From the
PRESIDENT
JOHN L . ROBERTS , MD GLMS President | john . roberts @ glms . org
CURLING & KENTUCKY POLITICS
The 2018 Winter Olympics in Pyeongchang , Korea are one year away . But in Kentucky we should start practicing our curling now .
The Olympic sport of curling is an old Scottish game that dates to the 16th century . The game has been described as a combination of bowling and shuffleboard on ice . In curling , one member of the team bowls a 42-pound polished granite stone towards a target of four concentric circles called the “ House ”. As the player releases the stone , there is a slight twist of the wrist that puts a spin on the stone and a curl to the path it will follow – hence the name " curling ." As the stone moves across the ice towards the “ House ,” other members of the team use special brooms to sweep the surface of the ice in front of the moving stone . Sweeping creates friction , melting the ice and forming a thin layer of water that allows the stone to maintain speed and change direction . The goal of the game is to get your stone into the House .
The Kentucky legislative session is about to begin and it is time to get out our brooms . The elections this past fall have defined our House . It is now 64 Republicans deep and 36 Democrats wide . The stone that the Kentucky Medical Association is about to bowl is a beauty : it is called “ Tort Reform .” Prior to the 2016 elections the House was controlled by the Democrats , and it proved impossible to get the tort stone positioned in the House .
When one hears the term “ Tort Reform ,” medical malpractice reform comes to the physician ’ s mind . But “ Tort Law ” involves much more than medical malpractice . Tort is a civil wrongdoing , by intent or negligence , that unfairly causes someone harm . While it may be appropriate to compensate the harmed , there are many things about the tort laws in Kentucky that adversely affect the business and health care environments , to the detriment of our citizens . States have come to be known as business-friendly or unfriendly based in part on their tort laws . A friendly state gets more businesses , jobs and physicians , creating a better quality of life and better access to health care . Kentucky is not known to be a friendly state in these matters .
Changing the tort laws in Kentucky will require a constitutional amendment .
Over half of the states in our country have enacted tort reform , many changing their constitutions to do so . Two of our neighbors , Indiana and Tennessee , have done so and now are more attractive locations for businesses and doctors . A major component of any meaningful tort reform is “ capping ” non-economic damages . And there are other innovative reforms that could improve the health care delivery climate in our state . Specially designed health courts could provide a fair and expeditious system for resolving medical liability claims using qualified experts as consultants . Liability safe-harbors have been proposed by the AMA for physicians who practice evidence-based medicine . And there are others .
The curl put on our stone must have our patients ’ interest foremost in mind . Our anticipated opponents , the trial lawyers , will roll stones to force our stone out of the House . They will try to “ brush us up ” as greedy doctors and hospitals who want to limit fair compensation to the injured . Our curl should be that there are unintended consequences of Kentucky ’ s tort law that adversely affect our citizens : Doctors practice defensive medicine , ordering more tests and driving up the cost of health care in a state struggling to provide health care to its citizens ; expensive malpractice insurance premiums , especially for obstetrics and surgery , limit the number of physicians in these disciplines and creates problems with access to care , especially in rural areas . Fear of litigation may lead physicians and hospitals to avoid disclosure of near-miss safety events and thereby miss opportunities to improve health care outcomes ; and others .
In the Olympic games the length of the curling court , known as a sheet , is 145 feet and the game typically takes about two hours to play . The game we will be playing in Kentucky will take longer . Changes to the state ’ s constitution can only be made during even numbered years because the change needs to be placed on the ballot for our citizens to vote . The next opportunity is November 2018 . However , we need to get our stone in motion now because there is a lot of sweeping to do . Our citizens , senators , representatives and governor need to be educated and convinced that reform is needed .
The captain of the curling team is called the “ skip .” Our skip is the KMA . The KMA is providing information so we can be consistent with our message and sweeping strategy . We will all need to use our brooms if this is to be successful . If you are not yet a member of GLMS and KMA , now is a good time to become one . It is important that our legislators and governor know that we are all on the team when it comes to tort reform . Educating the public will require an expensive media campaign – now is the time to give to the Kentucky Physicians Political Action Committee . Now is the time to get to know your representative and senator . Happy curling !
Dr . Roberts is a neonatologist with the University of Louisville Physicians and the Vice Dean for Graduate Medical Education and Continuing Medical Education at the University of Louisville School of Medicine .
JANUARY 2017 5