Florida's Sickest Children Are Hidden Victims of the State's Medical Liability Crisis, New Alliance Says.

Business Editors/Health/Medical Writers

TALLAHASSEE, Fla.--(BUSINESS WIRE)--March 11, 2003

Florida's sickest children -- many of whom come from low-income, working families -- are the hidden victims of the state's medical liability crisis because the healthcare network that cares for them is being steadily eroded, an alliance of children's hospitals, clinics and pediatricians says.

In some instances, children with head injuries or other neurological disorders are transferred long distances for treatment due to a lack of specialists. In others, children are placed on lengthy waiting lists to receive care, and children's clinics are seeing fewer sick kids than they otherwise could because they're forced to spend millions of dollars on escalating liability premiums.

"As a physician, it makes me sick to think of turning away any child who needs our help," said Dr. Ian Nathanson, a pediatric specialist with Nemours Children's Clinic of Orlando and a spokesman for the Children's Health Alliance of Florida. "Children are already losing the availability of healthcare services, and it's going to get worse if we don't solve this crisis."

The Children's Health Alliance of Florida was formed recently to seek improvements in the healthcare system for children, and in particular to spotlight how the state's worsening medical liability crisis is hurting Florida's kids. Alliance members say sick children have largely been left out of the debate on the crisis, and are its hidden victims.

The alliance includes the 11-member Association of Florida Children's Hospitals, Nemours Children's Clinics in Florida, the Florida Pediatric Association, the Florida Association of Pediatric Surgeons and the Florida Association of Pediatric Tumor Programs.

Alliance members held a press conference at the state Capitol on Tuesday to discuss their concerns and to urge the Florida Legislature to fix the state's broken medical liability system in 2003. The alliance called on lawmakers to adopt the 60 recommendations of the Governor's Select Task Force on Healthcare Professional Liability Insurance. Members said they support reforms to improve patient safety, stabilize the insurance market and create a more reasonable litigation climate, including a cap of $250,000 on non-economic damages in medical liability cases.

"The Legislature must recognize that this crisis is hurting sick children, especially those who come from low-income, working families," said Dr. Albert Wilkinson, President of the Association of Florida Children's Hospitals. "We need a legislative solution now, because kids are being harmed by the erosion of healthcare services."

Association members noted that the children's hospitals and the Nemours clinics treat children regardless of ability to pay, and that they treat a large share of Florida's Medicaid and uninsured children. The crisis, fueled by a growing number of uninsured children and unrealistically low Medicaid reimbursements, is straining the network's ability to provide services.

Annual admissions at Florida's children's hospitals have increased from 60,391 in 1990 to 80,925 in 2001. These hospitals provide care for the vast majority of chronically ill children in the state.

A particular area of concern is the dwindling number of pediatric neurosurgeons available in certain regions to treat kids with head trauma or other neurological injuries. Because there are no pediatric neurosurgeons in Jacksonville, Wolfson Children's Hospital is transferring children to Gainesville. Likewise, kids in Collier County with head injuries must be airlifted to Lee County or Tampa.

Because the children's hospitals and clinics invariably see the highest-risk children, most facilities face problems in recruiting and retaining specialists due to the constant litigation threat. Tom Rozek, CEO of Miami Children's Hospital, said his hospital is budgeting $12 million for liability coverage next year and is having a hard time recruiting pediatric neurosurgeons, neurologists, orthopedists and anesthesiologists.

"We could increase our number of emergency room physicians or our number of specialists, but we can't do it because we don't have the money," Rozek said. "We've got sick kids waiting in the queue for a month or two at a time, and they need services now."

Nemours Children's Clinics care for kids with complex illnesses in Jacksonville, Orlando and Pensacola. The medical liability crisis led to cost pressures that forced Nemours to close a subspecialty practice in Fort Myers and Naples in 1999, and to close or curtail pediatric neurology and ophthalmology services in Orlando.

Nemours spends approximately $9.8 million in medical liability coverage in Florida and $25 million for their entire enterprise. The money Nemours spends to protect pediatric specialists from lawsuits in Florida could provide over 250,000 immunizations for children, purchase over 100,000 car seats or treat almost one million ear infections. Additionally, Nemours, like other organizations, is having some difficulty recruiting some specialists to the state. This will also impact the services available to children.