills, the cap rates and extent of regulation varies considerably from state to state.
But, Redka said, more important than finance is the damage to doctor-patient relationships as a result of malpractice issues.
Redka has been named in five malpractice cases — one was settled, two were defended and won, and two were dropped. Discouraged by those cases, Redka blames the public for abandoning God for a “god of science.” Redka said the health system is in danger if people believe that a fault of nature is a fault of the doctor and that they deserve compensation.
Redka encourages Christians to pray for physicians to have wisdom and courage to do what's right, but he said Christians can also help alleviate malpractice issues.
“Scripture says, 'Don't take your brother to court.' Christians need to be challenged to do as Christ would do and be stewards of their health, seeing physicians as an ally,” Redka said. “If something goes wrong, it's better to look at how to fix it, not get back.”
The American Medical Association has declared about 20 states to be in a medical liability crisis, lacking adequate reforms and instigating further rises in premiums. States with reform bills often have a cap of between $250,000 to $350,000 on non-economic damages and a statute of limitations, according to the AMA.
Harris said many states are looking at reform, and other states are uncomfortable but not in a crisis.
“Short of legislative protection, [free] clinics have no solutions of their own,” Harris said. “They have little legal counsel and they're low-budget.”
“I would suggest inside the next three years, most states will have to re-look at their situation, and there will be some clinics in different states that just have to close,” Harris said.
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— Kirsten Pasha is an intern with Associated Baptist Press.