Monroe
Local physicians push for cap on state malpractice awards

By Christopher Schwarzen
Times Snohomish County bureau

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MONROE — Local doctors say they may be forced to leave the state if legislators don't find ways to control soaring malpractice-insurance rates.

Physicians from Monroe, Sultan and Everett urged state legislators Saturday at Valley General Hospital to place a cap on malpractice awards. Such a move, which has been done in other states, should lead to more insurance companies offering coverage and lower premiums, doctors said.

Washington state has no cap on the money patients can receive for pain and suffering if they win a malpractice suit. Combine the high cost of insurance with poor reimbursement from the state for social-service cases, and it's almost impossible to do business in Washington, the physicians said.

One obstetrician who works in Monroe said he's considering closing his office based on this year's premiums. One insurance company wants $275,000 to cover Dr. Rick Rybarczyk and two other physicians in his office. Three years ago, the same coverage cost about $65,000.

"Because of fixed pricing (on medical services) and (poor) state reimbursement, something has to give, and that's usually staff salaries," Rybarczyk said. "And none of us have even been sued."

Rybarczyk isn't alone.

For months, Dr. Mark Raney has worked with three physicians to take over the Sky Valley Medical Clinic in Sultan from Monroe's Valley General. A year ago, other owners were closing the clinic's doors because of increasing medical costs.

But Raney said the takeover may no longer be possible if he and his partners can't find a way to pay about $15,000 per general-practice doctor; the rate had been about $6,000 a physician.

"Last year we were looking at expanding to eight doctors," Raney said. "Now we're giving up a lot of what we were trained to do (to reduce insurance premiums)."

Legislators said help may be on the way during this year's short session, but only if bipartisan support can be found for one of many bills expected to enter the fray. Democrats, including state Rep. Hans Dunshee of Snohomish, say they want patient rights protected and are likely to consider a House option that studies and implements a scale for malpractice awards. A series of rates could take years to develop, however.

State Rep. Jeanne Edwards, D-Bothell, says she'd like malpractice-award caps for all physicians but might settle for caps covering emergency-room doctors and obstetricians.

Such a plan would help Dr. Jim Torres, who heads a group of emergency-room doctors called Northwest Emergency Physicians Group. The group has contracted with Valley General and Providence Everett Hospital, which has the busiest emergency room in the state.

Torres said he has lost sleep trying to figure out how to pay a $1 million premium for 32 doctors and 14 physicians' assistants. Three years ago, the same premium was $300,000.

Though Torres said any statute covering emergency-room doctors would be beneficial, it might take two or three years for insurance companies to return to Washington. Of 14 companies that Torres solicited for bids this year, only four sent estimates.

Even worse, said Tom Curry, the director of the Washington State Medical Association, such a measure might be nothing more than a Band-Aid that gives legislators a false sense of accomplishment while other doctors continue suffering.

Curry's organization wants the Legislature to implement malpractice-lawsuit caps for all doctors.

"During the last 3½ years of (malpractice awards) in this state alone, we show 47 malpractice cases for $80 million," he said.

But Dunshee says he fears that such caps would only harm patients, who, if suffering from malpractice, would have little recompense from or faith in the medical industry.

Valley General Hospital Commissioner Dennis Dinkla said the debate on how to handle malpractice in the state needs to end soon. If doctors close offices or leave the state because they can't afford to work here, then the hospital district and patients end up suffering, he said.

Christopher Schwarzen: 425-783-0577 or cschwarzen@seattletimes.com

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