Tampa Tribune – Florida Medical Association Case

Case settled afterward for eight figures

TAMPA TRIBUNE
Publication Date: Apr 3, 2006


The Florida Medical Association's raison d'etre is to serve "as an advocate for physicians and their patients to promote the public health, to ensure high standards in medical education and ethics, and to enhance the quality and availability of health care."

Unfortunately, the organization's legislative agenda this session has only one goal: protecting physicians' turf.

The organization's top priority is to make it harder for out-of-state physicians to testify as expert witnesses in Florida malpractice cases. It's a bad bill meant to intimidate doctors who testify against other doctors.

And at a time when emergency rooms are overflowing with patients who can't get in to see their doctors, the medical association has taken aim at health care professionals who could provide some relief.

In what has been described as a blatant power grab, the medical association pushed to give the FMA-dominated Board of Medicine regulatory authority over nurses and physicians' assistants. As originally written, the legislation would have required direct rather than general supervision of nurses, which would have shut down clinics where nurse practitioners and physicians' assistants provide health care.

These trained professionals serve an important role in extending the reach of primary care doctors, who are in short supply. No evidence exists that they provide poor care, and the physicians who supervise them regularly review their decisions.

Fortunately, in a compromise, the bill's new focus is on limiting the number of clinics that physicians can supervise.

The FMA's most alarming proposal would require out-of-state experts to be certified by the Board of Medicine before they can testify and would subject them to discipline if they provided false or misleading testimony.

Dr. Dennis Agliano of Tampa, immediate past president of the state medical association, says too many doctors who testify for plaintiffs lie or mislead unsophisticated jurors, who then rule against doctors.

But Florida already has placed significant - and needed - restrictions on those who testify as experts. As one example, a doctor who testifies against a specialist has to be a specialist as well. These rules, coupled with a prevailing attitude that discourages doctors from testifying against one of their own, have made it difficult for plaintiffs to find local experts.

Certainly some doctors make a living as hired guns and, without question, some lawsuits of dubious merit are filed against physicians. But threatening out-of-state experts with discipline by a medical board that disagrees with their testimony is not about helping patients, but about stopping malpractice claims.

This is not the first time the medical association's leadership has shown poor judgment. Remember the dueling constitutional amendments two years ago? At the time, trial lawyers offered FMA leaders a compromise: Rescind your proposed amendment to cap attorney fees in malpractice cases and we'll back off our proposal to revoke the medical license of a doctor with three malpractice verdicts. But the FMA stubbornly pushed ahead, creating a legal environment that discourages the recruitment of doctors and depresses those already here.

Despite what their mission statement says, it appears the Florida Medical Association's first and only duty is to attend to the legislative needs of doctors, a job at which it has hardly excelled.

As a result, lawmakers must stand up for the health care interests of citizens. As they consider the FMA's agenda to limit access to health care and the courts, legislators would be well served to remember the maxim: First do no harm.