Marcus Rayner â€¢ Times of Trenton / Op-Ed
Recently, I spoke to a young man who is studying medicine at the University of Medicine and Dentistry of New Jersey (UMDNJ). A lifelong New Jersey resident who excelled as an undergraduate, he represents the best and bright
As the national debate on health-care reform and tort reform unfolds, it is worth noting that here in New Jersey, we have our own health- care crisis under way. And it is driving out physicians, limiting patient access to care and increasing the cost of health care for all of us.
Recently, I spoke to a young man who is studying medicine at the University of Medicine and Dentistry of New Jersey (UMDNJ). A lifelong New Jersey resident who excelled as an undergraduate, he represents the best and brightest our state has to offer. With grand aspirations of becoming a doctor, he enrolled at UMDNJ, hoping to someday practice in his home state. Unfortunately, he has come to realize that his dream of practicing specialized medicine faces a significant hurdle — and it’s not just rotations.
This promising young medical student, whom I will call Jim, has become a casualty of our litigious health-care system. Growing up in a large family fostered Jim’s interest in delivering babies, prompting him to study obstetrics. Earlier this year, however, reality hit: Jim has the talent to become an OBGYN, but lacks the bottom line.
“I can’t afford it,” Jim realized. “I went to medical school thinking that if I worked hard enough, I would be able to practice my specialty of choice. Not being able to become an OBGYN because I can’t afford malpractice insurance was the furthest thing from my mind.”
Jim realized that in order to have a solvent future as an OBGYN, he would have to deliver scores of newborns each quarter just to afford the cost of his malpractice premium. Rates have skyrocketed for doctors practicing specialized medicine during the last few years. By the time Jim graduates, just to remain viable, he will likely have to see more patients and deliver more babies than any doctor reasonably could without compromising his patients’ quality of care. When we consider that Jim expects to be more than $200,000 in debt after completing his entire education, we see that it is not much of a choice at all.
Malpractice insurance costs so much because New Jersey’s current civil justice laws are decisively anti-physician. Malpractice awards in New Jersey are not capped, for one. In addition, some New Jersey courts allow cases to be built around weak “junk science” that is often not permissible in other jurisdictions. As a result, New Jersey’s courts have become a lottery for those wanting to turn an unfortunate medical outcome into a payday. Physicians, therefore, are required to prepare themselves with sufficient insurance should they find themselves — or others with whom they share a practice or support staff — to be the victim of frivolous litigation. This excessive physician liability also forces many doctors to abandon specialized medicine altogether, leaving many patients without care.
“The New Jersey Legislature has put tort reform on the back burner for far too long,” agrees Assemblywoman Amy Handlin, R-Monmouth. “We can’t lose sight of a basic truth: While health care must be affordable, affordability does not guarantee access. If New Jersey has no doctors in the specialty you need, the price of an office visit is irrelevant.”
It’s not just in the medical malpractice arena that New Jersey is known for litigation abuse. In 2008, 94 percent of New Jersey’s pharmaceutical class-action lawsuits were filed by non-New Jersey residents. Would-be plaintiffs are targeted by trial lawyers and encouraged to file suit in New Jersey against our companies, no matter where they live. Only a tangential relationship between the plaintiff, defendant and New Jersey are needed in order to sue our companies. If our laws are more favorable and the company has done business in New Jersey, our courts will welcome the suit. And the costs are borne by all of us.
While both federal and state governments bear responsibility for setting civil justice and medical malpractice policy, aspiring physicians in New Jersey are at a notable disadvantage. Medicine bears the distinction of being both business and personal. Why practice specialized medicine in New Jersey when our state’s proximity to Delaware, New York and Pennsylvania offers much less burdensome alternatives?
As for Jim, he is asking himself the same question, and he wonders whether it is worth it to relinquish the opportunity to practice specialized medicine just to stay in his home state, where, at some point, he is likely to be sued.
The American Tort Reform Association was prompted to designate Atlantic County as the sixth most prominent “Judicial Hellhole” in the nation for two consecutive years. As a state, we already face challenges retaining and attracting business and entrepreneurs. Perhaps with an informed debate about health-care reform, we can implement the changes we need to keep good doctors like Jim in New Jersey and taking care of our patients first.