Doctor’s proposal target
BATTLE OVER MALPRACTICE INSURANCE
UNDER DEBATE: AMA
considers whether to give its OK for physicians to refuse to treat trial lawyers
and spouses, except in emergencies.
BY CAROL M. OSTROM; Seattle Times
staff reporter: June 14, 2004
When a patient who
happened to be a trial lawyer told Dr. Steve Klein, "If you screw up, I'm going
to sue you," Klein sent him packing.
Being threatened makes it hard
for him to think clearly, said Klein, a brain and spine surgeon and chief of
surgery for Northwest Hospital & Medical Center. "I can't render the best
That's why Klein supports a proposal to allow doctors to refuse
to treat trial lawyers and their spouses, as long as it's not an
The resolution is being considered by American Medical
Association (AMA) delegates meeting in Chicago to set policy for the doctors'
The proposal, by a South Carolina surgeon who wants to
bring attention to the "professional-liability crisis," is expected to be
extremely controversial, said Tom Curry, executive director of the Washington
State Medical Association. Yesterday, it met with an angry response at the
Curry said the eight delegates from Washington state take the
position that "it's not unethical for a physician to refuse to treat, or
transfer care of a patient, if he or she feels there's a communication or trust
At the same time, the proposition that doctors could reject
all trial lawyers and their spouses is "highly problematic," he said. "Most
physician's would be concerned that would be a little too much."
Still, he said, all the doctor-delegates understand the strong feelings that led
to the resolution. "It's a sign of the times, and a good indication of the depth
of the frustration out there," he said.
The South Carolina surgeon,
Dr. J. Chris Hawk III of Charleston, has said he wants to spotlight the need for
reform of the civil-justice system.
"If trial attorneys were given the
opportunity to experience the access problems caused by the
professional--liability crisis, then perhaps they would be willing to help
change the system," he wrote in his resolution.
He has asked the AMA
to tell doctors they may ethically refuse to treat plaintiffs' attorneys or
their spouses, except in emergencies or when they are otherwise required by law
or regulation. Yesterday, Hawk attempted to withdraw the resolution; it wasn't
immediately clear whether it would be brought forward to delegates, who begin
voting on policies today.
According to the AMA’s current ethics code,
doctors can refuse care to individual patients, except in emergencies. But the
prospect of doctors barring a whole class of patients drew trial lawyers'
reactions ranging from gentle disappointment to edgy incredulity.
"It's silly," said Reed Schifferman, a Seattle plaintiff’s lawyer. "It's
disappointing. I would like to think the vast majority of doctors I know aren't
going to treat you based on your job."
Carlton Carl, spokesman for the
Association of Trial Lawyers of America, said it would demean the medical
profession to pass such a resolution.
"It would be a shame and very
disappointing if doctors turned the Hippocratic Oath into a hypocritical
position, denying access to medical care to a profession or specific group of
people," he said.
Frank Shoichet of Seattle, like many plaintiffs'
attorneys, says doctors should realize that problems with malpractice insurance
are caused by the insurance industry, not lawsuits.
ought to think about not treating insurance company executives instead - it
might get to the root of the problem," he said.
neurosurgeon, said he has a responsibility to his other patients and to his
family to turn away litigious patients, because a lawsuit is so destructive and
distracting for a doctor.
Most doctors he knows feel that way, he
said: "Why would you purposefully treat someone you believe is going to sue
He recalls his first threat, 20 years ago, from the mother of a
girl who had been shot in the head. Klein was in a trauma center, where he had
to try to help the girl. He told the mother the wound was life -threatening and
that doctors would do their best.
"She said, 'She better be the way
she was or you're going to pay,'” Klein recalls.
The girl died; the
Now, when patients or families say things like that,
Klein says, he helps them find another doctor, telling them they appear to have
a "gross misunderstanding of the nature of surgery," because they're not
accepting the fact that there are risks.
He's done some types of brain
surgery 500 times without problems, he says. But, he adds: "Statistics catch up
with you. These risks are real. It's the limits of medicine. If somebody can't
accept that, I don't want them as a patient, whether it's a trial lawyer, an
accountant, a reporter, another doctor."
Klein said he wouldn't refuse
treatment to someone simply because he or she was a trial lawyer or opposed
doctors' demands for limits on lawsuits.
"I'd even treat (U.S. Sen.)
Patty Murray," he joked.
Murray, who has opposed limits on noneconomic
damages in medical--malpractice suits on the grounds that it would
disproportionately hurt women and the elderly, has been targeted politically by
doctors and their allies.
Carol M. Ostrorn: 206-464-2249 or
Information from The Associated Press is included in