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They’re outta here

Patients may have to muster a little patience of their own this week because the doctor is not in. And he or she won’t be until Monday.

The mass exodus of South Philly doctors is due to a medical malpractice convention at Drexel University. Notices posted in doctors’ waiting rooms and office windows earlier this month warned patients not to expect to get an appointment from Aug. 26-30. The signs directed patients to go to the nearest emergency room for immediate medical attention.

A local organization called Politically Active Physicians Association (PAPA) has organized the weeklong outing called "Updates in Clinical Medicine 2002 Conference."

According to PAPA’s president, South Philly surgeon James J. Tayoun Jr., the nonprofit group expects about 300 doctors to attend the Glaxo-SmithKline-sponsored conference. Doctors will get Continuing Medical Education credits for their participation.

Despite what the title may imply, the conference is focusing on medical malpractice and tort reform, two issues of dire concern to area doctors.

"Malpractice rates are out of control right now. We’re going to lose a lot of our good docs if we don’t try to do something about this now," said Anthony J. DeMarco, an anesthesiologist at Methodist Hospital who serves on PAPA’s board.

But some in the medical community are skeptical about the doctors’ motives, and view this week’s convention as a guise for a strike. Even the Pennsylvania Medical Society, a membership and lobbying organization that represents 18,000 of the state’s 35,000-plus doctors, isn’t quite sure what to make of it.

"If their honest intent is to have a conference, then there is not a problem," said Chuck Moran, the society’s director of media and public relations. "If they are talking about a work stoppage, that is something that the Pennsylvania Medical Society could not support because a work stoppage would be illegal."

Moran added doctors attending the conference should have made arrangements to cover their patients so they are not left out in the cold.

Tayoun and his colleagues insist the last thing they want is to hurt their patients or put their health in jeopardy while the doctors attend the convention.

"I just hope people know that we are doing this so physicians will stay here in South Philly," said Jeanne Llenado, a urologist at Thomas Jefferson University Hospital with an office at Broad and Porter streets.

South Philly cardiologist Matthew DeCaro, who is affiliated with Jefferson and Methodist Hospitals, said each office is dealing with the closing differently.

He and the three other doctors in his practice at 1315 Wolf St., Salvatore Girardo, Barry Bravette and Debra Ahrensfield, are picking up messages between noon and 2 p.m. this week and addressing the more serious patient problems, said DeCaro. If a patient goes to the emergency room, one of the doctors in the cardiology practice also will go to the hospital, he said.

DeCaro, like his colleagues, said he has chosen to cut office hours and attend the conference for a simple reason.

"[Malpractice] is an important issue. There seems to be very little congressional support for this issue," said the doctor. "[Congress] seems to be marching in lockstep with the trial lawyers on this issue. We have to get our point out to the public because for the most part, the mass media is one-sided against the doctors."

Tayoun said the conference is intended to send a message to the state because, he contended, politicians are not doing anything about the malpractice crisis, which has resulted in part from large jury awards against doctors.

To do business in Philadelphia, Tayoun pays $120,000 a year for malpractice insurance, he said. If he moved his practice to New Jersey, he would pay $34,000, and a mere $7,500 in Delaware.

"This is the same surgeon, just different states. There is something really wrong here," remarked Tayoun.

"We’re not crying poormouth," added DeCaro. "I’m not starving, my kids are not starving. It’s just a matter of fairness. Something’s got to change."

All of the doctors maintained that malpractice rates are driving their colleagues out of the city, and that the problem is getting worse.

If physicians continue to clear out of Philadelphia, DeMarco said, medical services will slow down because there will be fewer doctors to handle the workload. "This is not about the doctors. It’s about the patients because patient care will suffer."

DeCaro said the general public is unaware of the magnitude of the problem, adding some Philadelphia doctors have moved their practices to upstate New York or even Arizona, where malpractice insurance is much more affordable.

"This is going to affect everyone, not just doctors. If [doctors] keep leaving, and costs keep going up, we cannot keep providing the quality of healthcare we’ve been providing. It’s going to affect the general populace, and people need to realize that," said the cardiologist.

He believes airing the issue in public is the last hope for local practitioners.

Moran, of the Pennsylvania Medical Society, said the organization shares doctors’ concerns about insurance costs. Behind New York, Pennsylvania has the second-highest medical malpractice payouts in the country, he said. In 2000, Pennsylvania paid out roughly $353 million in malpractice claims, according to the National Practitioner Data Bank. Moran pointed out that figure is nearly 10 percent of the national total of $3.9 billion, even though the state represents just 5 percent of the national population.

"There is something out of whack there," said the spokesperson, who believes Pennsylvania should model itself after California, where legislation has been passed to address malpractice costs.

California’s laws effectively cap settlements. Juries cannot award more than $250,000 for pain and suffering, and lawyers are limited in the percentage they receive from judgments. The statute of limitations also has been shortened to speed up the litigation process.

The way Tayoun sees it, there’s a simple cure for this state’s malpractice ailment.

Part of PAPA’s proposal for malpractice reform includes the creation of a special court to manage and try malpractice cases. "Presently, in Pennsylvania, the same judges who decide drug and murder cases also hear malpractice cases," said Tayoun.

His group’s proposal also includes a $500,000 limit on "noneconomic" damages such as pain and suffering in malpractice cases. Tayoun said the proposal also calls for a medical malpractice review board, made up of doctors, lawyers and non-medical but higher educated professionals, to review malpractice suits on a case-by-case basis.

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