Guest Columnist

How many medical offices have to close before Iowa acts?

Iowa's unfavorable medical liability climate contributes to closure of some high-risk services.

A stethoscope sits on an examination table in an exam room. Bloomberg photo by Andrew Harrer
A stethoscope sits on an examination table in an exam room. Bloomberg photo by Andrew Harrer

Medical practices in Iowa are struggling. By now you’ve likely heard the stories of how the COVID-19 pandemic has already cost our state’s health care system hundreds of millions of dollars. What you might not have heard is that before COVID-19, Iowa providers were already facing down another significant financial challenge — a wave of lawsuits, deploying questionable tactics to exploit difficult situations and drive up payouts from providers and facilities across the state. These lawsuits oftentimes target rural and independent practices who are the sole source of medical care in their community and they are having a huge impact. In the last three years alone, lawsuits have resulted in a record $85 million in awards against Iowa practices.

COVID-19 financial hit threatens Iowa’s hospitals

As a result, practices are forced to max out their professional liability insurance coverage, drain their reserve funds, and make difficult decisions about whether or not they are able to continue providing care in their community. The Legislature had an opportunity to help fix the problem this session by enacting a hard cap on non-economic damages in medical liability lawsuits. This would have created guardrails to protect against runaway judgments, while ensuring fair compensation for patients when a mistake is made. With several additional high-dollar lawsuits already in the pipeline and the COVID-19 expenses continuing to pile up, these basic protections are more important than ever.

That’s why it is so disappointing that the Iowa House failed to pass this hard cap. The Iowa Senate and many individual members of the Iowa House should be commended for their tireless work to push for these protections. They understood, now more than ever, that Iowa practices are vulnerable to financial collapse from a single multimillion-dollar lawsuit.

COVID-19 has challenged our health care delivery system like never before. Practices have lost millions from delaying all but the most urgent medical care in order to help preserve supplies and resources for front-line pandemic response efforts. Many clinics even temporarily closed their doors and went to extreme lengths to keep their own staff on the payroll until federal assistance became available. Now, practices are working to resume regular operations and they are having to pay a premium for basic supplies likes masks and gloves because traditional medical supply lines are still stretched thin trying to keep up with demand. Practices are also investing in new technologies to provide more medical services remotely and they’re extending hours to catch up on the backlog of delayed care. These financial losses and additional expenses have some practices on the brink of financial ruin.

Iowa’s unfavorable medical liability climate has already contributed to the closure of some high-risk services like obstetric care in many rural communities. With the additional strain of COVID-19 and more high-dollar lawsuits on the way, how many more clinics must close before the legislature takes action?

Iowa needs a hard cap on non-economic damages to protect the long-term sustainability of health care in our state. We look forward to additional conversations with legislators in the coming months. It is my sincere hope that when the General Assembly reconvenes in January, we can finally take action to protect those front-line practices that are working so hard to protect every Iowan.

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Brian Privett, MD, is an ophthalmologist from Cedar Rapids. He is the current president of the Iowa Medical Society,the largest statewide physician membership organization in Iowa.

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