Playing Games With Numbers

The medical liability insurers, hospitals and doctors are coming at Tennessee consumers this year in the Legislature – a full frontal assault in a effort to limit responsibility for negligence.

I have argued for years that the “reformers” use faulty numbers – and they do. The reformers have figured out that the numbers do not support what they want, so they have changed the focus of their attack to say (a) things aren’t bad in Tennessee yet but it will get bad if we don’t change the law; and (b) people are being deprived access to health care because doctors no longer practice _______ (fill in specialty) in _________ (name of city, town or hamlet).

“The sky is falling argument” is quite easy to defeat because legislators hear that the sky is falling from every lobbyist every day.

The second argument is more of a challenge because legislators want access to health care – for themselves and for their folks back home. And when someone says “if you live in Lake County you have to drive 60 miles to find an OB” or “you can’t find a doctor in Memphis to do ______________” that causes concern to those who accept it at face value.

It is also hard to respond to “polls” taken by doctor groups for doctor groups who know why they are being asked questions like “do you ever think about whether you will be sued if you do not order ___________ test” or “do you ever think about quitting the practice because of the cost of liability insurance?”

Well, here is a report by Public Citizen which shows we need to go on the attack on this front, too. The docs in DC made the argument that OBs were fleeing DC because of high malpractice insurance rates.

The reformers argued that there were “only” 151 OBs in DC. Public Citizen found 180. And look what else they found:

“Among those 180 OB/GYNs, there are at least 113 practicing OBs who are delivering babies in the District. (Nineteen percent of the 180, or 35 doctors, are gynecologists choosing not to do obstetrics.1) The doctors, meanwhile, claim to have identified only about 80. (This is based on a survey of 141 doctors, with over 40 percent reported having
stopped delivering babies.2) Thus, Public Citizen has identified 33 more actively practicing OBs than what doctors have been claiming to public officials and the public.”

And this: “Virtually all of the practicing obstetricians – at least 108 of 113, or 96 percent – are accepting new patients, Public Citizen found, which clearly shows pregnant women face little difficulty in finding a doctor to deliver their baby in the District.”

And don’t you love this:

“Public Citizen also fact-checked the medical society’s survey of District OB/GYNs, in which it claimed to have contacted 141 doctors out of 151 listed in the 2005 Washington Physicians Directory, finding that over 40 percent, or 61, of them had stopped delivering babies. Actually, there were only 137 OB/GYNs listed; among those, 21 had wrong or disconnected telephone numbers and three were retired. Of 113 doctors remaining, at least 78, or 69 percent, are in active practice delivering babies. While doctors claim over 40 percent have stopped delivering babies, Public Citizen found that when doctors of retirement age and those in non-obstetric specialties like oncology are excluded, only 19 of surveyed OB/GYNs, or 17 percent, do not deliver babies. This does not mean, however, that these doctors stopped delivering babies because of malpractice issues, as the medical society claims. They may never have delivered babies, or if
they stopped, may have done so for a reason other than malpractice insurance rates.”

Read the report here.

Public Citizen has showed us that we must look behind every statistic offered by the reformers; we cannot accept anything at face value.