A group of 30 angry doctors, whose malpractice insurance premiums have risen this month by as much as 135 percent, converged on Annapolis yesterday to demand extra time to pay the skyrocketing premiums and to seek legislation limiting future awards to victims of medical malpractice.
After a meeting between the doctors and state officials, four major insurance companies agreed to allow quarterly payments of annual premiums, which were due in their entirety yesterday. The rate increases were approved by the state insurance commission in the spring, but doctors said they were not notified of the hikes until they received their bills.
The doctors, primarily from Prince George's County, met with Edward Muhl, the state insurance commissioner, and with representatives from the office of Gov. Harry Hughes. Hughes aide Andrew Wigglesworth said later that four carriers had agreed to the partial payment plan. An official of one of the firms said the company already allowed quarterly payments.
Wigglesworth said Hughes was briefed on the meeting but made no commitments. Muhl did not return a reporter's calls.
The problem of rising medical malpractice premiums in Maryland mirrors similar situations in New York, California and Florida, where some surgeons have refused to take new patients, and some obstetrician-gynecologists have stopped delivering babies.
Insurance rates in Washington have increased about 40 percent this year, according to the District Medical Society. In Virginia, one of the main malpractice insurers had agreed upon a 15 percent rate increase, but the state bureau of insurance recently denied that request, according to an official of the Medical Society of Virginia.
Dr. Willie Blair, chief of the trauma center at Prince George's General Hospital in Cheverly, practices with two other surgeons. He said his group's insurance bills now consume about one-quarter of the group's income.
He said he was outraged when, about a week ago, General Accident Insurance Co. in Bethesda notified him that the group policy premium had increased from $32,000 last year to $77,600 this year. Blair said he also was annoyed that there had been no warning of the increase. "If the telephone people were going to raise the rates, they'd let you know," he said.
"I don't think any company tries to conceal that information . . . the rate filings are public information," said Joseph J. Spinella, executive vice president of Medical Mutual Liability Society of Maryland, which he said insures about 60 percent of the state's nearly 11,000 doctors.
Spinella said the rates his company charges increased an average of 29 percent this year, but obstetricians received an increase of more than 70 percent. "The OBs are being burdened by the problems of society . . . [hat] expects every baby to be perfect," Spinella said.
"The legal profession is in back of it," said Ronald Hairston, a Landover family practioner, of the rate hikes. Hairston said that although his premium only increased 25 percent over last year, he is concerned that frivolous lawsuits are escalating and causing the insurance companies to raise everyone's rates to cover their losses.
Angelo Troisi, executive director of the Prince George's Medical Society, is well aware of that problem. He said the medical society, which organized yesterday's meeting in Annapolis, also asked that the governor support a concept of "statewide tort reform" in the legislature to reduce the amount of money the courts award to malpractice victims.
Troisi said doctors were concerned that they would either have to stop practicing some of the more costly specialties or raise their fees beyond the reach of many patients, especially those who rely on limited payments through Medicare and Medicaid.
"There's no question that a certain number of physicians are going to stop doing obstetrics," said Marion C. Crenshaw, president of the Maryland Ob-Gyn Society. He said the new premiums amount to 10 to 40 percent of doctors' earnings and "represent a major drain on a practice which, in the long term, could be passed on to patients in some degree."