There are two difficulties facing doctors right now: the high price of insurance and the administrative duties that many of them have to engage in due to a lack of appropriate staff. Doctors are not starving, and it will never be a dying profession, but it is a profession that can be performed someplace else other than New York.
Councilwoman Elizabeth Crowley has been leading an effort to tell Albany, namely Governor David Paterson, that malpractice insurance rates need to come down. "We are losing our doctors to states like Arizona and Texas because of the cost of malpractice insurance," says Crowley. "We don't do enough to work with doctors."
Lowering the malpractice insurance rates is a tough task, seeing as those rates were only just raised two years ago. Paterson was not the governor then, but he can engineer a change in policy if he wants to. The rates are set by the New York State Insurance Department, which felt when it ordered the hike, that insurers would face a financial meltdown if they didn't act.
Crowley also wants to see a public malpractice insurance option as a means of keeping the city from hemorrhaging talented obstetricians and doctors that perform breast exams for women.
"There are 28 doctors," Crowley explains, "that practice obstetrics that will soon no longer be performing their duties in Manhattan, Brooklyn, and Queens due to insurance rates."
Add to that the fact that there are over ten hospitals that have stopped their obstetrical services altogether in recent years.
This is a woman's health issue as much as it is a citywide concern, because the doctors getting hit the hardest with rate hikes are the ones that help women detect breast cancer and perform regular mammograms. We like to point to the Canadian health care system and explain how long it takes for people to get services, but when services are cut in a more productive system such as ours, people find themselves waiting anyway.
Some hospitals have better insurance schemes set up for doctors. These are the hospitals that are not closing. What Crowley would like to see is an option where private physicians can use space in hospitals that offer more coverage. It's an idea that could at least keep doctors practicing obstetrics in New York.
"If it takes a village to raise a child, it takes a city to make sure a hospital runs efficiently," says Crowley.
A friend who has worked as a chief administrator in two major New York hospitals explains that hospitals will try to draw talent to their shores by offering top administrative services. This is a big calling card for doctors, who are not very good at organizing records and pulling all kinds of reports together. (You've seen your doctor's illegible handwriting haven't you?) They are scientists by trade, and not office people for the most part.
Rarely does a political season pass us by without rhetoric about tort reform. Trial lawyers, who happen to be big political contributors, do whatever they can to make certain that there are no caps on award settlements. Insurance companies know they might be paying out big bucks if a doctor makes a mistake, and so the rates go up. There is no easy answer to this as far as public policy is concerned. If your baby is born with cerebral palsy due to a mistake that a doctor made during childbirth, there is no amount of money that would - or should - satisfy you.
We need our doctors, and asking women to travel to give birth is a consequence we should try to avoid. Specialists, neurosurgeons for example, are hurting from these rate increases. Dr. Robert Goldberg of the Medical Society of New York State said the following in a statement when the rate hike went into effect in 2007, "The newest rate increase means that a Long Island neurosurgeon will now have to pay an outrageous $309,311 for just a single year of coverage; a Brooklyn or Queens OB-GYN will now pay $173,061, and a Westchester orthopedic surgeon will now pay $108,679."
Defenders of the rate hikes feel that doctors are not starving, so if they have to pay higher rates it should be no problem. But when you take into account all that a physician needs to pay out, you can see their point. Add college loans, the cost of insurance, the costs of running an office, and you have sky high expenses. If these doctors can practice in state other than New York, where their insurance rates are lower, and the cost of living is lower, the result could hurt New York.
You can sign a petition that Crowley has written at her City Council website that will be sent to Governor Paterson. It encourages him to lower the rates of malpractice insurance and consider options that would make staying in New York more attractive for physicians.