DOI: 10.1097/IPC.0b013e3181bf6113

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Issn Print: 1056-9103

Publication Date: 2010/01/01


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Stethoscopes in the Statehouse

Ted Louie

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I sat nervously in the back of the room, a single white coat in a sea of dark suits. Everyone else in the chamber seemed toknow one another. There were backslapping, exchanging of meaningful looks across the room, and people furiously reviewing their notes. It is said that the only nonlawyers and nonpoliticians who go to the Statehouse are those with too many traffic tickets of a substantial nature or those on a crusade.
My traffic record is perfect. I was not there to plea for my license.
I glanced out the window. My thoughts inevitably turned to the last time I had been at the Statehouse, in 2003.
That year, premiums for malpractice insurance had soared 30% to 40%. Physicians in low-risk specialties with clean records were aghast at their new rates, and physicians in higher-risk specialties were going out of business. One obstetrician told me that delivering babies was the most joyful experience of his life, and yet if his premiums kept escalating, he could not make enough to sustain his practice. Another well-respected obstetrician in her early 50s took off her white coat and stethoscope for the last time and went into real estate.
My own malpractice premium had increased substantially for 3 consecutive years. This was despite the fact that I had no judgements against me. Certainly, it was not because I was doing complicated procedures: for it is said in infectious disease circles that our procedure of choice is the Gram stain, but I had not even done a Gram stain in several years. The sharpest instrument I used, in fact, was a ballpoint pen.
For relief, we turned to the State Senate and Assembly to pass a meaningful, far-reaching tort reform bill: one that included a cap of $250,000 on pain and suffering awards to plaintiffs. This cap had seemingly worked well in the state of California, and we looked forward to seeing if it could lower our malpractice insurance premiums.
However, the state legislature had no intention of passing such a bill. It was then and there that many of us New Jersey physicians realized that to preserve our profession and the well-being of our patients, we had to become political advocates. This wellspring of political activism eventually culminated in physicians voluntarily shutting their offices and attending a huge rally in Trenton.
There, on a raw, damp February morning, 4000 New Jersey physicians stood in the square outside the Statehouse, holding placards reading, "Who will deliver your babies?" "No Caps, No Paps," and "I'd Rather Be Practicing Medicine Now."1 A number of prominent politicians, some of whom were physicians, also spoke to the crowd; one nearly lost his voice but gamely roused everyone with a rally of, "What do you want?" "TORT REFORM!" "When do you want it?" "NOW!!!" The demonstration was, in my opinion, a partial success. We had managed to mobilize as a group and to make our politicians understand that we wanted to be part of the political process. On the other hand, we also engendered some antagonism, the effects of which lasted for some time. We did see a compromise bill passed on tort reform, although it was not nearly as strong a bill as we would have liked to see.
I was roused from my nervous reverie when the Committee Chairman announced my name, and I was ushered toward the microphone to give my testimony. The discussion was on a proposed bill geared toward patient safety.
The bill had provisions for hospitals to report certain complications.
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