The O.R. is Dr. Michael Deren's second home. He's performed thousands of surgeries and procedures over his 30-year career.
In 1978, the Yale-trained thoracic surgeon set up his practice in his home state of Connecticut. At the time, he was one of four thoracic specialists at Lawrence and Memorial Hospital in New London.
As of today, he's the only one left doing emergency coverage, now that one of his remaining colleagues has decided forgo ER duty.
He pays $50,000 per year for malpractice insurance coverage. If he went off emergency room call, his medical liability, or malpractice insurance premium, is cut in half.
Physicians across the state said the medical malpractice landscape impacts how and where they practice.
Dr. William Handelman, a nephrologist in Torrington, and president of the Connecticut State Medical Society, lost a physician in his own practice this year to South Carolina.
Malpractice insurance rates vary greatly depending on a doctor's area of practice, with neurosurgery and obstetricians paying the most, he said.
Specialists in those areas of medicine can pay as much as $170,000 per year for malpractice coverage. A new survey from the CSMS shows that 75 percent of neurosurgeons have cut back on the number of high-risk procedures they're willing to do.
Handelman said the state has lost more than a third of its neurosurgeons in past few of years and today none of the hospitals in Litchfield County has neurosurgery coverage.
"There's certainly a potential risk because the safety net is shrinking. There may be a time if there's delay of hours before a patient gets the appropriate care they need. It continues to be a big issue and will be until there's some meaningful malpractice reform," he said.
It's a major sticking point with the state's trial lawyers.
Stamford attorney Angelo Ziotas acknowledges the malpractice system can be improved, but he draws the line at a cap on damages.
'The only thing I want to make sure I'm clear about is that no one of the changes that would be acceptable or fair should impact negatively on the people who've been hurt most by medical malpractice: those of the people who've been injured by it," he said.
State statistics show about 3,500 medical malpractice cases have been filed over the past decade.
Deren said the cost are an obstacle to providing proper patient care.
"Physicians see this as an enormous issue and problem, an impediment to what they're doing and impediment to taking patients, an impediment to coming to the state and giving the service that they want to do for patients," he said.
Handelman believes the issue is a major factor in a trend toward consolidation and regionalization of medical care in Connecticut.
He paints a bleak picture.
"It may be that fewer hospitals survive, that hospitals may be forced to close because they can't get physicians to cover the services a general hospital need to provide," he said.
The results of a three-year study by the state Departments of Insurance and Public Health should be released in the next few weeks.
That study will go a long way in determining whether medical malpractice reform will be up for discussion at the Capitol during the 2009 legislative session.
