Board Sees No Doctor Exodus From Nevada

Disciplined Doctors
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Despite warnings that doctors were leaving Nevada due to the rising cost of medical malpractice insurance, there are more physicians with active licenses now than there were at the end of 2001, when some say a medical malpractice crisis began, a state board reports.

Larry Lessly, executive secretary of the Board of Medical Examiners, said there now are 4,375 active licenses for physicians, compared with 4,347 in December 2001.

However, the current number of doctors was below that in December 2002, when 4,537 physicians had active Nevada licenses.

Despite the decline, Lessly said there was not a mass exodus of doctors from Nevada, as many had claimed. He said the number of physicians has remained somewhat constant.

Meanwhile, a recent congressional study found rising insurance premiums have reduced patient access to specialty health care in Nevada. The study also concluded some doctors might be exaggerating claims of a "malpractice crisis."

In five states with reported medical access problems, including Nevada, auditors with the General Accounting Office said it found cases where orthopedic surgeons and family practitioners were leaving or cutting back services"largely in response to the high cost of malpractice insurance."

But investigators questioned the extent of the problem.

"Some reports of physicians relocating to other states, retiring or closing practices were not accurate or involved relatively few physicians," auditors found.

The findings came from a 10-month study conducted by GAO auditors from September 2002 to June.

In Nevada, "random calls we made to 30 OB/GYN practices in Clark County found that 28 were accepting new patients with wait times for an appointment of three weeks or less," the GAO report said.

The calls were made after state lawmakers enacted reform measures and launched a state insurance program that relieved much of the liability pressure obstetricians-gynecologists were experiencing.

Surveys by the state Board of Medical Examiners found inaccuracies in reports that obstetricians-gynecologists were leaving the state, closing their practices or retiring due to malpractice concerns, the GAO said.

A survey conducted for the state Legislature in January showed about 100 doctors retired or left the state because of insurance problems, said Larry Matheis, executive director of the Nevada State Medical Association.

Matheis said it has been difficult to pin down how many doctors have taken actions that affect patient access.

"Doctors changed their practices, some left their practices, some moved and came back when things got better and they got insurance," he said.

State lawmakers enacted new medical liability laws during a 2002 special session to help stem the tide of departing doctors.

One law caps medical malpractice awards for noneconomic damages at $350,000 with two exceptions. Awards can exceed the cap in cases of gross malpractice or when the judge determines exceptional circumstances merit higher awards.

Doctors and insurance company officials say the exceptions to the cap render it ineffective.

"This is a real crisis with real numbers and real people,"said Dr. Raj Chanderraj, chairman of the Clark County Health Access Consortium. "The fact that premiums shot up so high that some doctors left or stopped doing certain procedures is not disputable."