I was quite surprised last night, at a meeting of local physicians to discuss the WV work stoppage, that, among such bedrock Republicans, the President's and Governor's "tort reform" proposals were sneered at derisively.

It was universally recognized, except by the lone FMA reprsentative, that the Bush proposed limits on "non-economic" damages of $250,000 would do nothing. He was shortly shouted down and ignored. Once again the AMA/FMA is out of step with their constituents. That is why most doctors are not members.

Besides the useless cap, the AMA and FMA are pushing the "Insurance Company and Lawyers Profit Protection Act of 2003." This program includes insignificant (and unlikely to pass) limitation of plaintiffs' attorneys fees, disclosure of collateral sources, mandatory structured awards, and elimination of joint and several liability. In Florida, we already have a pre-suit review process by experts, and it is useless. All of these try to reform the tort system, not realizing it is hopelesly broken. The current system is an impediment to improvements in medical practice and safety.

The doctors all felt this was too little and too late, even though the Legislature is unlikely to consider even these half-measures. The demands were for a rollback of malpractice premium rates and, to my surprise, institution of a "no-fault" malpractice system.

As I see it, this would include:

• elimination of medical malpractice from the tort system and institution of an administrative court system with specialized judges and lawyers, like Workmen's Compensation,
  
• introduction of a risk management and failure analysis system like the NTSA for all poor medical outcomes, regardless of any alleged nelgligence,
  
• state-wide or nationally mandated introduction of risk prevention systems into hospitals and out-patient surgical centers,
  
• open-ended indemnification of injured patients, with state-provided medical insurance and rehabilitation,
  
• medical review boards independent from organized medical lobbies charged with restricting or eliminating error-prone doctors from practice, and
  
• elimination of private malpractice insurance, replaced by risk-rated assessments paid by providers to a large state-run or regional pool, again analagous to Workmen's Compensation or unemployment.
  

In order for all of us to meet and learn how we are to survive the next decade, we are having a "CME conference." In order to attend this important educational function there will be a two day work stoppage on Monday 1/27 and Tuesday 1/28. All offices will be closed and no elective cases will be done. Selected doctors will be available to care for emergency cases in the hospitals and ERs. This will include doctors from Palm Beach, Martin, and St. Lucie counties. A similar educational conference will take place in Hillsborough (Tampa) and Pinellas County. Watch your newspapers.

If nothing is done, the next action is a open-ended work stoppage "leave of absence" beginning 2/15/03 until we can meet with the Governor and the President and our demands are met.

In America, it is illegal for doctors to act collectively. It's possible some of us will go to jail. I will keep you informed.