12 posts categorized "Doctor Shortage"

Thursday, February 07, 2013

A-1831 unanimously clears Assembly Health Panel

In our ongoing quest to keep good doctors practicing in New Jersey, NJLRA supported A-1831 before the Assembly Health and Senior Services Committee, which advanced it with bipartisan support.

If enacted, A-1831 would help lower liability insurance premiums, which is frequently cited as a key reason for New Jersey’s so-called medical brain drain.  Insurance premiums begin to increase the moment a lawsuit is filed.  This bill would prevent insurance carriers from raising liability premiums based on a claim of medical practice, unless the physician is found liable in court.  It would also prohibit insurers from increasing liability premiums in certain charitable or emergency situations. 

A-1831 is an important first step to help reverse the public crisis of doctors fleeing our state, which is expected to worsen significantly in the next few years.  

Practicing specialized medicine in New Jersey is comparatively difficult for recent medical school graduates.  In addition to their student loans, new doctors must bear New Jersey’s high cost of liability insurance premiums.  Specialties which carry some of the highest premiums, including obstetrics and gynecology, disproportionately impact New Jersey women.  It is no longer cost effective for many existing OBGYNs in New Jersey to deliver babies, and many have stopped doing so altogether. 

We thank the committee and Chairman Conaway for their advancement of this measure. 

Tuesday, February 05, 2013

Assembly Health Committee to hear medical liability reform measure

The Assembly Health and Senior Services Committee is scheduled to hear A-1831 on Thursday, marking an important step toward addressing deep concerns about the cost of liability insurance within the medical community.   

Sponsored by Chairman Herb Conaway (D-Burlington), A-1831 would prevent insurance carriers from raising liability premiums based on a claim of medical practice, unless the physician is found liable in court, and would prohibit insurers from increasing liability premiums in certain charitable or emergency situations. 

This legislation would also provide civil immunity to healthcare professionals who volunteer their services in good faith.  Civil immunity would be available to volunteer healthcare professionals who do not have an active provider-patient at the time of the emergency.  As our population outpaces the number of physicians we need to adequately care for the health of New Jersey residents, volunteer healthcare professionals will become increasingly important.  By offering civil immunity to these volunteer medical personnel, A-1831 takes a step toward addressing our New Jersey’s public health needs. 

Practicing specialized medicine in New Jersey is comparatively difficult for recent medical school graduates.  In addition to their student loans, new doctors must bear New Jersey’s high cost of liability insurance premiums.  Specialties which carry some of the highest premiums, including obstetrics and gynecology, disproportionately impact New Jersey women.  It is no longer cost effective for many existing OBGYNs in New Jersey to deliver babies, and many have stopped doing so altogether.  It’s not just a matter of addressing a significant healthcare cost-driver; it’s also about ensuring that New Jersey residents – especially women – have access to medical care.   

The hearing will take place at 10 a.m. in committee room 16.

Monday, January 14, 2013

A-3282 Passes Assembly Health Committee with Bipartisan Support

A-3282 clarifies that first aid, ambulance or rescue squads, as entities, have immunity from civil damages in certain circumstances

While this may seem to be a routine legislative clarification, the catalyst case, Murray v. Plainfield Rescue Squad, was eye-opening. 

In August 2004, a young man was shot by his own brother.  Alive and able to speak, his parents immediately called 911.  The Plainfield Rescue Squad arrived by ambulance and fruitlessly performed CPR; some believe that if he had instead been immediately transported to the hospital, Odis Murray would have had a 20 – 30 percent chance of survival. 

The Murrays decided to file a wrongful death lawsuit – not against their other son, Akeem Murray, who intentionally fired the shot that killed Odis – but against the Plainfield Rescue Squad

A lower court found that the because the Squad provided “intermediate life support services in good faith,” they were protected from civil liability under N.J.S.A. 26:2K-29, also known as the Good Samaritan Act. 

The Supreme Court ultimately disagreed.  The spirit of the act was to protect volunteers acting in good faith from liability so as to not dissuade volunteer responders from helping in the first place.  While it specified who would be protected, it did not define ‘rescue squads’ clearly enough for the Court’s liking. 

“The Legislature chose to provide immunity to volunteer rescue squads and to rescue squads rendering advanced life support services,” wrote Justice Barry Albin in a unanimous decision.  “By the clear language of N.J.S.A. 26:2K-29, the Legislature chose not to provide immunity to rescue squads, as entities, rendering intermediate life support services.

“If the failure to provide immunity to such rescue squads was an oversight, any corrective measure must be taken by the Legislature.”

The Legislature took the first step toward clarifying the intent of the Act today.  Primary sponsors of A-3282 include Assemblymen Eric Peterson (R-Hunterdon), Anthony Bucco (R-Morris), and Chairman Herb Conaway (D-Burlington).  Its companion bill, S-2165, is sponsored by Senator Kip Bateman (R-Somerset) and has been referred to the Senate Law and Public Safety Committee.   

Click here for Assemblyman Conaway's statement.  

Wednesday, November 28, 2012

When a child drinks cologne, by all means, sue the doctor...

It’s a story that’s easy to miss in the post-Sandy, post-Election Day, “fiscal cliff” news cycle, but one that will stick with you for a while after learning about it. 

A New Jersey appeals court has determined that an emergency room doctor must stand trial for failing to report to the Division of Youth and Family Services that he treated a child who ingested cologne. 

The 3-year-old patient, identified in court papers as “S.A.,” was abandoned by her mother soon after birth in 1998.  The Division (DYFS) placed her in the care of her father two years later.  She was brought to Jersey Shore University Medical Center in Neptune in early 2001 by other relatives, who said that she was “walking with an unsteady gait and was observed as lethargic and weak with an unusual odor on her breath.”

From a layman’s standpoint, it appears that the emergency room doctor, Daniel Yu, performed a thorough examination, leading him to conclude (correctly) that the young child ingested cologne.  She was treated and her extended family was on its way. 

Two months after the cologne incident, DYFS received a disturbing report: S.A., still under her father’s care, had been severely burned and beaten.  She had chemical burns on various parts of her body, including her vagina.  At this point S.A. was removed from her father’s custody by the Division.  She was later adopted by the plaintiff in this case, L.A. v. DYFS, A-2726-11, who is identified as L.A. in court papers. 

 

And in 2007, L.A. filed suit – not just against the Division, which evidently had some history with the child’s family – but against Dr. Yu and Jersey Shore University Medical Center.  DYFS settled with L.A. for $5 million.  No suit was filed against the child’s abuser.  

N.J.S.A. 9:6-8.10 requires anyone who believes a child is being abused or neglected to contact DYFS.  Mercer County Superior Court Judge Paul Innes didn’t believe that a toddler ingesting a foreign substance was indicative of abuse.  It’s the sort of thing that happens in the happiest of homes from time to time, to the tune of at least 100,000 childhood emergency room visits each year.  The appellate court, however, disagreed with his assessment, and the case will be going forward. 

The medical community fears that if Dr. Yu and the hospital are found liable, doctors and hospital staff will be pressured to report abuse for tiniest of infractions, overwhelming a DYFS system that is already overwhelmed and creating an adverse affect on children’s health and well-being.  The threat of DYFS involvement may discourage parents from seeking immediate care when children swallow things they shouldn’t, mask their child’s symptoms, or even deter them from bringing their child to the emergency room altogether in order to avoid the legal scrutiny and uncertainty to follow. 

The need to reform our legal system isn’t just about the taxes we pay or improving New Jersey’s economy.  It’s also about injecting common sense into real-life situations we all face. 

So, should the doctor and hospital be found liable of malpractice for not reporting that a toddler drank cologne to DYFS, you may want to prepare yourself for a barrage of questions the next time you take your kid to the E.R. for sticking a LEGO in his ear.     

Wednesday, October 03, 2012

ICYMI: Read NJLRA’s Letter-to-the-Editor in the Asbury Park Press

Reforms to liability laws might keep doctors in N.J.

Friday, September 21, 2012

NJ is Treacherous Ground for Physicians: A Panel Discussion

Ten years ago the Medical Society of New Jersey (MSNJ) worked hard to enact meaningful medical liability reform in New Jersey.  Since then, court decisions have gutted key statutes and insurance premiums have skyrocketed.  We are now on the brink of a severe doctor shortage as other states enact liability reform and attract new physicians. 

MSNJ will be hosting a panel discussion on Thursday, September 27th with leading legislative and legal experts to discuss what can be done to combat the unique issues facing New Jersey’s doctors and their impact on public health. 

To register for this free event, please click here to visit the Medical Society’s website

Tuesday, August 14, 2012

Protecting volunteers may expand healthcare in Trenton, NJ

As our nation continues to debate health insurance mandates and cost-drivers that left preventative medicine out of reach for many, volunteer doctors quietly set up shop in some of New Jersey’s most underserved communities, trying to alleviate public health burdens on a patient-by-patient basis. 

Trenton is one of these communities.  In a Trenton Times report earlier this week, City Health Officer James Brownlee explained that years of funding cuts forced its clinics to greatly reduce the services they could offer. 

But there may be light at the end of the tunnel.  And that light is federal “free clinic” status.

According to the Times, such a designation would provide “essential malpractice insurance for a new staff of volunteer doctors, nurses, and other professionals who have retired from local hospitals,” bringing with it an opportunity for clinics to begin expanding their outreach once again.   

Medical liability insurance is routinely cited by New Jersey’s medical community as a disincentive for doctors to practice in the Garden State.  Such premiums, particularly for OB-GYNs, are significantly higher than premiums in other states. 

New Jersey faces a doctor shortage by the end of the decade if we simply do nothing.  Physicians who volunteer a portion of their retirement to continue treating patients help close a gap that we have yet to fill – a gap that will only increase as the number of physicians per capita decreases. 

Some aren’t convinced that assuaging doctors’ concerns about medical liability insurance increases access to care.  But in some of Trenton’s most underserved neighborhoods, it’s clear that it may make a world of difference.    

Assemblyman Herb Conaway is the sponsor of A-2178, which would provide civil immunity for certain volunteer physicians, nonprofit clinics, and federally qualified health centers.  It was second-referenced to the Assembly Judiciary Committee after passing favorably from the Health and Senior Services Committee in May.  Chairman Peter Barnes has not indicated whether he will post it for a vote. 

The bill’s Senate counterpart, S-1165, has the bipartisan support of Senators Loretta Weinberg (D-Bergen) and Diane Allen (R-Burlington). 

Monday, August 13, 2012

Christie, Romney, and Legal Reform

Paul Ryan is Mitt Romney’s vice-presidential pick.  This means Governor Christie officially belongs to New Jersey for at least another 16 months. 

With movement on pension and education reform, legal reform and medical liability reform may rise on the Governor’s agenda.  The need for legal reform has grown more apparent in recent months as studies confirmed that New Jersey will face a shortage of physicians by the end of the decade.  The State Senate unanimously passed legislation authorizing DHSS to convene a summit to analyze the shortage’s implications for New Jersey residents; its Assembly counterpart, A-1828, awaits action by the Assembly Health and Senior Services Committee. 

Wednesday, June 27, 2012

How will SCOTUS Obamacare decision affect NJ? Read NJCJI’s op-ed in the Star-Ledger to find out

Excerpt:

Later this week, the U.S. Supreme Court is expected to decide the constitutionality of the Affordable Care Act, more commonly known as “Obamacare.” The law’s constitutionality has sparked discussions and debate over the past three years as we vet the best way to keep ourselves healthy. But irrespective of your position on the mandates and regulations that comprise it, New Jersey has a health care crisis all its own — one that has the potential to affect how its residents access specialized medical care in the very near future, and one that the court’s decision isn’t likely to affect.

New Jersey’s crisis is a shortage of doctors. And the hemorrhaging will affect us all.

Ask around and you’re likely to hear frustration about the amount of time it takes to schedule a visit with an OB-GYN. Unfortunately, that is becoming the norm. The New Jersey Council of Teaching Hospitals reports that there is already a 12 percent gap between physician supply and demand. New Jersey’s medical schools graduated 860 newly minted physicians in 2009; only 370 stayed in the state. By 2020, New Jersey is expected to be short an additional 3,000 physicians needed to care for its population.

And these shortages are most profound in obstetrics, cardiovascular specialties and family medicine. In short, women will bear the brunt.

Link.

Tuesday, May 08, 2012

Protecting those who help others is gaining traction in New Jersey

In recent years, concerns regarding civil liability have prompted some entities and individuals to think twice before getting involved during an emergency. 

A trio of bills, including one which is scheduled for consideration by the Assembly Health and Senior Services Committee on Thursday, seeks to change that.

 

A-2178/S-1165                          Status: on AHE agenda, 5/10/12

Many New Jerseyans rely on healthcare services offered by federally qualified health centers, nonprofit clinics, and retired-but-certified volunteer physicians who provide treatment.  The threat of liability for these individuals and entities, however, is a powerful disincentive.   Legislation sponsored by Assemblyman Herb Conaway and Senate Majority Leader Loretta Weinberg would provide civil immunity to the aforementioned acting in good faith. 

 

A-2099/S-1416                        Status: 2nd reading the Assembly

When a West Virginia woman was unable to speak after calling 9-1-1, first responders arrived at her home but did not have consent to forcibly enter.  She was later found dead by family members.  An assembly committee approved legislation which would grant civil immunity to first responders who must forcibly enter a property in order to provide emergency assistance.  It awaits consideration by the Senate Judiciary Committee (contact Senator Scutari).    

 

 A-832/S-852                        Status: Signed into law

Automatic external defibrillators can save lives if they are used within the first few minutes of a cardiac arrest.  That is why the John Taylor Babbitt (JTB) Foundation made it its mission to fundraise and donate AEDs to places of public assembly, according to the Chatham Patch and Mendham-Chester Patch.  The problem the Foundation encountered is that for each device donated, 8 – 10 were being rejected.  The reason, according to JoAnne Babbitt, is that some organizations, including churches, youth recreation leagues, and schools, will not accept a donated AED because of the increased liability they assume.  AEDs were not covered under New Jersey’s Good Samaritan law. 

Fortunately, that changed with the stroke of a pen last week, as the Governor signed A-832/S-852 into law with overwhelming legislative support from both parties.  Senator Nicholas Scutari was the lone legislator to vote against it.  New Jersey has joined the ranks of 43 other states which grant civil immunity to those who own or utilize an automatic external defibrillator (AED) during a cardiac arrest. 

 

Let’s hope the positive momentum help A2178 and S1416 materialize as well. 

Monday, February 13, 2012

NJLRA Applauds Passage of Bill Requiring Study of NJ’s Looming Physician Shortage

The State Senate unanimously passed S-173, sponsored by Senator Robert Singer, which would require the Department of Health and Senior Services (DHSS) to conduct a study of New Jersey’s looming doctor shortage. 

“The New Jersey Council of Teaching Hospitals warned us in 2010 that New Jersey will be short nearly 3,000 doctors by 2022 if preventative measures are not taken,” said Marcus Rayner, executive director of the Alliance. “This is on top of the current 12% gap between physician supply and demand.

“It’s encouraging that the Legislature is taking this issue seriously and trying to avert a crisis situation.

“New Jersey’s doctors, especially those in high-risk specialties, carry some of the highest liability insurance premiums in the country.  It is becoming harder for the average physician to undertake the expense of practicing in New Jersey when so many other states have enacted cost-saving liability reform during the past several years.

If enacted, S-173 would convene a strategic planning summit of stakeholders.   The Department would be required to report findings and recommendations to the Governor and Legislature six months after enactment. 

The legislation was approved by a vote of 40 – 0.  It awaits action by the General Assembly. 

Friday, February 03, 2012

New this week…

Assemblyman Herb Conaway, chair of the Assembly Health and Senior Services Committee, reintroduced legislation granting civil immunity for certain volunteer physicians, nonprofit clinics, and federally qualified health centers. 

A volunteer physician is defined in this bill, A-2178, as a physician who is retired but maintains licensed and is not receiving compensation for patient care. 

New Jersey is projected to be short by nearly 3,000 physicians by the end of the decade.  Medical specialties, including OB-GYNs, are expected to be among the hardest hit.  By protecting volunteer physicians, nonprofit clinics, and federally qualified health centers – acting in good faith – from liability, A-2178 would remove a significant disincentive to practice in areas in which there is high demand for such services. 

Assemblyman Conaway is also the sponsor of A-1806, which would accomplish similar objectives and reverse the 2010 New Jersey Supreme Court decision in Ryan v. Renny.  The decision gutted the state’s affidavit of merit statute