Seven years ago, Georgia lawmakers approved a small step toward giving patients more knowledge about their doctors.
The legislation, amending the state’s Patient Right to Know Act, required physicians to disclose to the Georgia Composite Medical Board whether they have malpractice insurance. The board, in turn, was tasked with adding the information to the doctors’ profiles on the board’s website.
But what seemed like a simple thing at the time has proven to be a major challenge for the board and given its critics more fodder.
Because of a computer software issue, the board has been unable to update the physician profiles with the insurance information. As a result, patients still don’t have easy access to the information even though the law mandating it has been on the books for seven years.
“I think that’s insane,” said Susan Witt, an Atlanta attorney who represents plaintiffs in medical malpractice and other personal injury lawsuits. “Seven years? Give me a break.”
While most physicians have malpractice insurance, more than 2,200 doctors with active licenses in Georgia currently have told the board that they don’t have it. The number includes doctors in other states as well as some who wouldn’t need coverage because they work for the government or hold positions in teaching or research, an analysis of medical board data by The Atlanta Journal-Constitution found.
But it also includes physicians with practices throughout Georgia. And in that group, the AJC found, are hundreds specializing in obstetrics, surgery and other high-risk areas.
The 2011 legislation was introduced by Dr. Ben Watson, a Savannah internist who had just won a seat in the Georgia House. Fourteen states have laws requiring physicians to have liability coverage in some form, but the law Watson sponsored required only that doctors inform the medical board whether they have insurance and that the board include the information in the physician profiles so it would be easy for patients to find.
Now a state senator, Watson expressed surprise when he learned from the AJC that the law still hadn’t been properly implemented.
“I just want the consumer — the patient, the family, whomever — to have access to whether their physician has malpractice coverage,” he said. “But it looks like (the board) needs to clean things up, doesn’t it?”
LaSharn Hughes, the board’s executive director, said the board has been unable to post the insurance information with the physician profiles because of limitations with its computer system. That should change early next year with the advent of a new system, she wrote in an email.
Hughes also cited the problem with the computer system when the AJC first wrote about the law in 2014.
Asked why it has taken so long to make a change, she wrote: “It took so long because we were already in a contract with our soon to be former vendor and we could not afford to reconfigure the system. They no longer service our current system.”
As a temporary measure, the board has been posting lists on its website showing whether doctors have malpractice insurance, but even that has been problematical. The website linked to two lists, one of which was two years old, until the AJC pointed out the problem recently.
The insurance issue adds to the questions that have long plagued the board over the physician profiles, which were mandated by the Legislature when it passed the Patient Right to Know Act in 2001.
The profiles, posted alongside each doctor on the “Look Up a Licensed Provider” section of the board’s website, are supposed to provide consumers with detailed information, including felony convictions, public disciplinary actions, malpractice judgments and settlements and restrictions on hospital privileges.
However, because much of the information is provided by the physicians themselves and isn’t checked by the board, numerous profiles have been found to include ambiguous, misleading or even false statements.
Richard Mitchell, an Atlanta attorney who has tried to get the board to correct erroneous information that has appeared on several physicians’ profiles, called the board’s failure to update the profiles with the malpractice insurance information “ridiculous.”
“Most people look to see if a doctor has been sued,” he said. “But if they are sophisticated enough to care about that, they probably also would want to know if (the doctor) has malpractice insurance.”
Practicing without insurance, known as “going bare,” makes a doctor personally responsible for compensating patients who claim they have been harmed. In certain situations, that means patients or families can get little or nothing even though they have had to deal with death or long-term disabilities.
An AJC analysis of the latest insurance list posted by the medical board shows that 2,270 of 28,058 licensed physicians in Georgia — or eight percent — are uninsured. A similar analysis by the AJC four years ago found roughly the same percentage.
As was the case in 2014, some of those without insurance appear to be working in fields where contact with patients is limited, such as medical education, healthcare administration or research. Others appear to be in the military or working for the Department of Veterans Affairs, meaning they would have coverage from the government. Some apparently are retired even though their licenses are active.
However, many who likely see patients in Georgia appear to be practicing in specialties that are among the most frequently sued. Excluding doctors whose profiles show them as practicing in other states, no longer seeing patients or affiliated with military or VA hospitals, the AJC found 115 OB/GYNs or obstetricians, 59 general surgeons and 49 anesthesiologists without malpractice insurance.
In dozens of cases, physicians who reported having no insurance also stated on their profiles that they have privileges at hospitals in Georgia.
Of the uninsured OB/GYNs and obstetricians with practices in Georgia, 11 list judgments or settlements in malpractice cases on their profiles or have been disciplined by medical boards for failing to provide proper care. Six of the uninsured surgeons have similar histories.
Knowing the background
Witt, who represents several women who have claims against cosmetic surgeon Dr. Windell Davis-Boutte, the so-called “dancing doctor,” said the main value of knowing whether a physician has malpractice insurance is what it says about his or her background.
“If (someone in) the general public knows that their physician doesn’t have insurance, the next question would be, `Why not?’” she said. “Physicians who don’t have a bad track record can get insurance.”
The fact that nearly 10 percent of the doctors currently licensed by the state are uninsured is frightening, she added.
Robert White, a senior vice president with The Doctors Company, the nation’s largest physician-owned malpractice insurer, said requiring physicians to disclose whether they have insurance adds an important layer of transparency for patients.
“It allows patients to choose what’s important to them,” he said. “And if it’s important to them that they be treated by a doctor who has insurance, they can make that decision.”
White, who oversees the company’s operations in Georgia and seven other southern states, said doctors with insurance show a “level of concern” for both themselves and their patients. But he cautioned that practicing “bare” can be misinterpreted. Some physicians believe having malpractice insurance makes them targets for lawsuits, while others simply are no longer willing to pay premiums that can reach six figures, he said.
“As the price of insurance goes higher, it’s a choice that physicians have to make,” he said.