2004 DMLR Campaign Posts Huge Successes – Through NPHCA Neurosurgery Presses On for Liability Reform

When leaders from many of the high-risk specialties sat down to discuss the medical liability crisis 18 months ago, few envisioned that they would be able to organize, create and launch a campaign as large and dynamic as that which Doctors for Medical Liability Reform put together in 2004. Neurosurgery participates in the DMLR coalition of specialties through Neurosurgeons to Preserve Health Care Access, known as NPHCA. The power of DMLR’s 230,000 physicians working toward one goal has been astounding and has shown that when the specialties work together, progress can and will happen.

The goal of DMLR’s 2004 Protect Patients Now campaign was to tell medicine’s story in a hard-hitting, compelling way that would inform voters about the crisis and force political candidates to take a position on the issue of medical liability reform. After the U.S. House of Representatives passed medical liability reform legislation for the third time in 20 months on May 12, 2004, DMLR turned its attention to picking up additional pro-reform votes in the U.S. Senate. DMLR set out to target three to five Senate races with hopes of picking up two or three pro-liability votes. The campaign, ultimately deployed in four states, gained three new votes for reform toward the magic number of 60 votes required to pass reform in the Senate.

In total, pro-reform candidates won in six out of eight open Senate races with victories in Florida, Georgia, Louisiana, North Carolina, Oklahoma, and South Carolina. In addition, pro-reform candidates staved off tough competition in Alaska and Kentucky. In South Dakota, pro-reform candidate John Thune pulled off a stunning victory over former Senate Democratic Leader Tom Daschle. DMLR thus helped narrow the possible votes needed to override a filibuster from 11 to 7 in one election cycle.

2004 Campaign Overview
DMLR officially launched its $8 million campaign in February 2004. While the campaign focused on states with key Senate races, including Washington, North Carolina, South Carolina, and Georgia, there was also a national element. Through television newsmagazines, newspaper and radio advertisements, the medical liability reform pledge, the Web site and a dynamic grassroots effort, DMLR fought tirelessly for medical liability reform through Election Day.
  The Newsmagazines The centerpiece of the public education campaign was the 30-minute television newsmagazine programs, which featured real doctors and real patients relating true-life stories about the medical liability crisis. Dozens of physicians, including many neurosurgeons, and patients told their stories in the newsmagazines and asked Americans and policymakers to protect patient access to healthcare by supporting medical liability reform. In total, the newsmagazines ran 2,797 times in 19 media markets and were seen by more than 13 million Americans. Besides being viewed by millions of voters on network television in four key states, many of the 230,000 DMLR physician members also aired copies of the newsmagazines in their office waiting rooms or over internal hospital stations.
  The Advertisements DMLR also ran focused, targeted full-page paid advertisements in newspapers. In target states ads that explained the crisis ran in the Seattle Times, the Raleigh News and Observer, the Atlanta Journal-Constitution, and the Charleston Post and Courier. Nationally, ads that explained the financial impact of the crisis on businesses and local economies ran in the Wall Street Journal and USA Today. Inside the Beltway, ads that urged support for specific liability bills ran in the Washington Post and Capitol Hill publications.
  Earned Media The DMLR campaign earned unpaid media placements by generating hundreds of radio, print and television stories about the campaign and the medical liability crisis. The press office fielded calls from more than 310 reporters and overall the earned media outlets reporting on the campaign had a circulation off nearly 6 million readers, listeners and viewers, and generated more than 2 million media impressions.
  The Web Site Both the newsmagazines and the ads directed viewers to the DMLR Web site, www.protectpatientsnow.org, which still is active today. The Web site carries extensive information on the campaign and state-by-state information on the medical liability crisis. Regularly updated data on the crisis, its affect on patient access to healthcare, the local economy and dozens of other factors is just a click away. Visitors to the Web site can watch and download the newsmagazines and also view the ads and other campaign materials. The Web site, which serves as a portal for citizens to e-mail or fax a letter to their senators urging them to support reform, received more than 14,000 hits daily during the campaign.
  The Pledge DMLR educational materials all had a single focus: to make medical liability reform a campaign issue in 2004. To ensure that candidates were aware of the issue and developed a position on reform, the DMLR pledge was created. By signing the pledge, candidates promised to “unequivocally support medical liability reform” by “seeking passage of federal legislation that would include an effective limit on noneconomic damages.” In total, 43 candidates for federal office signed the pledge. Notable signatories who won election to the U.S. Senate included: Richard Burr, R-N.C.; Jim DeMint, R-S.C.; Johnny Isakson, R-Ga.; Tom Coburn, R-Okla; Arlen Specter, R-Pa.; Lisa Murkowski, R-Alaska; David Vitter, R-La.; and Mel Martinez, R-Fla.
  Grassroots Development During the campaign, DMLR created networks of physicians, medical groups, business organizations and patients in its targeted states. Through these grassroots networks, DMLR identified local spokespersons, organized events, wrote letters and editorials, and monitored progress on the ground. The Web site proved to be an effective grassroots tool, not only conveying information but also allowing individuals to indicate their support for DMLR and reform and a massive listing of supporters to be created.

Looking Forward to 2005 and Beyond
DMLR’s goal for 2005 is to pass federal medical liability reform. The legislative priorities released by both President Bush and Senate Majority Leader Bill Frist, MD, put medical liability reform near the top. DMLR’s leadership will call on every one of our 230,000 members to put every ounce of energy they have into lobbying their respective senators to 1) support a comprehensive medical liability reform bill that includes, among other things, a reasonable limit on noneconomic damages; 2) debate that bill; and 3) have an up-and-down vote on its merits. If opponents of reform filibuster the legislation, the DMLR will use hard-hitting tactics to break the impasse. While success of federal reform legislation cannot be guaranteed, it is certain that no one will be working harder for its passage than DMLR.

To reach its goal, DMLR will expand grassroots and earned media campaigns in 2005. The DMLR’s best assets are its 230,000 physician members and the patients they serve, and both of these resources will be mobilized and utilized fully. In addition, DMLR will reach out to other medical groups that share the goal of passing federal medical liability reform, adding to the number of voices raised in support of reform. When a medical liability reform bill is introduced, DMLR’s army of advocates will be prepared to march to Capitol Hill with ads, testimony, briefing materials, news releases and grassroots alerts in hand.

If need be, DMLR also will begin laying the groundwork for a U.S. Senate campaign in 2006. Once again, efforts will focus on vulnerable anti-reform candidates and bringing the issue of medical liability reform to the fore in their races. It is imperative that elected officials understand that there are consequences for voting against protecting patient access to healthcare. In 2005, DMLR will be monitoring the positions of elected officials and possible candidates and declaring its support for pro-reform candidates early and loudly.

Neurosurgeons Can Support Reform Through NPHCA
In 2003 and 2004 neurosurgeons answered the call to action and actively participated in the DMLR’s Protect Patients Now campaign in many ways, including writing letters to Congress, speaking out in the media, and educating their patients about the issues. Most importantly, however, neurosurgeons helped fuel the campaign engine by contributing over $2 million to help fund the effort.

As the 2005 campaign moves forward, once again the support of every neurosurgeon is needed to help assemble the multimillion dollar war chest that is necessary in order to produce a hard-hitting advertising campaign that focuses public and U.S. Senate attention on the medical liability crisis. Organized neurosurgery will continue to participate in DMLR through NPHCA. As a nonprofit advocacy organization, NPHCA can receive contributions from corporations and individuals, and there are no limits on the amount of money that individuals can contribute.

Medical liability reform is within our grasp. With a few minutes of time and a contribution that each neurosurgeon can afford, victory can be achieved for all doctors and patients.

A. John Popp, MD, is chair of Neurosurgeons to Preserve Health Care Access.
Katie O. Orrico, JD, is director of the AANS/CNS Washington office.