Magdalena D. Guerrero, M.D. (dr G)



The Malpractice Liability Insurance Crisis and I

     This must be of extreme importance because I ordinarily will not reveal any clue about my age unless critically necessary.
On July 1974. I arrived in Arizona already a Junior Fellow of the American College of Obstetricians and Gynecologists.  That means I was automatically marked as a top level victim of the Medical Malpractice Insurance Fee System.  Neurosurgeons and Obstetricians are the top two specialists with the highest malpractice insurance bill.  Fortunately, I worked full time as a County Physician at the time and was covered by the county liability system.  Then hell broke loose and I WAS OUT OF THE SYSTEM BY 1976.  I had to figure out where to get the money to pay for malpractice insurance while working part time for the Health Department.  Fortunately again, the physicians of Arizona decided to form its own malpractice insurance company.  Since I was one of the original contributing members, I had my fee limited to the lowest in my specialty because of my part time status and financial level of patients.   I was taking care of the same type of patients being seen at the free clinic our organization is helping in Stanfield.  My employment later extended to more almost charity level clientele.  I was involved in the care of very high risk Prenatal patients under the first and only State Prenatal Program, the brainchild of the Arizona Perinatal Program because our county had the worst statistics as far as Prematurity, neonatal death, infant deaths, etc. were concerned.  This was in addition to Family Planning, Adolescent  Program, Women's Prison, Training Center, and a taste of sliding scale practice at a free standing out patient clinic..  No doctor would have survived except someone like me supported by a working husband and crazy enough to insist on helping those who are the most likely to sue the doctor.  The physicians insurance company knew this and when finances got bad, I was billed the regular fee for my category in 1989 ($70,000).  I did the most logical thing to do ... change my specialty category.  I went for a residency training program in Family Practice.  I needed a year of continuous formal training (at my age) to prove that I am a lower risk doctor.  After that my fee was reduced to around $20.000 a year.  A history of having previously delivered babies and involvement in the care of high risk pregnancies are never forgotten when dealing with malpractice insurance rates.  Most of you are familiar with the type of practice I had since then.  It was definitely not lucrative but survivable with careful control of overhead expenses, having no employees, no office manager, billing, purchasing etc. personnel. 
     There is a plan to build a BioMedical Center in the state to get us in step with our century.  We cannot expect doctors to practice in my style instead.  I further lowered my level to General Practice by challenging the newly formed board and passing the second oral board certification examinations given by this "new SPECIALTY".   Who are going to take care of the surgical, Perinatal, Ophthalmological , etc. advanced research and developments?  Certainly not I or someone reduced to the category I was in.  I retired two years ago because of the economical disaster from 9-11.  I was planning to retire this year anyhow.  With the prospect of another Malpractice Insurance Crisis coming up, I decided to stop two years earlier.  In 1986, ALL the doctors previously delivering babies in this town had to stop doing so because of malpractice  insurance premiums skyrocketing.  I have been out of hospital practice from1976 to mid 1990.  So I did not have to stop but I had the misfortune of suddenly inheriting a lot of pregnant patients flocking to the free standing out patient clinic and the Health Department.  Referring them to ER's in hospitals that would accept them when delivery was imminent was not as difficult as trying to get sympathetic doctors and centers to take care of the emteen problems that can go wrong in the nine month course of pregnancy.  The State Prenatal Program ended just in time to help me concentrate on our town.  The referral system developed while it was in progress helped save countless babies and women in our county during the crisis.
     The doctors all over the country worked time and time again to get the legislature to cap liability case rewards in an effort to curb malpractice insurance rates.  Trial lawyers get quite a bit of these rewards and lawyers often have connections to or positions in government.  A state has won and lost  again later.  In states where the rewards are capped, the malpractice insurance rates are more reasonable.
     Please understand the problem and for the sake of simply being sympathetic, please do what you can to not let this happen again.  It did RIGHT HERE.  This is the U.S.A.?

War and terrorism will continue regardless of presidential election results.  That is devastating enough.  Do we have to continue ignoring the health and safety of our citizens also?  We should not let our opinions about Iraq dominate all issues.

Magdalena D. Guerrero, M.D., FACOG, GP, retired (dr G)

Constructed 28 October 2004

Last Updated 24 March 2005