The Assembly Judiciary Committee voted Friday to recommend passage of legislation lifting the cap on court judgments against doctors.
But even with the amendment offered by the lawyers pushing AB495, area physicians and hospital officials say the impact will be devastating on health care in Nevada.
Bill Bradley, representing the Nevada Justice Association, said the need to change the rules was highlighted by the Hepatitis C outbreak caused by bad hygiene and medical practices at two clinics in Las Vegas.
"On behalf of patients that were harmed, we're glad to see the committee take this step," he said.
The amended bill would lift the $350,000 cap on punitive judgments for cases involving "gross negligence" only. The cap would remain for "professional negligence." It also defines gross negligence as medical care that amounts to "conscious indifference" and a "disregard for and indifference to the safety and welfare of the patient."
It also would give victims up to four years to file an action charging malpractice instead of three years.
While a majority voted to recommend Assembly passage of AB495, the 8-6 vote was far from unanimous. Assemblywoman Bonnie Parnell of Carson City was the only Democrat to join Republicans in opposing the bill.
"I don't think it solves the problem," she said. "If we have bad doctors, they should lose their licenses."
She also expressed concern Nevada could lose some good doctors, reducing access to health care.
Dr. Stuart Stoloff of Carson City said the legislation has nothing to do with preventing physicians from unethical practices.
"This bill has to do with lawyers deciding they want and should receive more income when they file and go through court proceedings on malpractice," he said. "It does not have anything to do with what transpired in Las Vegas."
Stoloff and Bill Welch of the Nevada Hospital Association both said the bill would drive good doctors away from Nevada by driving up malpractice insurance costs.
Stoloff pointed out the caps were put on by a special session of the Legislature in 2001 because of skyrocketing rates for doctor liability insurance which were causing physicians to leave Nevada.
"It's all about money," he said. "It isn't about protecting anybody and does not improve the quality of health care or protect the citizens of this state."
Welch said the legislation would put Nevada back in the situation that existed in 2001 with insurance rates rising and insurance companies pulling out of Nevada. He said it won't fix the problem because the bad doctors "still get to practice."
"This does not stop them," he said.
Welch said when hospitals in his association have a bad doctor, "we remove them from our medical staff."
"Unfortunately, they still have their license," he said.
Dr. Sandy Koch, an OB-GYN practicing in Carson City, said the Nevada tort reform law has worked well, that there are something like 11 insurance companies offering malpractice coverage in the state with rates as much as 40 percent lower than before the malpractice reforms were passed.
"When we passed this tort reform, it completely turned around the state of medicine here," she said. "Now there are doctors coming into the state. If we pass this, I suspect we will again see the exodus of physicians out of this state."
She said that will hurt access to health care.
"Why, at a time when policy makers are trying to improve access to health care and bring down health care costs, would they support something that subverts both of those goals " and subverts the will of the people," she said.
Todd Rich, executive director for physician services at St. Mary's in Reno, said the attempt to undo the malpractice limits created in 2001 was "very concerning."
The 2001 decision "leveled the playing field and it's gotten malpractice costs back under control," he said.
Rich said hospital officials are concerned because so many physicians in western Nevada are nearing retirement " two-thirds are over age 55.
"To replace those, we're going to have to recruit into Nevada, and if the malpractice environment is bad, they won't come quickly," he said.
Instead of opening doctors to huge lawsuit judgments, Welch said the state Board of Medical Examiners needs to take the licenses of the bad doctors and put them out of business.
AB495 goes to the Assembly floor for a vote. If approved, it must go through the same process on the Senate side of the Legislature.
Contact reporter Geoff Dornan at firstname.lastname@example.org or 687-8750.