I practiced medicine in Vicksburg, Mississippi and other locations in the troubled years prior to tort reform. I use the word “troubled” very intentionally and in reference to the growing and pervasive threat of malpractice suits experienced by most physicians and surgeons beginning in the early 1990’s. The environment became increasingly hostile toward insurance carriers and their insureds and, while I can’t speak for all doctors in this state, the discussions around the doctors’ dining room table often turned to this topic. The pressure eventually became intense and a few doctors began to leave Mississippi in search of a less threatening and more appreciative practice environment. This was not a mass exodus, but the possibility that such would happen sparked a successful effort toward “tort reform”, a change in the law which I firmly believe has had a dramatic beneficial effect on the practices and emotional health of physicians and their families throughout Mississippi.
A brief outline of my story may be illustrative of undesirable changes forced upon many of us. I practiced as an internist in Vicksburg from 1981 until 1994. In that year, I decided to return to UMMC to obtain additional training and began my Nephrology fellowship. I returned to Vicksburg in 1996 after completing my fellowship and began solo practice with cross-covering arrangements, which I shared with another nephrologist. The first lawsuit ever brought against me during the course of my career came in 1998. Although this was eventually dropped by the plaintiff, the stress of being sued exacted a significant toll on me and my family.
My coverage beginning in the mid 1980’s was by a physician-owned company from California. With no warning to its policy holders, this company abruptly chose to leave Mississippi. I was presented by letter with this information and given the option, which I exercised, to purchase tail coverage for around $55,000. The sole reason given by this company for abandoning their Mississippi policy holders was the increasingly hostile litigation environment. At that point, there were no other companies taking new clients in Mississippi. It seemed that it would be necessary for me to either seek employment in another state or ask my local hospital to hire me. The contract for my employment with the hospital was offered on the final day of my malpractice insurance coverage. I didn’t know until that day whether I would be able to continue taking care of my patients on the following day and thereafter. I was not eager to become an employed physician, but no reasonable alternative existed. So I became a hospital employee, a relationship that actually worked fairly well. The hospital needed a nephrologist and I needed a job. Becoming an employed physician might seem a good outcome for some, but that was not the career path which I preferred. Things were satisfactory only because of the corporate philosophy which, at that time, was remarkably compliant with my needs. Matters affecting the management of employed physicians are highly subject to change toward a more intrusive style.
Finally, some great news arrived. Not long after major tort reform was enacted in Mississippi, MACM resumed accepting applications for coverage. I quickly pursued this opportunity and, after submitting necessary documentation and being interviewed by a room full of my peers, my application was approved. I happily returned to my solo practice in January 2009. In 2016, I retired completely. Finding a successor was difficult, but in an environment such as existed prior to tort reform, I am quite certain that attracting a suitable successor would have been impossible. My departure from practice would have then been highly disruptive to patient care in the hospitals and dialysis units where I served.
The travail of liability struggles in Mississippi for decades prior to tort reform cannot be overstated. It is to the advantage of doctors and patients alike that this change in the law has been enacted and maintained. A return to the days of rampant litigation would be a disaster for Mississippi, including businesses, consumers, professionals of all kinds, and their clients, especially doctors and their patients.