OLYMPIA – Doctors and trial lawyers have agreed to changes in the state’s medical malpractice system, less than four months after pummeling each other with multimillion-dollar initiative campaigns.
Their compromise, hammered out in weeks of secretive negotiations with Gov. Chris Gregoire, was unveiled on Monday. It will be embedded in a revision of a patient safety bill wending its way through the Legislature.
All the parties involved hailed Monday’s announcement, while also cautioning that more work remains.
“No one got everything they wanted – myself included,” Gregoire said at a news conference. “But that’s the nature of negotiations.”
Trial attorneys and doctors have argued for years over who’s at fault and what the cure is for rising malpractice rates and large lawsuit payouts to patients injured by medical care.
The two sides waged acrimonious initiative campaigns last fall, raising some $15 million and setting a state spending record.
The doctors’ measure, Initiative 330, sought limits on punitive damages against doctors and hospitals, saying large jury awards in civil suits drive insurance premiums to unaffordable levels.
The trial lawyers responded that insurance companies, not court cases, are responsible for the high malpractice rates. With Initiative 336, they sought stiffer discipline of incompetent doctors.
Voters defeated both measures, and it seemed the matter was dead. That is, until Gregoire brought the parties together for 10 meetings over 45 days. She participated in several of the sessions.
Monday’s compromise incorporates ideas from both campaigns, including:
* Allowing doctors to apologize in the immediate aftermath of medical mistakes without worry that their statements will be used as admission of negligence in court.
* Expanding the authority of the state’s insurance commissioner by requiring prior approval of malpractice rate increases and broader reporting of resolved claims.
* Informing civil juries of compensation or payments that a malpractice plaintiff has received, and requiring statements that a malpractice lawsuit probably has merit.
* Providing for voluntary binding arbitration for civil cases involving up to $1 million in damages. The intent is to wrap up most cases within a year.
The deal does not set caps on damage awards, as the medical industry desired, nor does it establish a “three strikes” malpractice license revocation for doctors, as sought by lawyers.
While not a solution to the thorny issue of malpractice, the negotiations have produced a solid framework for overhauling the system, said Randy Revelle, senior vice president of the Washington State Hospital Association.
Barbara Flye, who led the campaign against Initiative 330, praised the agreement as a breakthrough in the long-deadlocked debate. She said one of the biggest gains for patients is access to more information on their doctors and the ability to hear from their medical personnel if something wrong occurred.
Peter Dunbar of the Washington State Medical Association said one of the most important aspects is the “protection of apologies” by doctors.
While it may not reduce lawsuits or lessen “defensive medicine,” it will give doctors “a window of opportunity to say what they want” to a patient without fear that it will be used against them later.
Gregoire said she wants the parties to continue working on the issue before the next legislative session. She said one of her major goals was to strengthen the state’s medical disciplinary board.
“I believe it’s in need of major reform,” she said.
Insurance Commissioner Mike Kreidler, who argued against both malpractice initiatives last year, said the changes contained in the compromise will help the state prepare for the next cyclical crisis in malpractice insurance.
There is no such crisis now, he said.
“The insurance companies right now are making record profits in malpractice insurance,” Kreidler said. “At the same time, rates are coming down.”
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