"I feel demoralized and devalued," Ampey said.
Though nearly everyone in the audience at Washington Adventist Hospital wore suits, not white coats or scrubs, most were doctors, from a variety of specialties, and they listened knowingly as Ampey and others detailed the steps they've taken to cover the steep insurance increases.
Legislation being drafted by Miller is intended to address the squeeze in the short term. A fund created by the state would cover a portion of insurance companies' malpractice payouts in exchange for their agreement to freeze doctors' premium costs.
Miller said that there are several ways to pay for such a fund but that his preference is ending the state's exemption of HMOs from a 2 percent premium tax imposed on for-profit insurance carriers.
Legislation to end the exemption has passed both the House and Senate in recent years but was vetoed by Ehrlich in 2003, as part of a package of corporate taxes. State fiscal analysts determined that such a bill would generate close to $50 million in its first year and increasingly more in subsequent years.
Donald J. Hogan Jr., a policy aide to Ehrlich, said the governor remains cool to the idea of an HMO tax but would reserve judgment until he sees Miller's proposal.
But Hogan said Ehrlich remains opposed to a special session merely to create such a fund. "Without a long-term solution, just creating a fund is a non-starter," Hogan said. "That's just feeding the beast."
In an interview, Busch ticked off a wide range of long-term proposals he is exploring to contain insurance costs. Some were included in a bill that passed the House last session but died in the Senate. Others are far more ambitious.
Those include the possibility of moving some medical malpractice cases out of the tort liability system and into a system similar to the one for workers' compensation, where payouts are made according to a schedule.
Busch said he also plans to closely examine the way malpractice insurance is sold in the state and explore several measures to protect patients' safety.
Within a month, "I think we'll have a pretty good package," he said.
Many who attended Wednesday's meeting in Montgomery County said such solutions are overdue. "Ultimately, if there's not an answer, doctors will end up leaving Maryland," warned George Schweitzer, an emergency physician at Montgomery General Hospital for 30 years.
Norton Elsen, an internist and pulmonologist at Washington Adventist, said he is about to pack up his office. His partner has taken a position with the federal government. "The legislators in Annapolis are going to have to face the reality on the ground," Elsen said.