BackWords

Dear Governor Rendell,

I am one of the dwindling numbers of solo practitioners in the Philadelphia area. Each day, I provide family medical care and back pain care to people from around the Delaware Valley.

Like many physicians, I am very frustrated by the current medical malpractice insurance situation here in Pennsylvania. PA physicians face some of the highest malpractice premiums in the country, while being reimbursed lower than national average for services provided.

Each day I work in my office, I have calculated that the first five hours of each day go towards paying my overhead- a disproportionate amount of which is appropriated by my malpractice insurance costs. Part of that cost is the mCare premium- an expense which physicians in other states do not need to incur. Now, my understanding was that this additional premium, paid by me and every physician in the state, was to cover awards and expenses not covered by our regular insurance premium. I was also lead to understand that this mCare fund was created to keep MP insurance carriers in the state, and supposedly to keep our premiums from continuing to rise. On the first point, of course it kept them here- they got to keep more of their profits. Clearly, it has failed on the second count, as my insurance is roughly 30% higher than my friend is paying for the same coverage in Delaware.

So, while there may have been some legerdemain which justified the existence of the fund in the first place, there is no cover up or trick which you can use to justify the actions regarding the fund in the past month or so.

When physicians learned that there was a surplus of funds in the mCare coffers, and that you decided to direct those funds into the general budget to cover non-physician related costs, some said it was tantamount to theft.

It is not tantamount to theft- it is theft. Plain and simple, and you sir, are the thief.

Now, while I understand that you have no one to answer to, as you are not seeking re-election, you could have made the just and honest choice to waive the mCare fees, and/or return some of this ill-gotten money to the physicians who have worked so hard in your state to earn it. Instead, you chose to provide yet another reason for more doctors to flee this state in droves. I train student physicians and residents, and when I ask them where they would like to practice when they finish their training, they almost universally reply; “Anywhere but here.” This will result in a shortage of care in this state- and it will be your responsibility.

How long will physicians be willing to pay a tax for the privilege of practicing medicine in one of the most medically hostile environments in the country? I don’t know. How many physicians will be willing to pay the premium when they are sent their 2010 bill? I don’t know that either. What I do know is that you are rolling the dice , and the well being of Pennsylvania’s citizens is what’s at stake.

How about doing the right thing here. It’s not too late to fix what could be a catastrophic mistake.

-Andrew S. Kirschner, D.O.