A public forum on Maui sponsored by the Hawaii Medical Association (HMA) last year focused on problems residents face in accessing medical care.
Courtesy of HMA

AAOS Now

Published 6/1/2009
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Linda J. Rasmussen, MD

Hawaii legislature advances medical tort reforms

AAOS grant helped push bill through House

Hawaii may be paradise for vacationers, but not for physicians. Island doctors are leaving at an alarming rate, citing low insurance reimbursements and increasing numbers of medical liability lawsuits. The result is that patient access to health care continues to decline.

Between 2006 and 2008, the number of practicing physicians in Hawaii decreased by 6 percent. Over the past 11 years, the number of practicing orthopaedic surgeons has dropped from 68 to 46. Physicians have been warning legislators about the potential consequences of this crisis for several years, and patients are now joining this effort and talking with lawmakers about the impact of a shortage of physicians in Hawaii.

Patients organize to help
An organized effort of patients and concerned consumers, “Save Our Doctors,” was formed and is educating the public on the link between the access to care crisis and the need for medical liability reform in the state. Save our Doctors has been disseminating this information to the public and keeping this as an important public health issue through mailings, print and newspaper advertising, booths at health and senior fairs, and a Web site sponsored by a generous grant from the AAOS State Orthopaedic Society Policy Action Fund.

Supporters of reform contend that physicians in Hawaii pay among the highest premiums in the country for medical liability insurance. In addition, Hawaii currently does not have limits on noneconomic damages, which results in unpredictable awards in medical liability lawsuits.

Two legislative informational forums were held at the state capitol with more than 300 persons attending each forum. David Teuscher, MD, secretary of the AAOS Board of Councilors, attended one of the forums and discussed the need for medical liability reform. He also testified during a state Senate hearing on the need for reform.

Halfway there…
As a result of these efforts, the Hawaii House of Representatives passed HB 1784 by a vote of 37 to 13. This bill limits noneconomic damages to $250,000 in medical liability cases involving orthopaedic surgeons, neurologists, obstetrician/gynecologists, emergency physicians, and general surgeons. It also places a cap of $3 million on awards for gross negligence.

The state Senate, however, failed to pass the tort reform measure through the Senate Health Committee. But because the bill passed the House, it will not have to be reintroduced there and will only have to pass the Senate in 2010.

Linda J. Rasmussen, MD, is the Hawaiian representative to the AAOS Board of Councilors. She can be reached at lindamd1@juno.com