Malpractice premiums, Online medicine
In addition to purchasing malpractice insurance, physicians in Pennsylvania are required to pay a surcharge to underwrite the state's Medical Professional Liability Catastrophe Loss Fund, which will provide excess coverage of $700,000/$2.1 million in 2001. The CAT fund started this year with a $35.4 million surplus. But a heavy flood of payouts from the fund (they've increased from $269.8 million in 1998 to $341.3 million in 2000) means the state needs an additional $25 million to cover this year's claims. A $76 million shortfall is anticipated in 2001.
That money will come fromyou guessed itPennsylvania doctors and hospitals. Physicians will pay from 7 to 56 percent more next year, depending upon specialty and practice location. The 2001 surcharge has been set at 61 percent, the same rate as this year, but doctors' actual payments will be substantially higher. That's because the premium for the state's joint underwriting association, on which the surcharge is based, has grown significantly. Typical primary care physicians, for instance, currently pay $3,020 in Harrisburg and $6,174 in Philadelphia. Next year, the same physicians will pay $3,795 and $7,762, respectivelya 26 percent increase.
In 1995, when the fund faced a similar shortfall, it imposed a surcharge on top of the surcharge.
A recent survey shows that 54 percent of adult Internet usersnearly 41 million peopleconsult health care sites online. And 25 percent of the adults who have visited disease-information sites say they've asked their physicians to prescribe brand-name medications. Moreover, while only 3.7 million US adults say they've e-mailed a doctor's office, nearly 34 million more would like to be able to interact with their physicians electronically.
These latest findings are from Cyber Dialogue, an online firm that analyzes market data for health care companies. Similar conclusionsthat patients would like to contact their doctors by e-mailhave been reflected in nearly every national survey.
Nevertheless, most of the physicians in the survey still believe that patients have no interest in online access to their doctors. Indeed, only about 10 percent of the more than 700 doctors polled in October communicate with patients via e-mail, according to Medem, the e-health network cofounded by the AMA and other medical societies.
While about half of the polled doctors claim to be concerned with privacy and security issues, a comparable number admit that they'd be more inclined to use e-mail if they were reimbursed for it. And while 79 percent of offices are now Internet-enabled, most respondents say they discourage staffers from going online because they believe it's a waste of time.
Joan Rose. Practice Beat. Medical Economics 2000;24:17.