After 28 years, Roop Shivpuri couldn't afford to be a doctor any more.
At the end of her medical career, Shivpuri, now the president of the Kane County Medical Society, was paying $135,000 a year for malpractice insurance for her Elgin practice.
(Andrew A. Nelles/For Sun-Times Media)
(Michael Smart/Staff Photographer)
(Submitted)
• About this series
• Day 1: When illness strikes
• Day 2: How to pay for reform?
• Day 3: Uninsured: No safety net
As the health care debate rages in Washington, we asked for your thoughts about this controversial issue. The response was overwhelming. Hundreds of you wrote, e-mailed or went online to share your feelings. This series addresses the issues you’re most passionate about.
• Sunday: When illness strikes
Even those with insurance aren’t protected from financial and emotional disaster.
• Monday: Don’t take my money
Many taxpayers don’t trust the government to fix the problem; nor do they want to bear the burden of those uninsured.
• Tuesday: Speaking of uninsured
Those who can’t afford health insurance want more options than disability or welfare.
• Wednesday: Fire the lawyers
Some are convinced tort reform could go far in fixing our health care woes.
• Thursday: Your suggestions
So how do you really feel? We look at more of your concerns.
The ob/gyn calculated that, based on the amount she was making vs. the amount she was paying for malpractice insurance, she was basically doing the first six months of each pregnancy for free.
"I was drawing from my savings for several months before I thought, 'What am I doing? This makes no sense,'" she said.
She opted for an early retirement, dissolving her practice two years ago this month.
And that brings us to coffee from McDonald's.
Held up as an icon of excess in a case of legal fault, the anecdote centers on a 73-year-old patron of the fast-food chain who spilled hot coffee onto her lap and later was deemed deserving of a $2.86 million jury award — nearly every one of those dollars in punitive damages.
A jury later reduced the sum to $640,000, but the case still rankles Sandra Kaptain of Elgin.
"The spilling the coffee on their laps — as far as I'm concerned, that's their problem," Kaptain said. "That's a terrible thing for a nurse to say."
Although Illinois is one of a handful of states that has set a cap on malpractice awards, longtime nurse Kaptain is among those readers who told The Courier-News that tort reform is a key element needed in the overhaul of the nation's health care system. That would include a limit on settlements for medical wrongdoing.
Barbara Gies of Elgin wrote that passing laws for tort reform "would lower insurance premiums for doctors and would lower health care fees."
One anonymous reader suggested tort reform so doctors "can't get sued for not ordering every test in the book," which is a waste. And another noted there are "too many lawsuits (lawyers). Everyone is protecting their backs."
Kaptain said, "Any little thing — something comes up with a small, little thing — they should not be able to sue. That's one of the major things I think needs reformed."
Tort reform finds understandable support among those in the medical profession. According to Howard Peters, excess liability is responsible for $100 billion in health care costs every year because physicians and other health care workers feel they must go to great lengths to guard against "unfair lawsuits."
"We strongly believe that if you want to reform health care and you want to squeeze costs out of the health care system, you're going to have to do comprehensive liability reform," said Peters, senior vice president for government relations for the Illinois Hospital Association.
It's also finding some support in Congress.
The Medical Rights and Reform Bill — also known as HR2516 — is sponsored by U.S. Rep. Mark Kirk, R-Northbrook, and cosponsored by Rep. Judy Biggert, R-Hinsdale, along with 18 other House Republicans. It includes a suggestion to "encourage states to adopt 'alternative to litigation' reforms such as early disclosure and compensation, administrative determination of compensation, and specialized health care courts."
The proposal also calls on doctors to consider practice guidelines supported by clinical evidence as a way of reducing defensive medical practices, and includes "stabilized compensation" for those who are injured in the course of receiving treatment.
Are suits justified?
Some people assert that eyebrow-raising awards are justifiable in some cases, especially "in severe cases where people depend on that money," noted Elgin's Kaptain.
As a nurse, she's seen such cases — like the disabled man who for 11 years was bed-bound and relied on the money from the lawsuit to get the care he needed in his own home.
"People want to be at home," she said, "and if the government can help people be at home, that's cheaper than any nursing facility."
Kathleen Zellner believes reducing malpractice awards would do nothing to bring down health care costs. Zellner, a former Naperville attorney now practicing in Oak Brook, represents patients in medical malpractice actions.
Citing a Harvard University study that found 200,000 Americans die unnecessarily each year because of medical errors and infections contracted in hospital settings, Zellner is not about to absolve the medical community of big-ticket responsibility for bad outcomes.
She argued successfully for a $13.3 million settlement for the estate of a woman who committed suicide after she was sent home from the hospital even though she was severely depressed. Even after the award was split in half to account for the deceased's role in the tragedy, the case holds the U.S. record as the largest malpractice award involving a suicide, Zellner said.
Setting limits
Kane County's Dr. Shoop Shivpuri said physicians will continue to practice defensive medicine, ordering every unnecessary test and adding billions in medical costs until limits are set on malpractice suits.
"When a patient comes to see me, I will always have in the back of my mind that this is a patient who can sue me," she said.
Also complicating the task of bringing down costs are cases in which doctors follow established medical protocols, but something beyond their control goes wrong — and the case ends up in court.
"Sure, somebody needs to have a forum to address some of these true medical errors or mistakes, but if you're talking about an outcome that the doctor really didn't have anything to do with ... this is clearly one of the reasons why the United States has one of the most expensive health care systems in the world," McKibbin said.
As for Shivpuri, she did not recommend medicine when her two children, now adults, came to her for career advice.
"I told my son, if you can't beat them, join them," she said. "He's an attorney."