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Doctor-lawyer leads AMA fight on malpractice capsHouse set to vote on malpractice bill Thursday
WASHINGTON (AP) -- Looking for an edge in the doctors vs. lawyers clash of lobbying titans, the American Medical Association is turning to a physician-attorney to make its case for limits on malpractice judgments. Dr. Donald Palmisano, a surgeon and attorney from New Orleans, has taught colleagues how to avoid costly malpractice lawsuits. Now, as the AMA's incoming president, Palmisano is at the heart of a battle of powerful interest groups playing out this week in Congress. The doctors' and trial lawyers' lobbies are arming lawmakers with statistics and horror stories about what's wrong with the current system of malpractice lawsuits and medical mistakes. Both sides are digging up human anecdotes that lobbyists can share on Capitol Hill. Both are peppering the airwaves with ads aimed at influencing lawmakers on the benefits and dangers if lawsuits are limited. At stake is legislation, set to be voted on Thursday in the House, that would create a $250,000 national cap on noneconomic damage awards, such as those for pain and suffering, in medical malpractice lawsuits. "For the death of a child in a botched delivery, this law would say to that child's parents, `Your child is worth no more than $250,000,' no matter how awful the malpractice or how horrible the death," said Carlton Carl, a spokesman for the Association of Trial Lawyers of America. For the AMA, Palmisano argues people in many parts of the country are losing doctors and have to drive long distances for specialty care because physicians can't afford malpractice insurance. Palmisano has become a lightning rod in the debate. He scoffs at the trial lawyers' suggestion that he's nothing more than a hired gun for doctors and their insurers. "If I drop dead tomorrow, the same No. 1 legislative activity of AMA will be carried out by someone else," Palmisano said. "We need to deal with it with logical arguments." The Bush White House has allied itself with doctors, insurers, drug makers, nursing homes and other health professionals who would benefit from the cap. The administration argument is that such limits ultimately will reduce insurance premiums for average Americans and keep doctors from going out of business in some parts of the country. Trial lawyers' deep rootsTrial lawyers have deep roots, including millions of dollars in political donations, with Democrats in Congress. They argue they are being made into bogeymen, and the caps won't reduce insurance rates but will leave Americans who are damaged by medical mistakes unable to recoup their full losses. Within days of the February death of Jesica Santillan, a teenager who died at a North Carolina hospital after botched transplant surgery, ATLA was pointing out that the legislation would limit the ability of families like hers to win compensation.
ATLA contends that insurance companies need to lower their rates to help physicians. While the malpractice legislation is modeled after a California law, it took a ballot initiative on insurance to stabilize rate increases there, the association says. Much of the criticism directed at the AMA's lobbying has focused on Palmisano, whose consulting firm, Intrepid Management, tells physicians how to avoid malpractice claims and manage them if they are filed. "Listen to your attorney in a deposition or suit. If your attorney instructs you not to answer a question, obey! Never say, `Oh, don't worry, I know the answer to that,"' Palmisano's firm advises in a list of its top 25 physician "risk management" principles. "Remember your expertise is in medicine, and not in deposition or trial tactics." Opponents of the malpractice litigation bill contend Palmisano's legal work and ties to insurers -- he is a founding member of a physician liability insurance company -- have as much to do with his push for the legislation as his medical practice does. The trial lawyers' lobby contends it shows the often hidden ties between physicians and insurers. Palmisano said he has put his work at Intrepid on hold while serving the AMA. He sees nothing in his background as a conflict of interest, and said that although the insurance industry and physicians are on the same side here, they have been opponents on other issues. Palmisano said the AMA isn't focusing on its trial lawyer opposition, although he is quick to note that some trial lawyers sign contracts that pay them 33 percent and up from their client's damage awards. Both the AMA and ATLA are coveted political donors. Republicans have been courting the AMA, whose political action committee has become leaned more toward the GOP over the past few years. The AMA political action committee gave roughly $2.7 million in the last election cycle -- $6 of every $10 to Republicans. Most of its $2 million in independent spending last November went to support candidates in close races who favored the malpractice legislation. Most were Republicans; the GOP won control of Congress. ATLA's PAC has long leaned toward Democrats. It gave about $3.4 million in the last election cycle, 90 percent to Democrats, according to the nonpartisan Center for Responsive Politics. Copyright 2003 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
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