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Study questions insurance cost effect on Pa. doctor supply

Spiraling-malpractice insurance costs appeared to have little effect on the number of doctors in high-risk specialties practicing in Pennsylvania over a 10-year period, according to a new study.

Opponents of efforts to limit pain-and-suffering awards in malpractice lawsuits said the study refutes claims that insurance costs have forced doctors to leave Pennsylvania. A doctors’ lobbying group questioned the findings.

Researchers based their conclusion on an analysis of more than 47,000 doctors who participated in the state’s medical-malpractice insurance fund known as Mcare from 1993 to 2002. The study found that an average of 16 percent of doctors in high-risk specialties such as urology, neurosurgery and orthopedics stopped practicing in Pennsylvania each year from 1999 through 2002, which researchers defined as the “crisis period” after insurance rates spiked. The number of high-risk specialists leaving the state from 1993 through 1998 averaged 15 percent a year, by comparison.

“What this study shows is, at least on a statewide level, that (the malpractice crisis) doesn’t seem to have resulted in noticeable decreases in the number of physicians available in particular specialties,” said research-er Bill Sage, vice provost for health affairs at the University of Texas at Austin.

Researchers found that the total number of doctors practicing across all specialties in Pennsylvania increased by nearly 6 percent between 1993 and 2002 and the total number of high-risk specialists grew by 3.3 percent.

The study identified a nearly 8 percent decline in obstetrician-gynecologists as the only notable decrease among high-risk specialists, but it also noted that the number of live births in Pennsylvania dropped during the study period.

In recent years, the Pennsylvania Medical Society has unsuccessfully lobbied state lawmakers to pass monetary caps on pain-and-suffering awards in medical malpractice lawsuits. The organization has said high malpractice insurance rates have led doctors in high-risk specialties to leave the state.