Gov. Robert L. Ehrlich Jr. yesterday repeated his call for the General Assembly to reconvene this summer to address medical malpractice insurance, citing a request for a 41 percent rate increase filed a day earlier by the state's largest malpractice carrier.

Ehrlich urged citizens to lobby their representatives for a special session, saying the situation was so bad that some doctors, particularly obstetricians, are abandoning their practices.

"This is about the ability of a pregnant woman to have confidence that her OB will be in practice in three months, six months," Ehrlich said at a news conference in front of a Baltimore emergency room.

Ehrlich (R) said he hoped the large proposed rate increase, coming on the heels of a 28 percent increase last year, would push the legislature to act.

But yesterday the president of the state Senate -- whose support would be necessary to call a special session -- said he was unmoved.

Sen. Thomas V. Mike Miller Jr. (D-Calvert) said a special session would not accomplish anything until there is consensus about what should be done.

"You only have a special session when there's agreement on something," Miller said.

Doctors, and Ehrlich, would like to see caps on the awards that malpractice victims could win in court. A failed bill supported by the governor in the spring would have reduced the state's caps on damages for pain and suffering, from $635,000 to $500,000.

Trial lawyers, including Miller, say the solution lies in addressing an insurance system that continues to raise rates on its customers.

Miller himself said he supports creating a state-funded "risk pool." Under this arrangement, the state would essentially provide insurance to the malpractice carriers, agreeing to cover them if there were a spate of excessive claims. In theory, the insurance companies could then avoid rate increases.

Miller said he believed there would probably be a special session of the General Assembly in mid-August to deal with another hot topic in Annapolis: slots. If some compromise had been worked out on malpractice, he said that issue might have been be tacked on.

One thing both sides agree on: The proposed insurance rate increase is too high.

The proposal for a 41 percent rate increase came from the Medical Mutual Liability Insurance Society of Maryland, which covers most Maryland doctors.

Jeff Poole, the insurance group's chief operating officer, said the rates had increased because of a sharp rise in malpractice claims: from $49.5 million in 2001, he said, they jumped to $93 million last year.

Poole said the reason was not more lawsuits but more generous jury awards. Knowing that juries are more likely to dole out millions of dollars in damages, Poole said, the insurance company is more apt to settle out of court.

"What your expectations are in the courtroom dictates what [cases] you can take to court," Poole said.

Malpractice insurance rates vary depending on doctors' location and specialty. For instance, Poole said, a family practice doctor might pay about $19,000 a year, while an obstetrician -- among the highest-risk professions -- could pay about $160,000 after the proposed rate increase.

Medical experts agree that obstetricians are among the hardest hit by the rate increase. Their practices are considered high risk in part because, if an infant is injured, doctors and their insurers could be forced to pay a full lifetime of damages and treatment.

Ehrlich spoke yesterday to a crowd of doctors at Towson's Greater Baltimore Medical Center, where four doctors have stopped handling obstetrics cases and another was about to drop that specialty, said President and Chief Executive Officer Larry Merlis.

In addition, officials said yesterday, fewer medical students are studying in high-risk fields in Maryland, and Maryland hospitals are finding it harder to entice new doctors.

"It's become a real problem to recruit the kind of excellent pediatric sub-specialists . . . that our children really need," said Timothy F. Doran, chairman of pediatrics at the medical center.