Doctors, Lawyers Clash Over Medical Liability

Representatives of the medical and legal professions, appearing before a meeting of the American Bar Assn., clashed sharply Saturday over proposals that the law be revised to make it more difficult to sue doctors for malpractice.

An attorney for the American Medical Assn. said that escalating malpractice awards and insurance costs have created a crisis that is forcing some physicians to practice “defensive medicine” and avoid high-risk cases for fear of lawsuits.

“Doctors don’t want hard cases today because they know they are going to be sued,” Kirk B. Johnson of Chicago, general counsel to the AMA, told the meeting.

Johnson’s call for changes in the legal system and his analysis of the problem drew strong expressions of opposition from several spokesmen for the legal profession, however.

“The fact of the matter is, doctors think they are a special breed of cat and that they shouldn’t be sued at all,” said Robert E. Cartwright of San Francisco, former president of the American Trial Lawyers Assn. “What they’d really like is to eliminate malpractice cases altogether.”

Law, Medicine at Odds

The often-barbed exchanges took place amid a growing nationwide debate between doctors and lawyers over whether a major change in the legal system is needed to limit the number of medical malpractice suits.

The 271,000-member AMA last year said that malpractice claims were adding at least $15 billion a year to medical bills in the United States, and were starting to drive doctors from their profession. The medical association proposed several changes in the law, including limits on attorneys’ fees, abolition of punitive damages and limits on separate monetary awards for pain and suffering. A wide array of proposed legislation is pending in Congress and many state legislatures.

But the 320,000-member ABA appears to be poised for a vigorous counterattack. The bar association’s policy-making body, the House of Delegates, convened here for the ABA’s midyear meeting, will vote on a special committee report that recommends rejection of most of the medical association’s major proposals.

The report dismisses as unjustified and overstated the AMA’s contention that there is a crisis that warrants sweeping changes in laws and procedures. The report firmly opposes new limits on damage awards and attorney fees.

The committee accuses the AMA of attempting to “trade away the rights” of the victims of medical negligence, and warns against giving doctors “special treatment under the law.”

At a panel discussion Saturday, Johnson told his audience of lawyers that he found the ABA’s committee report “extremely disappointing.”

“I don’t think it’s objective, and I don’t think it’s fair,” he said. “This report doesn’t even say we should study malpractice.”

Johnson noted that malpractice insurance premiums paid by physicians had been increased 44% in the last two years, and that a neurosurgeon in New York now must pay $100,000 a year for coverage against lawsuits. The average malpractice jury award has risen from $94,000 in 1975 to $338,000 in 1984, he said.

Johnson strongly urged that punitive-damages awards not be permitted in malpractice cases. He noted that there are professional disciplinary measures and other means of penalizing doctors for severe negligence. “You’re not going to find much willful, grotesque negligence that would justify punitive damages,” he said.

But Talbot D’Alemeberte, dean of Florida State University’s Law School and chairman of the committee that prepared the latest ABA report, said that the medical association was not justified in seeking “vast changes” in the legal system. “I do not believe there is any special crisis,” he said.

The ABA report cited findings of several studies as refuting the AMA’s claims. One study showed that in 1983, the nationwide cost of medical malpractice insurance was $1.5 billion--a small amount compared to the nation’s overall medical costs of $355 billion. Another study, made in 1984, found that only about one in 10 injuries caused by medical negligence actually led to a legal claim, the report said.