The Florida Legislature and Florida Medical Association Making Docs the Fall Guys

I wrote and mailed my annual $250 check to the Newborn Injury Compensation Act (NICA) fund today. In 1982-83, when there was a medical malpractice crisis and no physician could get insurance to practice, the Florida Medical Association (FMA) cut a deal with the trial lawyers and our elected officials to form NICA. Every physician, regardless of specialty, is required to pay $250 annually into this fund to cover the cost of injuries to newborns. Obstetricians pay $5,000 annually.

In exchange for making the social problems of the state the responsibility of Florida physicians alone, the legislature passed some changes to the medical malpractice laws which encouraged insurers to return to and start writing policies in Florida. Isn’t it time for the State of Florida and its citizens to assume their responsibility for providing reproductive education and prenatal opportunities to women of child bearing age nearly 40 years later? Why does it remain my responsibility as a physician to continue to fund this entity? The FMA thinks it is still a good deal and will not discuss lobbying for a change.

Recently I attended one of many continuing education courses mandated by the elected officials in Tallahassee. It was on prevention of medical errors. It’s the same course I took two years ago and two years before that. Most of the errors are surgical and do not apply to me. The others are communication issues.

I have proposed over and over to my hospital’s chief medical officer and medical staff that we form a medical staff communication committee to facilitate doctor to doctor, and doctor to staff, communication to improve patient safety and care. Time after time they turn a deaf ear to the suggestion yet they host the medical error meeting yearly.

They also host the Domestic Violence lecture yearly. It too is mandatory for license renewal in Florida. The same message is delivered every year. “If the assault is made with a knife or gun call the police because they can do something. If a weapon is not involved your only option is to recommend counseling and safe shelters.” The Legislature has done nothing to toughen domestic abuse laws but they make us sit through the lecture every two years.

I have the same message for the legislature, the FMA and the Florida Board of Medicine, “You can kiss my grits!”

NICA, Florida’s Newborn Injury Compensation Act – 2010

In the early 1980’s there was a major medical malpractice insurance crisis in my home state of Florida.  Obstetricians and gynecologists could not afford to purchase medical malpractice insurance at the price it was being offered at, when it rarely was being offered. The fear was that an Ob-GGYN would deliver a deformed or injured child while performing his hospital required emergency department coverage and be sued for a staggering sum to pay the medical costs and damages for the infant for the rest of his or her life. Obstetricians stopped agreeing to see and treat pregnant women because of the risk involved.

The Florida State Legislature then came up with the idea of creating the Newborn Injury Compensation Act which created a fund to pay for the medical care and damages associated with injuries occurring during the childbirth process.  This fund was supposed to keep obstetricians out of court. This compromise legislation was initially supported by the Florida Medical Association as a short term solution to a problem. Every doctor in Florida was fined, or taxed, $250 per year to pay for birthing injuries while obstetricians paid $5000 per year. The first thing that happened after this was signed into law is that the Florida Trial Lawyers Association found away around it so they could continue to sue obstetricians for medical malpractice.  The second thing that has occurred in the twenty some odd years since its inception is that the NICA fund has never paid out anything to an injured party.

NICA is essentially an additional $250 per year tax on physicians for the privilege of practicing medicine in the State of Florida. The Legislature has decided that expectant mothers who live on a diet of barbecue potato chips, pineapple soda pop and Marlboro’s and has their first pre natal visit when in their ninth month and crowning are the legal responsibility of doctors only. The Florida Medical Association has been so busy with so many issues that it has not had the time or resources to work for the abolition of this unfair tax on physicians.

It’s time this unfair tax is repealed. Reproductive education, prenatal care and visits to a doctor when pregnant are not only the responsibility of the physicians’ community alone but of the public at large.