Malpractice: Patients Help

In some areas of the country, skyrocketingmalpractice premiums are becomingthe biggest expense that medical practicesface—bigger than staff salaries, rent, orequipment costs. The response has beendocumented countless times: Physiciansquit practice entirely, pull back from performinghigh-risk procedures, or pull upstakes and move to locales where the costof malpractice insurance is more reasonable.As a last resort, some doctors haveeven decided to give up malpractice coverageentirely and go bare. Now anotherapproach has appeared on the scene—asking patients to kick in to help pay thecost of malpractice premiums.

Although most medical practices thathave asked their patients for additionalfees to help defray malpractice costs havemade them voluntary, a few have madethem a requirement, even though the government'sMedicare program specificallyforbids charging extra fees to its enrollees.The annual surcharges generally rangebetween $10 and $25, although some areas high as $125. In pitching the voluntarydonation idea to patients, many medicalpractices are couching the issue in termsof survival, implying that without help topay malpractice premiums, the doctorsmay be unable to continue in practice.

Some doctors also see the added fee asan eye-opener for patients that can helpmake them more politically aware of theextent of the malpractice crisis. Doctorswho have put the fees in place report thatpatient response has been generally favorableand point out that, since the fees areusually voluntary, anyone who can'tafford them will still be provided withmedical care. According to a 2004Wirthlin Worldwide survey, 82% ofAmericans fear that health care accesscould be impacted as doctors leave practicedue to increasing liability costs.