Scott Shepard, Memphis Business Journal
Wear your seat belt on your next trip South and hope it’s not too cloudy for a helicopter ambulance: of 34 neurosurgeons, there are only three left between Memphis and Jackson, Miss., who have insurance coverage to work in an emergency department. Crushing costs for medical malpractice insurance are driving physicians from the state and discouraging others from taking their place.
Even temps, known as locums tenen, don’t want to go to Mississippi; they say it’s too frustrating and slow to get a license, and the risk of being sued is too great. “We’re having an extremely difficult time finding locums physicians to work in Mississippi,” says Zane Brantley, a senior marketing consultant for the Southeast at Dallas-based Staff Care/Med Travelers, one of the nation’s largest locums tenen firms. “It’s much more difficult to get a license in Mississippi, which is a huge factor. You add in that a lot of them aren’t interested in rural, small town jobs, and we have just a handful of physicians in the whole state.” The Magnolia State has become the center of a malpractice crisis in which doctors blame trial lawyers for huge awards that drive up insurance rates, while lawyers say insurers are just making up investment losses on the backs of policyholders. 17 carriers have abandoned the state, but continue to write medical malpractice elsewhere.
Just this year, Mississippi juries have awarded more than $28 million in just seven cases: 65% of that was in non-economic damages. 10% of the state’s physicians have left the state or abandoned high-risk services, and the Mississippi State Medical Association is documenting a laundry list of problems: A majority of this year’s graduating class at the University of Mississippi School of Medicine say they are leaving and don’t plan to return. In Greenwood, where 800 babies are born each year, two of the four obstetricians have left. One who is left is now pregnant and will be delivered by her partner, and then take maternity leave. Five family practitioners in Kosciusko have stopped delivering babies, and the OB recruited by Montfort Jones Memorial Hospital has changed his mind. The nearest place is now Jackson, about an hour away.
A man died earlier this year in Greenwood of a bleeding ulcer, a simple fix, but there was no surgeon available. “There’s a tremendous need for subspecialties, especially in obstetrics, gastroenterology and urology,” Brantley says. “They need people across the board, but family practice and internal medicine are the most sought after. All the surgical specialties have been hit really hard, and we’re finding rates going up every couple of months.” Staff Care is one of only two large agencies that provide malpractice insurance for its temp physicians, but even that benefit isn’t an inducement to go to Mississippi, he says. There’s a growing national shortage of doctors, and most can start work sooner someplace else with fewer obstacles. Mississippi requires applicants to pay a $650 filing fee up front. The wait can be a couple months, after which applicants must travel to a state for what’s called a personal interview, but is little more than a written quiz based on state-specific material. “They only do this one afternoon a week and you have to fly in for the quiz,” Brantley says. “Most states don’t require this, and the more difficult you make something, the less likely people are to do it.” The typical temp doctor falls into three areas. Fresh out of residency, they may want to work in a variety of environments. Or they’ve been at the same practice for a decade and use temp work to fill in the gap while they consider their options. The largest category is older docs who want to travel and work part time.
Other states in the Southeast, including Tennessee and North Carolina, are among the easiest and straightforward for placing physicians. Staff Care operates a licensing department to help speed the process, but unlike most states, Mississippi officials refuse to deal with them and will only talk to the individual physicians. Mississippi government has discussed malpractice and tort reform for several years but so far has not acted. Hearings began this week leading to a special session later in the year called by Gov. Ronnie Musgrove. But the governor has limited the session to medical malpractice and not the larger issue of tort reform and liability. “Locums is very cyclical, and this tells us that we’re going to be looking at a physician shortage across the board over the next five-10 years,” Brantley says.
CONTACT staff writer Scott Shepard at 259-1724 or sshepard@bizjournals.com