5 steps doctors should take to achieve liability reform

A message to all physicians from the chair of the AMA Board of Trustees, J. James Rohack, MD.

By J. James Rohack, MDis senior staff cardiologist at the Scott & White Clinic in Temple, Texas. He was AMA president during 2009-10 and served as chair of the AMA Board of Trustees during 2004-05. Posted Feb. 7, 2005.

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"A great flame follows a little spark." The poet Dante Alighieri wrote those words in 1321, but for the American Medical Association, they have never been more timely.

In the last two years, the No. 1 legislative priority of the AMA has been to achieve meaningful medical liability reform.

And during these last two years, we have seen some sparks fly.

Sparks like the passage of laws in Texas, Florida, Wyoming and Nevada that have helped protect access to high-risk specialties to patients in those states.

The case for national reform is compellingly made in the document "Medical Liability Reform -- Now!" which is available on our AMA Web site (link).

As we begin 2005, spurred on by the results of the 2004 elections, the time is ripe for success on the federal level. But this success will come only with your help. And we are asking you to do five things -- to take five steps to help us succeed.

First, during the week of Feb. 21, we ask that you and your patients participate in a town hall meeting with your elected members of Congress and the Senate when they return to their districts and states from Washington, D.C.

Our legislative process works only when our elected officials hear from their constituents.

And now, they need to know what needs to be done to fix a broken liability system.

Our immediate solution is to enact legislation that mirrors MICRA, the reforms passed in California in 1975.

MICRA has a proven track record of success at controlling the unpredictable escalation of premiums due to uncertain jury awards for noneconomic damages. By capping the noneconomic damages at $250,000 -- but allowing full compensation for economic and medical costs -- the system has shown to be fair to patients and those providing care.

Second, we ask you to help us get in touch with individuals who can relate their experience with the broken liability system. Regretfully, in this current culture, they must be able to withstand the expected media scrutiny and attacks from the trial bar.

Third, we know that the legislative process is often driven by compelling human stories that put a face on a problem. That is why it is crucial that we develop a shared data warehouse that highlights the loss of patient access to care, higher direct and indirect costs and the inequities of jackpot justice.

And we need to utilize this information among all the partners in our medical Federation. If you have such anecdotes or examples, or know someone who can contribute, please let us know.

Fourth, the issue of access of patients to physicians is not a partisan issue, though to some it has appeared to become one. When I see patients, I am not thinking about what state they are from, or whether they are Democrat or Republican. I just know that patients need my help.

For liability reform to pass the Senate, 60 votes are needed to end the filibuster on any legislation.

Contact your senators -- be they Democrat or Republican -- and discuss the issue with them.

If they support reforms, thank them. If they are opposed, then be forceful but respectful.

As Sir Isaac Newton noted, "Tact is the knack of making a point without making an enemy."

Fifth, it is clear that we cannot accomplish this alone. We must build partnerships with those who support reform. So we will work with others like the American Tort Reform Assn., the Healthcare Coalition on Liability and Access and the U.S. Chamber of Commerce to advance tort reform activities.

And we ask our grassroots physicians to work with them as well -- and to work with anyone else who can help make reform a reality.

We want to protect those states with meaningful liability reform while enacting national legislation that has a proven track record of success. While significant change in the American tort system as a whole is needed, the many proposals suggested by groups such as Common Good show promise, but are still unproven.

When the patient is bleeding, it is best to first stop the bleeding before trying unproven therapies. We need action now.

Finally, to control the escalation of medical costs, the issue of defensive medicine and its unnecessary use of limited resources must be solved. That is why it is so important that Congress pass patient safety legislation and get it to the president's desk for his signature. It would be key to making the American medical system safer -- and thus, less costly.

Patient safety is one step. Meaningful medical liability reform is the other. I ask you to take these steps with us -- and start creating some sparks. As Dante said, "The secret of getting things done is to act."

And to take action together. Because together, we are stronger.

J. James Rohack, MD is senior staff cardiologist at the Scott & White Clinic in Temple, Texas. He was AMA president during 2009-10 and served as chair of the AMA Board of Trustees during 2004-05.

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