“As physicians we can no longer stand by and watch as our patients are placed at such an unacceptable level of risk. We have a duty to them-and to the profession we have chosen as our life’s work-to lead a medical liability reform movement that will, finally, protect patients now.”
With this emphatic call to action Gail Rosseau, MD, alerted media across the United States to the launch of Protect Patients Now, a multimedia public information campaign for federal medical liability reform that was announced Feb. 10 from the platform of the National Press Club in our nation’s capital. The campaign features 30-minute television newsmagazines and full-page newspaper advertisements, as well as an interactive Web site, www.protectpatientsnow.org. The news conference, broadcast live on the Web, was complemented by satellite press conferences held in two of the 19 medical liability crisis states, North Carolina and Washington.
Dr. Rosseau, a national spokesperson for this multimillion-dollar public information campaign, explained that the aim of Protect Patients Now is to enlist the public’s support for federal legislation that will stem the tide of relentlessly rising professional liability insurance premiums, the most notorious symbol of the medical liability crisis. She emphasized that to be effective, comprehensive federal medical liability reform legislation must include a cap on noneconomic damages because that is what has been proven to be effective in states considered stable: California, Colorado, Indiana, Louisiana, New Mexico and Wisconsin.
“The exorbitant liability premiums are just one manifestation of the ill effects of this medical liability crisis,” stated A. John Popp, MD, president of the American Association of Neurological Surgeons (AANS). “Federal medical liability reform tops the AANS agenda because so many of our colleagues across the country have been forced to alter, retire, or close their practices, leaving patients in some areas of our country far from neurosurgical care; it simply is an untenable situation that in the United States good doctors with extensive skill and training in neurosurgery are rendered powerless to care for people who are in need of specialized care.”
AANS President-Elect Robert A. Ratcheson, MD, agreed. “While there are many challenges facing neurosurgery, federal medical liability reform must remain at the forefront of the AANS agenda until success is achieved,” he said. “The Protect Patients Now campaign is an essential element in the overall strategy for attaining effective reform.”
Protect Patients Now is the brainchild of Doctors for Medical Liability Reform, a 230,000-member strong coalition of specialty physicians, a group that particularly has experienced the negative effects of the medical liability crisis. The DMLR’s sole purpose is to conduct national public education and grassroots initiatives leading to passage of comprehensive federal medical liability reform legislation that includes a cap on noneconomic damages. Neurosurgery is well represented in the DMLR through Neurosurgeons to Preserve Health Care Access, a 501(c)(4) advocacy organization through which the American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons speak with one voice on the subject of medical liability reform.
The NPHCA is one of 11 specialty groups that comprise the DMLR. Joining the NPHCA in this effort are the: American Association of Orthopaedic Surgeons, American College of Emergency Physicians, Society of Thoracic Surgeons, American College of Surgeons Professional Association, American College of Obstetricians and Gynecologists, American College of Cardiology, American Academy of Dermatology, National Association of Spine Specialists, American Urological Association, and the American Society of Plastic Surgeons.
Together these groups are contributing more than $10 million to fund the Protect Patients Now campaign. Representatives from nearly all of these groups served on the DMLR panel at the Feb. 10 campaign launch, projecting a unified voice calling for federal medical liability reform.
Stewart B. Dunsker, MD, has accepted the dual roles of NPHCA president and DMLR chair. More than 30 years of neurosurgical practice serving in leadership roles, including his tenure as 2000-2001 AANS president and on the AANS/CNS Washington Committee, helped prepare Dr. Dunsker to lead a determined, fact-based effort for tort reform.
In his remarks to the crowd gathered at the National Press Club, Dr. Dunsker promised that the Protect Patients Now campaign would feature “moving personal accounts of how a medical liability system gone awry has affected the practices and lives of each of the physicians here today.” He also introduced a sampling of the
“cold, hard and extremely troubling facts” behind the personal stories, citing a 2003 U.S. Department of Health and Human Services report that showed:
- 76 percent of physicians surveyed said medical liability litigation has hurt their ability to provide quality care to patients.
- 33 percent avoided practicing a certain specialty because they feared it would subject them to greater liability exposure.
- Specialists in 18 states without caps on noneconomic damages experienced increases in liability insurance premiums of 39 percent between 2000 and 2001 and another 51 percent in 2003.
Campaign Components
The DMLR crafted Protect Patients Now with the help of a national communications firm to optimize impact and use of available resources and to aid in the quest to educate and inform the public about the destructive effects of the medical liability crisis on patients’ access to healthcare. The Protect Patients Now strategy is to conduct a national campaign focusing in particular on those states that are in dire need of medical liability reform.
One such state is Washington, where an exodus of 500 doctors in the last few years not only has jeopardized many patients’ access to care, but also has negatively impacted the economy. In addition to initial launch of the campaign in Washington and North Carolina, the DMLR also is targeting South Carolina, Georgia, Florida, Illinois, Nevada and Pennsylvania.
The campaign is reaching out to people primarily through television newsmagazines and newspaper advertisements that are complemented by an information intensive, interactive Web site.
“Real” Reality TV
At the core of the Protect Patients Now campaign are the 30-minute television newsmagazines that reveal real doctors and real patients grappling with the life-altering manifestations of the medical liability crisis. The unscripted interviews, which Dr. Rosseau characterized as “tragic, but powerful,” provide compelling evidence of the need for change.
The 30-minute newsmagazine format was selected to allow enough time for the complete picture of the medical liability crisis to be developed and told in their own words by a variety of specialty doctors and their patients. Their potent personal stories are complemented by information explaining the causes underlying the crisis.
Neurosurgeons and their patients are featured in several newsmagazine segments. David Pagnanelli, MD, is featured in the North Carolina segment called “On the Move&Again.”
The segment introduces Dr. Pagnanelli as he is house hunting in Oklahoma and goes on to explain why he is moving his practice and his family for the second time in two years. After 18 years as chief of neurosurgery at a hospital in Pennsylvania, escalating professional liability premiums forced him to relocate. “The year that I left Pennsylvania, more than 1,000 physicians left the state,” he explains. Then, after less than two years in Hendersonville, N.C., skyrocketing liability insurance premiums forced him to relocate once again, this time to Oklahoma.
“Basically I’m sick by it,” he says. He notes that in one-and-a-half years his premium went up to $194,000-without any claims. Of his move, which leaves Hendersonville without a neurosurgeon, he says, “I have no choice … I don’t know what else to do.”
One of his patients, Dan Pace, shares his response to Dr. Pagnanelli’s predicament: “[He] deserves to be able to practice what he loves to do and that is creating miracles of healing. We will grieve and we will hold our politicians particularly responsible because they could have done something, but they haven’t.”
In the segment called “Don’t Get Sick in Washington,” Christopher Smythies, MD, describes the consequences when, without warning, a professional liability insurance carrier dropped his 10-neurosurgeon group in the Puget Sound area.
“My jaw fell and hit floor because I knew what it meant—without liability insurance as a physician you can’t practice,” he explains. “We couldn’t schedule any patients for surgery, and in fact we stopped seeing patients altogether, so there was a scramble for these folks to find someone else to take care of them.”
One of the group’s patients, Kim Reading, describes her reaction as the crisis impacted her own treatment: “I was desperate, absolutely desperate, yet there was nowhere to go, there was nobody to turn to,” she says. “When a doctor can’t live up to his oath to help patients because the insurance company says as of this date you no longer have coverage … you wouldn’t think it could happen in America.”
The DMLR intends for viewers, like the doctors and patients who participated in the newsmagazines, to take the campaign’s message to heart. During broadcast of the newsmagazines, viewers are asked to contact their legislators and to support federal medical liability reform with caps on noneconomic damages. Also provided is the address of the campaign Web site, www.protectpatientsnow.org, which enables viewers to find additional information and respond to the campaign’s call to action.
Print Ads Pack a Punch
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| Print Ads Pack a Punch Pictured are details of two of four advertisements developed for the Protect Patients Now campaign. The full-page newspaper ads have brought the need for federal medical liability reform to the attention of nearly 5 million people so far. | |
To reinforce the Protect Patients Now message, two full-page newspaper advertisements were readied for campaign launch. Both have appeared in national publications including The Wall Street Journal, USA Today, and The Washington Post.
One advertisement, headlined “Senator, Heal Thyself,” introduces the DMLR and hits the main points explaining why federal medical liability reform legislation is necessary.
“Doctors and politics normally don’t mix,” the ad reads. “We’re healers, not fighters. We focus on patients, not politicians. But we can no longer idly watch patients lose access to healthcare because their doctors can’t afford skyrocketing insurance premiums. Not while the politicians who could solve the problem choose to ignore it.”
The other advertisement focuses on the economic impact of the medical liability crisis, not only on the healthcare system, but also on businesses and the economy in general. The headline reads: “If You’re Considering More Business in Washington State: Before You Move In, Look Who’s Moving Out.” It shows a procession of healthcare professionals walking one way, giving a man holding a briefcase reason to pause in his progress toward “Washington State.”
A full-page advertisement also was created and placed in the Seattle Post-Intelligencer to counter an editorial that was printed in the newspaper on Feb. 20. Both the advertisement and the press release that accompanied it are headlined, “Since You Can’t Trust the Seattle Post-Intelligencer, Who Can You Trust? Your Doctors.” The ad copy counters point-by-point several statements made in the editorial. In the press release, Cynthia Wolfe, MD, director of emergency services and chief of medicine at Capital Medical Center Olympia commented, “Emergency doctors are used to chaos, stress and panic, but I am not used to deception, either intentional or inadvertent, and the Post-Intelligencer is not telling the truth. As a doctor, I cannot stand by while my patients are being deceived about the critical need for federal medical liability reform.”
A fourth advertisement was unveiled April 6 in The Washington Post and Roll-Call. The headline asks, What Do Senate Democrats Have Against Patients? The answer, “Trial Lawyers, That’s What.” Release of the ad coincided with the April 7 cloture vote on S. 2207, the “Pregnancy and Trauma Care Access Protection Act.”
Web Site Provides Information, Spurs Action
The entire Protect Patients Now campaign can be viewed online at https://www.protectpatientsnow.org . The site serves physicians, patients and media as a repository for the print advertisements and for the campaign’s newsmagazines, which can be sampled by clicking on an image, or downloaded and viewed in their entirety. At press time the complete 30-minute Washington and North Carolina newsmagazines and additional video clips from several other states were posted; new stories will be added as they become available.
The site contains a wealth of explanatory and breaking information about the DMLR and the medical liability crisis. While the campaign targets medical liability reform legislation that protects the entire country, a state-by-state breakdown that shows the level of crisis and provides an overview of the local legislative landscape is available. Also, the press kit for the Feb. 10 news conference is available online, as are up-to-date news releases. For example, the March 29 news release announcing that Richard Burr, an N.C. candidate for U.S. Senate, signed the Protect Patients Now pledge can be found at www.protectpatientsnow.org/958.htm.
The pledge, states, in part, that “as a U.S. senator or candidate for U.S. Senate with the public interest at heard, I … pledge that I will unequivocally support medical liability reform in the United States Senate seeking passage of federal legislation that would include an effective limit on noneconomic damages….” The pledge itself is online at www.protectpatientsnow.org.
In addition to the up-to-date news and information found on the site, the interactive site allows doctors and the public to share their medical liability stories and thoughts using an interactive form. They also can sign up to receive breaking information alerts so they won’t miss important votes or opportunities to participate in grassroots effort that facilitate reform legislation.
One Impression, a World of Impact
Just one month after the launch of Protect Patients Now, a media analysis showed that the campaign had reached more than 11.5 million people.
The newsmagazines alone generated nearly 5 million “impressions,” an important distinction because impressions are defined as the portion of viewership over the age of 18-that is, voting age.
In addition, the “paid” media-the campaign’s newsmagazines and advertisements-generated “free” coverage in the print and broadcast media that totaled approximately one-fifth of the campaign’s outreach. In addition to Washington and North Carolina, media coverage was documented in Florida, Missouri, Indiana, Washington, D.C., and Kentucky.
Other campaign efforts are directed toward coalition building, which focuses on outreach and events designed to motivate doctors to become active in the campaign and enlist their patients’ support. The campaign also continues to make additional contacts with the media, piquing reporters’ interest in the Protect Patients Now story and aiding them with information and spokespeople who can provide commentary.
The Message Hits Prime Time
A prime time special on the medical liability crisis aired on Fox News in March and again in April. The hour-long program called “Breaking Point: Why Doctors Quit,” prominently featured neurosurgery. After viewing it, Dr. Dunsker noted that one of the special’s strongest segments focused on a child with a head injury who had to be evacuated to another hospital hours away because a neurosurgeon wasn’t available for treatment.
“This life-threatening scenario is illustrative of what has to be the most frustrating and, frankly, heart-rending aspects of the medical liability crisis,” he said. “The crisis is not just about insurance premiums, it is about life and death. It is about physicians who have had to cease performing high-risk procedures — like intracranial surgery — and stop operating on high-risk patients — like children — because of the high liability risk. Politicians have a duty to pass federal medical liability reform legislation that gets doctors back to helping patients in the emergency rooms and in the operating rooms.”
The medical liability crisis has even seeped into prime time drama. On March 14 an episode of “The Practice” featured a story line in which an obstetrician and his hospital are sued for $3.2 million after a woman died during childbirth. In a striking demonstration of art imitating life, the obstetrician offers $800,000 of his personal funds — “all the money I have” — to settle the case. He explains that if he has a verdict against him, he will lose his liability insurance and be unable to practice. He also testifies that he was the only obstetrician available to care for the patient because the medical liability crisis had forced the others out of practice.
Final Impact
While the Protect Patients Now message is percolating in the media, the question on everyone’s mind is whether — or when — the DMLR’s goal of enacting federal medical liability reform with a cap on noneconomic damages will occur.
The most recent legislative action was on April 7, when the U.S. Senate failed to allow debate on medical liability reform legislation. The cloture vote on S. 2207, the “Pregnancy and Trauma Care Access Protection Act,” failed 49 to 48, short of the 60 votes necessary to bring the bill to the floor for consideration.
“While it may seem that we are getting nowhere, each time the Senate votes on this matter politicians add to their record of how they stand on medical liability reform,” said Katie Orrico, director of the AANS/CNS Washington Office. “The Senate may bring additional liability reform to the floor for consideration later this year, and continued pressure on senators may make a difference in how they vote.”
She urged neurosurgeons to contact their senators and thank those who voted “yes” as well as express disappointment to those who voted “no.” An e-mail letter can be sent expeditiously online by accessing https://capwiz.com/noc/home , selecting the Action Alert and entering the appropriate zip code. Additional information on recent legislative action is available there as well.
Dr. Dunsker urged physicians to stay the course. “We all are familiar with the ancient fable of the tortoise and the hare, and it will come as no surprise to anyone that in this fight, we are the tortoise,” he said. “That being the case, perhaps a related and more recent observation by James Bryant Conant will serve to inspire us in our quest: ‘Behold the turtle. He makes progress only when he sticks his neck out.’
“With Protect Patients Now, we specialty physicians have stuck our necks out,” Dr. Dunsker continued. “But working together we are making progress toward effecting federal medical liability reform. If all 230,000 of us do our parts financially and at the grassroots level, our impact increases several-fold. The participation of each and every one of us is key to achievement of our goal.”
Manda J. Seaver is staff editor of the Bulletin.
For Further Information
Protect Patients Now!
www.protectpatientsnow.org
Protect Patients Now News Conference
Archived Video Broadcast, Feb. 10, 2004
National Press Club, Washington, D.C.
www.connectlive.com/events/dmlr
I Pledge to Protect Patients Now!
www.protectpatientsnow.org/fileadmin/pdfs/DMLRPledge.pdf
Doctors for Medical Liability Reform (DMLR)
www.protectpatientsnow.org
Neurosurgeons to Preserve Health Care Access (NPHCA)
www.neuros2preservecare.org
Cover. “Federal Medical Liability Reform: Neurosurgeons Plan to Preserve Patients’ Access to Care.” AANS Bulletin. Fall 2003;12(3):7-21. www.AANS.org, Article ID 13303
Cover. “A Profession at Risk.” AANS Bulletin. Fall 2001;10(3):6-14. www.AANS.org, Article ID 12953