Again, A Slowdown

By Brown in a malpractice-insurance reform bill, the legislation had little chance of passage and the slowdown would go on.

The bumper sticker on a doctor's Cadillac in Beverly Hills last week read:

FEELING SICK? CALL YOUR LAWYER.

That was the physician's way of telling the public that it had brought on itself the latest California doctors' slowdown by suing for excessive malpractice awards. Since the start of the new year, four-fifths of the 11,000 physicians in the Los Angeles area had refused to treat patients, except in the most serious emergencies. In some hospitals, wards were closed and the services of such specialists as orthopedists and neurosurgeons all but unavailable.

Malpractice Fund. As in similar medical slowdowns elsewhere in the country, including a four-week walkout in northern California last spring, the doctors are protesting the skyrocketing cost of malpractice insurance that underwriters insist is made necessary by mounting jury awards. Effective Jan. 1, Travelers Insurance Co., which covers three-quarters of the area's doctors, hiked premiums by an average of 400%.

For certain high-risk specialties, the increase was even more staggering. For example, Dr. Paul Muchnic, a Los Angeles orthopedist, found that his premiums had suddenly risen from $6,500 to $36,000 a year. He angrily announced that he was quitting his $65,000-a-year practice. Others have pulled up stakes and moved to other states where there are fewer malpractice suits, smaller judgments and thus more reasonable insurance rates.

To protect doctors against astronomical malpractice awards for death or total disability--20 of which have exceeded $1 million--California's Governor Edmund Brown Jr. has backed the creation of a statewide malpractice fund that would collect fixed annual fees averaging $4,000 per doctor and use that money to pay off claims. These now average $36,000. But Brown wants something in exchange from California's doctors; he has asked them to treat more patients under the state's limited-fee Medi-Cal program,* provide free care for the poor and set up a "medical Peace Corps" for areas of California that are short on medical facilities and personnel.

So far, the doctors have balked at Brown's efforts to link social problems with what to them is the purely economic question of malpractice rates. Says Dr. Carl Goetsch, president of the California Medical Association: "We don't feel anyone should put us in a position of a trade-off because we are not playing politics with peoples' lives or health."

At week's end both sides remained adamant. It seemed probable that unless the doctors showed a willingness to accept some of the social-responsibility provisions demanded by Brown in a malpractice-insurance reform bill, the legislation had little chance of passage and the slowdown would go on.

*The doctors say that they are already treating 85% of Medi-Cal patients.

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