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High jury awards stymie medical field

Our schools have been mocked in Doonesbury. Our unemployment rate leads the nation. We are the hungriest state in the Union.

And now, Oregon has joined the list of 17 states in a medical liability crisis.

Some of the states Ñ Florida, New Jersey, West Virginia and Pennsylvania Ñ have experienced doctor walkouts. We hope that doesn't happen here.

Mississippi, another of the crisis states, has lost 15 percent of its doctors because of the liability problem. Women can't find prenatal care in their communities. According to an American Medical Association paper submitted to Congress last year, the U.S. Chamber of Commerce has warned businesses to stay out of Mississippi because of the state's overall liability record.

Oregon isn't far behind. Four years after the Oregon Supreme Court overturned caps on pain and suffering awards, the 'prayer' Ñ the amount that lawyers ask for Ñ has skyrocketed to $1.5 billion on 465 pending lawsuits. That's $500 for every man, woman and child in Oregon. The vast majority of these claims are thrown out as meritless or lose in court.

But since the Supreme Court decision, medical malpractice awards have risen dramatically and unpredictably. The two factors increase insurance rates so that all doctors are paying more. Oregon rates have increased more than 100 percent in three years. Some obstetricians are paying nearly $100,000 a year, and at least one neurosurgeon will have to pay $230,000.

The rise in insurance costs prevents many doctors from moving here, makes other doctors leave and causes still others to reduce their risk by limiting services to pregnant women, seniors, trauma patients and others throughout the state. In fact, 124 doctors have stopped delivering babies here in the past four years, a decline of 22 percent!

Lawyers try to blame insurance companies and bad investments. Poppycock. While there have been some problems, most U.S. physicians are insured through co-ops Ñ doctor-owned companies created to insure themselves. More than 85 percent of their funds are invested in bonds.

Lawyers warn that caps will reduce an injured patient's rights. Poppycock again. With limits on pain and suffering in place from 1987 to 1999, we had the same number of lawsuits that we have now. Physicians practicing in California, a state with limits on pain and suffering since 1975, are sued at twice the rate of Oregon doctors.

We know that despite our best efforts, mistakes happen. They happen at Duke University, and they happen in Oregon. We do our best to minimize them, and we must do more.

But lawyers give themselves too much credit when they say the fear of lawsuits increases medical quality. This fear only increases the practice of defensive medicine Ñ ordering additional tests that may contribute very little to a person's care or increasing the number of potentially unnecessary specialty referrals Ñ costing our country another $50 billion to $100 billion a year. We call this 'the lawyer tax.'

The Federal Aviation Administration has increased airline safety with a system that protects openness and honesty from the threat of lawsuits. In this system free from blame and shame, anyone from an airline mechanic to a senior pilot can anonymously report problems (mechanical failures, near misses, etc.) to the FAA. The FAA then looks for trends and shares this information to make flying safer for everyone. True improvements in medical safety can only happen in a similar setting, free from the fear of lawyers.

For patients who have been truly injured, we believe in full payment of their economic damages (medical expenses, loss earnings, special needs, etc.). We also believe in reasonable compensation for their pain and suffering. We will continue to live up to our responsibilities to all of our patients.

What we cannot do is stand idly by while skyrocketing pain and suffering payments rob Oregon communities of needed medical care.

Dr. Colin Cave is a specialist in otolaryngology Ñ head and neck surgery Ñ and president-elect of the Oregon Medical Association. His practice is in Beaverton; he lives in Lake Oswego.