I love science and math, but you can take history, wars, dates, names, and places: they are just downright boring—at least, that is, until it involves time warps, time travel, wormholes, and other really cool stuff like the Déjà Vu Reality Show of living 70 years. At ACEP’s 2014 Leadership and Advocacy Conference (LAC) this May, I sat in a Washington, D.C., hotel ballroom surrounded mostly by old ACEP friends (even a few old friends I have yet to meet) and slowly slipped into a wormhole that took me back in time and space to Maine in my early years of practice.
In D.C., we were being briefed on the Safe Harbor Liability Protections (H.R. 4106) when the wormhole opened. The speaker’s voice droned on, “ACEP supports the Saving Lives, Saving Costs Act, introduced by Reps. Andy Barr (R-Kentucky) and Ami Bera (D-California), which provides increased liability protection in the form of a legal safe harbor to physicians who can demonstrate they followed clinical practice guidelines/best practices developed by a multidisciplinary panel of experts…. The case would be heard by an independent medical review panel of professionals in the relevant field of clinical practice.”
During the 1980s, like the nation as a whole, Maine experienced marked increases in medical malpractice suits and professional liability premiums. These suits were partially responsible for the rising cost of health insurance as physicians practiced more defensive medicine, ordering tests and procedures primarily to avert liability claims. To protect the 1.2 million people in a state with only 2,000 physicians, the Maine legislature enacted tort reform legislation, much of which was supported by the Maine Trial Lawyers Association.
In 1987, I helped lobby for pretrial medical malpractice screening panels, legislation that subsequently passed into law. Then I had the honor of testifying in front of several panels and even serving on a few. And, surprise, surprise, between 1988 and 1991, medical malpractice insurance premiums in Maine dropped by 22 percent.1 By 2003, Maine ranked 46th in the nation, with 9.2 paid claims per 1,000 physicians (36 total claims paid).2
Sitting in our nation’s capital, I was transported back in time to 1990 Maine where I worked with Maine Chapter ACEP, other medical specialty societies, the Maine Medical Association (MMA), the Maine Board of Licensure in Medicine, and the Maine Bureau of Insurance. We prevailed on the Maine legislature to pass Chapter 26: Medical Liability Demonstration Project (Practice Parameters and Risk Management Protocols).3