Doctor shortage and malpractice insurance pose challenges to reform

The Associated Press reports: "Due to increasing medical demands from aging baby boomers, the U.S. faces a dangerous shortage of primary-care doctors whether sweeping overhaul is passed or not."

"Several doctors' groups are backing the legislation, citing in part provisions to expand the work force. For example, the proposed House legislation would add funds, loan repayment and training grant programs designed to promote use of specialized nurses, encourage doctors to work in underserved areas and entice new students into primary care. Existing medical schools also have begun to increase enrollment, while new schools are under development from El Paso in West Texas to central Michigan. Still, it remains to be seen whether the efforts will be far and fast enough, given the long-standing attraction of medical specialties which offer students higher salaries and more prestige" (Yen, 9/15).

Newsday reports on the struggles doctors face, and the issue of malpractice insurance, by looking at the experience of one obstetrician-gynecologist, Dr. Stuart Lustberg. Newsday reports: Lustberg "starts each day at 8:30 a.m., often works until 10 p.m. at his Huntington office, and is on call seven days a week if one of his patients goes into labor. Every nine days, he moonlights at Huntington Hospital for a 24-hour shift to take care of emergencies or uninsured patients who walk through the door. This extra money helps pay his $175,000-a-year malpractice insurance, which represents 28 percent of the revenue from his medical practice. ... 

"Lustberg said 'tort reform' -- capping awards in malpractice lawsuits -- would be the single biggest thing legislators could do to lower health care costs because doctors would no longer feel compelled to order every test. But he is gloomy about its prospects. In his speech last week before Congress, President Barack Obama said he would authorize demonstration projects in some states to look at ways to reduce malpractice insurance" (Ochs, 9/15).

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