Important Information to NJ-ACEP Members On Medical Malpractice "Work Stoppage"

To Our Valued Patients: A Letter From Your Emergency Physicians

January 21, 2003

No issue in recent times has resonated with the New Jersey physician community like the professional liability insurance crisis. For over a year, NJ-ACEP has participated in hundreds of meetings, coalitions, rallies, grassroots efforts and concerted lobbying for short- and long-term solutions to this problem.

We know you have heard about the work slowdown efforts recently held in West Virginia. The physicians in New Jersey are planning a similar effort - and many hospital medical staffs have already met and decided to target the week of February 3, 2003, for this initial "walk out."

Attached below are recent communiqués from the Medical Society of New Jersey and the New Jersey Hospital Association, which provide more information on the effort - it is a grassroots effort, not driven by any one organization or hospital.

To help our NJ-ACEP members prepare adequately for this initiative, we provide the following:

• First and foremost, we are proud of all the NJ emergency physicians! We understand and feel, firsthand, the frustration and pain of the impact of this medical liability crisis. Emergency physicians are truly the "safety net" of the health care system - and we will staff our EDs and be available to the citizens of New Jersey.
• Emergency physicians are planning to work more and be available to work during this period in order to assure the safety of our citizens.
• We urge you to dialogue with the medical staff and hospital leadership on the individual plans of the physicians in your community. West Virginia EDs experienced increased volume - and that is expected in New Jersey as well. In fact, we need to be prepared for more patients than usual, perhaps even exceeding weekend/holiday volumes.
• You should be prepared for the Press at the doors during the week of February 3. If you have an opportunity to serve as a press spokesperson, you may want to stress your support of your colleagues, your understanding of the frustration, and that legislative tort reform - specifically a $250,000 cap on non-economic damages - is the proven solution. States with these caps, such as California, have a much more stable med mal market. Tort reform is complex - you may want to simply highlight your overall support of the physician community and the cap initiative.
  
• We urge you to dialogue directly with the leaders of large group practices in your community - particularly family practice, internal medicine, orthopaedics and pediatrics. We will need a "pressure valve" should the need develop. We will need their practices to open should dangerous conditions develop in our EDs from over-crowding. All physicians are obligated to provide emergency services for all patients, including emergency surgery, etc.
• NJ-ACEP has signed on in support of a statewide health care ad campaign - designed to educate and activate the patient community. Enclosed with this mailing is a reproduction of one of the ads that will be printed in the major dailies across NJ. We urge you to post this ad in your emergency department waiting room - and provide phone accessibility for your patients. During their wait time, they can call their legislators and ask for tort reform. The fastest way to secure tort reform is by grassroots (patient) lobbying.
• Also enclosed is a "Patient Information" flyer that you can reproduce and distribute to explain the problem.

Rest assured that the NJ-ACEP leadership is front and center working hard on your behalf to prompt legislators to pass meaningful tort reform as quickly as possible!

Please don't hesitate to call NJ-ACEP (609-392-1213) or email us at membership@njacep.org for more information. Our newly designed website - www.njacep.org -- has links to other physician sites for additional background.

Alison J. McDonald, MD, FACEP
President

Enclosures: Medical Society of New Jersey press advisory
New Jersey Hospital Association memorandum
Medical Malpractice advertising (poster)
Patient education flyer

It is our goal, as always, to evaluate and treat you as quickly as possible. We apologize for any delays and inconveniences you are experiencing due to the job action by the physicians in New Jersey. Medicine in NJ, as we have known it, is in critical condition and on life support, and we desperately need your help.

NJ legislators and trial lawyers have refused to listen to our pleas for relief from unprecedented rate hikes in malpractice insurance premiums.

The average physician has seen their premiums increase 20-30% this year - even if they had never been sued for malpractice. Most high risk specialties, such as OB and Emergency Medicine have seen premium increases of 30-300%, which can mean as much as $20,000 to $250,000 per year per physician!! Where will the money come from to pay these bills and keep offices open to care for you? We should not be paying these rates at all because the high premiums are due to outrageous jury awards. There is no money remaining in the health care system to pay these high premiums. We have to stop the rapid increase in multi-million awards that are bankrupting insurance companies, physicians and citizens like you who pay for health care.

The inaction on the part of the legislature and governor has left many physicians no other choice but to quit medicine and leave NJ because of unaffordable liability insurance. 23% of OB/Gyn's have stopped delivering babies this year. Emergency physicians and trauma surgeons are unable to find insurance companies to even offer insurance. Will you or someone you know have to deliver their baby in the car because she has to drive to another county to find an OB? Will your trauma centers be able to remain open?

Beginning February 3rd, a majority of physicians at our hospital have joined their colleagues throughout the state in cutting back their availability. This is being done to give the community at large a sense of what it is going to be like in the very near future when there is a shortage of physicians. We hope that you would agree that this would be a tragedy but it can be avoided if our elected state representatives will listen to us and pass meaningful tort reform.

The fact that this Emergency Department remains open and its staff are here to take care of you today is proof that emergency medicine is here to serve and protect you. We are trained to treat any and all emergencies and dedicated to be available to care for you and your family for any - and all - problems 24 hours a day and 7 days a week. Despite the Emergency Department's critical mission to all of society, the specialty practice of emergency medicine has been threatened by the current tort system driven by trial lawyers. For example. several insurance companies that used to insure emergency physicians have left the state or are no longer offering coverage to emergency physicians.

How can you help??

If you have any questions regarding what you can do to better understand the issues you can go online to www.msnj.org or www.njacep.org or to voice your opinion, please contact your legislator at www.njleg.state.nj.us/members/legsearch.asp.

Call Governor McGreevey at 609-292-6000 and demand that he lead the legislature to pass a reform bill that will preserve access to care in New Jersey.

We ask that you contact your state legislators and tell them that you are concerned about the survival of health care in NJ. We (and that includes you - the patient) need to demand liability reform NOW and it must include:

1. $250,000 caps on non-economic damages. This will NOT limit the amount of money that can be awarded for economic damages (hospital bills - past and future medical expenses) but will limit the amount for punitive damages and pain and suffering.

2. Caps DO WORK. There are numerous studies that have proven this despite the information being spread to the press by the American Trial Lawyers Association. In the last 10 years, California has had caps and has seen premiums rise 167%. The rest of the country without caps has seen premiums increase 500%!

3. Statute of limitations of less than 6 years on injuries that occur in childhood. Parents should be able to recognize that there was a bad outcome within the first several years and not be able to sue a physician 15 to 20 years after the fact. This lack of a statute of limitations is killing OB and Pediatric practices.

4. There need to be protections against frivolous lawsuits. It costs $30,000 on average to defend oneself against a medical malpractice lawsuit - even if you are found to have not done anything wrong! In addition, the suit is held against you even if you are dismissed from the case.

We are here to serve you but we have to let you know that there is a crisis. We need your help.

Please call your representatives in Trenton and your Governor!

Please call 1-877- KEEPMDS to contact your legislator!

Sincerely,

Your Emergency Physicians

© 2003 NJACEP