If you go     ° What: Town hall meeting for physicians concerned with soaring malpractice insurance rates   °7 p.m. Monday   °Doubletree Hotel at Reid Park, 445 S. Alvernon Way   °Pima County Medical Society, Arizona Medical Association, Pima County Pediatric Society   °Who's invited: local physicians   °RSVP: Pima County Medical Society, 795-7985

Insurance premiums for Arizona doctors are rising so high that some are leaving the state and others are being forced from their practices. With the state's population growing at nearly 3 percent per year, the supply of physicians is not keeping pace, doctors and hospital administrators said. In the future, Arizona patients, especially those who need high-risk surgeries, may not be able to find physicians. "Many doctors are being asked to pay more than they can make in a year," said Dr. Mary Cochran, a pediatrician and member of the TMC HealthCare board of directors. "If this continues we will not be able to take care of the people of Arizona." Concern about malpractice insurance hit a fever pitch last month, when Southern Arizona nearly lost all its pediatric surgeons because one of them lost insurance coverage, Cochran said. The three-doctor partnership considered leaving the state before TMC intervened to help them obtain coverage. A recent survey of 340 doctors at Tucson Medical Center found that because of rates that in some cases are double what they were last year, 2 percent are planning to leave the state, 16 percent are considering leaving and 45 percent are having trouble affording insurance. Even those who can afford the higher premiums face losing coverage altogether if they're sued and settle or if they perform high-risk procedures, said Dr. Patrick Smith, chief of staff at St. Joseph's Hospital. Among those specialties: neurosurgeons, obstetrician-gynecologists, cardiac surgeons and pediatric surgeons. Seeking solutions for what they see as a crisis, medical groups have organized a town hall meeting for physicians on Monday night. But a solution may come too late for some doctors - and their patients. Maria Siqueiros of Tucson was expecting her Spanish-speaking obstetrician, Dr. Adam Newman, to deliver her boy by Caesarean section on May 6. But Newman is closing his practice April 30 and moving to Indiana. The reason, he said, is that on May 1 his malpractice insurance premiums double to $100,000 per year, and coverage for previous years - called "tail" coverage - costs an additional $160,000. Indiana has capped some awards in malpractice suits, which helps keep insurance rates down, he said. Arizona's constitution prohibits laws limiting damage awards. So instead of Newman, his partner, Dr. Edward Miller - the chief of staff at Northwest Medical Center - will perform Siqueiros' C-section. That's all right, but Miller speaks less Spanish, and Siqueiros has built a relationship with her original doctor, she said. "It worries me because I don't know the other doctor, and with him (Newman) I have total trust," she said. What's pushing Newman and others to consider leaving the state are higher rates going into effect this year. On April 1, the Mutual Insurance Co. of Arizona raised rates upon renewal by an average of 16 percent. On May 1, G.E. Medical Protective is raising its rates by an average of 92 percent. At Northwest Medical Center, three surgeons have been forced to stop working in the past month because they couldn't afford the higher rates, said CEO Jeff Comer. Hospitals require doctors who practice there to have malpractice insurance. Dr. David Beal said he was told Monday that he couldn't work anymore at Northwest, where he had been delivering 30 babies a month. He and Newman, the doctor leaving for Indiana, had been the hospital's busiest obstetricians, delivering about one-quarter of the babies there, said Miller, Northwest's chief of staff. G.E. Medical Protective dropped Beal in December 2002, Beal said. Its reason, he said, was not just that he had been sued three times over 18 years, but that lawyers had made legal inquiries of the insurance company without actually suing. For a year, he could afford insurance from a high-risk carrier, but the rate rose too high this year, Beal said. The company wanted $220,000 a year in premiums plus $75,000 in "tail" coverage for previous years. He couldn't pay. Now Beal's colleagues are picking up his pregnant patients, whose babies Beal can no longer deliver. All he can do is perform routine appointments at his office. "I'd be happy to work without malpractice insurance, but I don't have that option," Beal said. "It's very tough on my patients." Tough on him, too. "I don't want to leave what I do. I love what I do," he said. The main reason for the premium increases is the growing amounts awarded by juries to patients who sue doctors for malpractice, said Dr. James Carland, president of the Medical Insurance Co. of Arizona. Insurance companies base their rates on the projected payoffs they will make, and those projections rise with jury awards. As jury awards rise, so do out-of-court settlements. But doctors can't pass on the cost to customers, because their fees are locked into their contracts with health-insurance providers, said Andrea Smiley, director of communications for the Arizona Medical Association. "At some point," Smiley said, "they run out of money to cover their overhead costs, pay their staff, pay their premiums and accommodate the regulations that are coming down on them." If you go

 

° What: Town hall meeting for physicians concerned with soaring malpractice insurance rates °7 p.m. Monday °Doubletree Hotel at Reid Park, 445 S. Alvernon Way °Pima County Medical Society, Arizona Medical Association, Pima County Pediatric Society °Who's invited: local physicians °RSVP: Pima County Medical Society, 795-7985